As an instructor, you are working with a nursing student to develop a problem-focused exam involving the musculoskeletal system and extremities. Formulate potential questions to support the student in soliciting specific information about the patient related to past history, drugs that may adversely affect the musculoskeletal system, family history, and psychosocial profile, and provide rationale.
Obtaining patient information is a crucial aspect of the process of providing care. Accurate and detailed health history helps to clarify the onset of a problem, the location, symptoms, and any given complaints (Sand‐Jecklin & Sherman, 2014). The process offers subjective data that guides the physical examinations to take. This paper aims to review some of the potential questions that a nursing student may use to obtain information from a patient with a musculoskeletal system, and the rationale behind the questions.
|Past History||· Have you had juvenile RA, muscular dystrophy, or cerebral palsy in your growth and development?
· Have you ever had any treatments or surgery of injured joints, muscles, or bones?
· Have you had/ do you have any medical problems or infections?
· Have you had any immunizations before such as for polio and tetanus? And when?
· Have you ever served in the military or gone for adventure travels such as hiking or camping?
|· History of any musculoskeletal problem may provide substantial background for current physical findings.
· The answer provides information that can be used to explain current observations (Georg & Zary, 2014).
· This question is essential as there are different ailments such as syphilis, Epstein-Barr Virus, Tuberculosis, and HIV that can cause musculoskeletal problems.
· The information provided is significant in the diagnosis process (Georg & Zary, 2014).
· There is a high likelihood of exposure to chemicals and illnesses that may affect the musculoskeletal system when one is in the military or traveling from one region to another (Gross, Fetto & Rosen, 2015).
|Drugs History||Have you been taking any of these medications?
· Adrenocorticotropic hormone
· Central nervous system stimulants
· Antigout agents
· Miscellaneous skin agents
· Side effects include osteoporosis, muscle wasting, muscle weakness, vertebral compression fractures (Gross, Fetto & Rosen, 2015).
· Antidepressants can cause musculoskeletal pains and aches
· Diuretics can cause muscle cramps
· Stimulants may increase motor activity
· Antigout agents can cause myopathy after prolonged administration
· General muscle aches, bone pain, and joint pain.
|Family History||Does your family have a history with musculoskeletal problems such as osteoporosis, arthritis, or gout?||An affirmative response to the existence of such ailments increases the patient’s level of risk (Gross, Fetto & Rosen, 2015).|
|Psychosocial profile||· What practices do engage in promoting the vigor of your musculoskeletal system? Do you wear protective gear at work? When did you last go for a physical exam?
· Would you please describe a typical day of your life?
· What is your typical daily meal?
· Do you smoke, consume alcohol, or use any drugs?
· What is your occupation?
· How do you cope with stress, and who are your social support?
|· This helps to identify the health practices and activities towards self-care.
· Musculoskeletal problems affect the performance of daily activities forcing others to use assistive devices. Sedentary living increases the risk of musculoskeletal problems (Reed et al., 2014).
· Daily meals can show the patient’s nutritional patterns, assess diet, minerals, and vitamin intake. Some foods can promote musculoskeletal complications while others promote health.
· Drug abuse is a risk factor to illnesses such as HIV, gout, inflammatory arthritis, and osteoporosis that affect the musculoskeletal system (Gross, Fetto & Rosen, 2015).
· Some jobs can increase the risk of musculoskeletal problems, for example by exposing one to harmful chemicals or heavy lifting (Reed et al., 2014).
· Stress is a high-risk factor to one’s health and identifying one’s social support can be significant in implementing a plan of care (Fidan et al., 2016).
Fidan, F., Alkan, B. M., Tosun, A., Altunoğlu, A., & Ardıçoğlu, Ö. (2016). Quality of life and correlation with musculoskeletal problems, hand disability and depression in patients with hemodialysis. International journal of rheumatic diseases, 19(2), 159-166.
Georg, C., & Zary, N. (2014). Web-based virtual patients in nursing education: development and validation of theory-anchored design and activity models. Journal of medical Internet research, 16(4), e105.
Gross, J. M., Fetto, J., & Rosen, E. (2015). Musculoskeletal examination. John Wiley & Sons.
Reed, L. F., Battistutta, D., Young, J., & Newman, B. (2014). Prevalence and risk factors for foot and ankle musculoskeletal disorders experienced by nurses. BMC musculoskeletal disorders, 15(1), 196.
Sand‐Jecklin, K., & Sherman, J. (2014). A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. Journal of clinical nursing, 23(19-20), 2854-2863.
Also check: Health Assessment