Focused Note

In clinical settings, patients often present with musculoskeletal conditions such as chronic back pain. Drugs are typically prescribed to help manage this type of pain for patients. There are many different pain medicines, and each one has benefits and risks. To add to the complexity, each patient may also have a slightly different response to a pain reliever. When over-the-counter medications do not address a patient’s pain, more powerful prescription pain relievers, such as opioids, can be effective but also sometimes have serious side effects. There is also a risk of addiction. More than 70,000 people died in 2017 from drug overdoses, and almost 68% involved a prescription or illicit opioid. Drug overdose deaths continue to increase in the United States (Centers for Disease Control and Prevention, n.d.).

For the advanced practice nurse, these statistics highlight the need to effectively screen for, diagnose, and manage opioid use. It is essential to carefully observe and watch for signs of drug abuse during patient evaluations. Because not all musculoskeletal conditions require narcotics, a thorough patient evaluation will help to ensure the development of an appropriate treatment plan with patient safety in mind.

This week, you will continue to engage with Meditrek, recording your clinical hours and patient encounters. You will also learn about evaluation and management of musculoskeletal conditions in the reading selections as well as conduct a patient evaluation of a patient from your practicum experience who has a musculoskeletal condition. Based on diagnostic and treatment options you identify for the patient, you will identify a primary diagnosis, as well as a treatment and management plan.

Reference Centers for Disease Control and Prevention (n.d.).  CDC’s response to the opioid overdose epidemic.   https://www.cdc.gov/opioids/

 

LEARNING OBJECTIVES

Students will:

· Describe clinical hours and patient encounters

· Formulate diagnoses for adult patients

· Justify adult patient treatment options

· Advocate health promotion and patient education strategies across the adult lifespan

· Synthesize the assessment and diagnosis of health conditions for a clinical patient

· Fowler, G. C. (2020).  Pfenninger and Fowler’s procedures for primary care (4th ed.). Elsevier.

· Chapter 174, “Shoulder Dislocations” (pp. 1163–1167)

· Chapter 175, “Ankle and Foot Splinting, Casting, and Taping” (pp. 1168–1175)

· Chapter 176, “Cast Immobilization and Upper Extremity Splinting” (pp. 1176–1185)

· Chapter 177, “Knee Braces” (pp. 1186–1192)

· Chapter 178, “Fracture Care” (pp. 1193–1211)

· Chapter 180, “Joint and Soft Tissue Aspiration and Injection (Arthrocentesis)” (pp. 1221–1239)

· Chapter 181, “Trigger-Point Injection” (pp. 1240–1244)

· Chapter 235, “Principles of X-Ray Interpretation” (pp. 1566–1575)