Assessing and Managing Patients with Musculoskeletal Conditions - Article Example

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The journal, which is the focus of this critique, is entitled "Assessing and Managing Patients with Musculoskeletal Conditions", written by Nicola L. Judge. It was published in the Nursing Standard last September 2007…
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Assessing and Managing Patients with Musculoskeletal Conditions
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Assessing and Managing Running head: ASSESSING AND MANAGING PATIENTS WITH MUSCULOSKELETAL CONDITIONS "Assessing and Managing Patients withMusculoskeletal Conditions": A Journal Critique
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The journal, which is the focus of this critique, is entitled "Assessing and Managing Patients with Musculoskeletal Conditions", written by Nicola L. Judge. It was published in the Nursing Standard last September 2007. The journal dealt with how a nurse should assess patients presenting with musculoskeletal conditions. Some of the aims of this journal were for the readers understand the pathology of several common musculoskeletal conditions as well as the principles of common symptom management. The population discussed in this journal is musculoskeletal patients, and these would include athletes or people who engage themselves in an active lifestyle. Judge (2007) gave important anatomy and physiology concepts regarding the musculoskeletal system such as the type, classification and function of muscles, bones, ligaments and joints. The author also discussed common musculoskeletal conditions such as osteroarthritis, rheumatoid arthritis, osteroporosis, fractures and sports injuries. Judge (2007) also considered examination techniques and principles of nursing care. The health assessment procedures stated in this journal includes some of the most important information to ask the patient during history taking. The author stated that the cause, whether it is traumatic or non-traumatic should be first established. Next, the onset of the symptom, whether it is acute or gradual and the severity, pertaining to the extent of the affectation should be asked. Any precipitating and relieving factors should also be noted. In cases where the patient complains of pain, swelling or stiffness, the author recommends to ask whether it is focal, diffuse or radiating, whether it is continuous or intermittent and whether it is most painful at a particular time of day. The presence of weakness, localized or generalized should be assessed whether it is secondary to pain or limitation of motion. Numbness in the extremities should be checked as to its distribution and whether it is associated with any other conditions such as cold environment. Since muscles and joint provide mobility and
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stability, it is likely that the patient may experience functional difficulties. Judge (2007) also stated that is important that nursing staff note any previous medical and surgical disorders, and consider those that may affect the presenting complaint. As for the drug history, this is important as some medications' side effects affect the musculoskeletal system. Pain assessment can be done using the mnemonic PQRST, P- is the pain provoked by anything, Q - what is the quality and quantity of pain, R - where is the region of pain and does the pain radiate, S-what is the severity of pain and T-what is the timing of pain (Judge, 2007). In addition to the subjective assessment, the author also mentioned some principles in objective examination. It included general inspection, regional examination and range of motion. Judge (2007) also discussed some fundamental aspects of nursing care to be considered when treating the patient's musculoskeletal complaint. For acute, undiagnosed conditions, a nurse can implement RICE, which stands for Rest, Ice, Compression and Elevation to reduce swelling and inflammation of the muscular structures at the site of injury. Monitoring for risks for neurovascular complications, especially in post-operative patients and those who have case immobilization by checking for the five P's pallor, pain, paresthesia, pulses and paralysis, is a vital role of a nurse as quick diagnosis of such can ensure prompt and adequate treatment. It is also a nurses' role to educate the patient about signs and symptoms of deep venous thrombosis, pulmonary embolism, chest infection, pressure ulceration, constipation and urinary stasis.
Among the strengths of this journal is its simple and clear explanation of key concepts. I believe this is also a well-written journal since the thought process or flow of the concepts is very linear, and doesn't jump from one concept to another. It began with the anatomy and physiology and I think this is helpful more readers who may not be so familiar with the said
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medical terms and concepts and continued to the nursing and assessment part. It made use of mnemonics (PQRST for pain assessment) and arranged pertinent information in tables for easy referencing. This article was able to capture my interest because it is very light to read. It didn't bombard me with too many facts but it was clear and concise for me. Yes, I am able to relate this article to my area of practice. Being a nurse in subacute to long-term care, I am sure to handle patients affected with musculoskeletal conditions, most probably in post-operative patients. And as with the interdisciplinary approach in medicine nowadays, my additional knowledge regarding this kind of conditions will help me to relate better with members of the rehabilitation team such as the physiotherapist and doctor. I think I will be able to apply the subjective as well as objective assessment outlined by the author, most especially the treatment part. This helped me be more adapt on how to assess the patient through inspection and palpation. Yes, the health assessment strategies were clearly explained. I believe more research articles should be written about this area of health assessment, most especially in the pertinent things to check during emergencies. The population who will benefit from this article ate the nurses working in the rehabilitation or orthopedics division. This may physiotherapists, as well as athletes who are prone to injuries.
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Judge NL. (2007). Assessing and managing patients with musculoskeletal conditions. Nursing Standard (Royal College of Nursing (Great Britain) : 1987). 22 (1), 12-18. Read More
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