NURS 6501 Module 5 Case Study Analysis

NURS 6501 Module 5 Case Study Analysis

Sample Answer for NURS 6501 Module 5 Case Study Analysis Included After Question

Module 5: Case Study Analysis Assignment

Scenario 1: 74-year-old male with a history of hypertension and smoking, is having dinner with his wife when he develops sudden onset of difficulty speaking, with drooling from the left side of his mouth, and weakness in his left hand. His wife asks him if he is all right and the patient denies any difficulty. His symptoms progress over the next 10 minutes until he cannot lift his arm and has trouble standing. The patient continues to deny any problems. The wife sits the man in a chair and calls 911. The EMS squad arrives within 5 minutes. Upon arrival in the ED, patient‘s blood pressure was 178/94, pulse 78 and regular, PaO2 97% on room air. Neuro exam – Cranial nerves- Mild left facial droop. Motor- Right arm and leg extremity with 5/5 strength. Left arm cannot resist gravity, left leg with mild drift. Sensation intact. Neglect- Mild neglect to left side of body. Language- Expressive and receptive language intact.

Mild to moderate dysarthria. Able to protect airway.

Scenario 2: Patient is a 24-year-old female administrative assistant who comes to the emergency department with a chief complaint of severe right-sided headache. She states that this is the sixth time in the last 2 months she has had this headache. She says the headaches last 2–3 days and have impacted her ability to concentrate at work. She complains of nausea and has vomited three times in the last 3 hours. She states, “the light hurts my eyes.” She rates her pain as a 10/10 at this time. Ibuprofen and acetaminophen ease her symptoms somewhat but do not totally relieve them. No other current complaints.

Scenario 3: A 58-year-old obese white male presents to ED with chief complaint of fever, chills, pain, and swelling in the right great toe. He states the symptoms came on very suddenly and he cannot put any weight on his foot. Physical exam reveals exquisite pain on any attempt to assess the right first metatarsophalangeal (MTP) joint. Past medical history positive for hypertension and Type II diabetes mellitus. Current medications include hydrochlorothiazide 50 mg po q am, and metformin 500 mg po bid. CBC normal except for elevated sedimentation rate (ESR) of 33 mm/hr and C-reactive protein (CRP) 24 mg/L. Metabolic panel normal. Uric acid level 6.7 mg/dl.

Scenario 4: A 67-year-old man presents to the HCP with chief complaint of tremors in his arms. He also has noticed some tremors in his leg as well. The patient is accompanied by his son, who says that his father has become “stiff” and it takes him much longer to perform simple tasks. The son also relates that his father needs help rising from his chair. Physical exam demonstrates tremors in the hands at rest and fingers exhibit “pill rolling” movement. The patient’s face is not mobile and exhibits a mask-like appearance. His gait is uneven, and he shuffles when he walks and his head/neck, hips, and knees are flexed forward. He exhibits jerky or cogwheeling movement. The patient states that he has episodes of extreme sweating and flushing not associated with activity. Laboratory data unremarkable and the HCP has diagnosed the patient with Parkinson’s Disease.

Please do a 1 to 2-page case study analysis. In your Case Study Analysis related to the scenario provided, explain the following:

  •            Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
  •            Any racial/ethnic variables that may impact physiological functioning.
  •            How these processes interact to affect the patient.

 

Module 5 Assignment: Case Study Analysis 

An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other. 

Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role. 

 

Photo Credit: jijomathai – stock.adobe.com 

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans. 

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health. 

To prepare: 

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor. 

Assignment (1- to 2-page case study analysis) 

In your Case Study Analysis related to the scenario provided, explain the following: 

  • Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms. 
  • Any racial/ethnic variables that may impact physiological functioning. 
  • How these processes interact to affect the patient. 

Day 7 of Week 8 

Submit your Case Study Analysis Assignment by Day 7 of Week 8. 

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting. 

Submission and Grading Information 

To submit your completed Assignment for review and grading, do the following: 

  • Please save your Assignment using the naming convention “M5Assgn+last name+first initial.(extension)” as the name. 
  • Click the Module 5 Assignment Rubric to review the Grading Criteria for the Assignment. 
  • Click the Module 5 Assignment link. You will also be able to “View Rubric” for grading criteria from this area. 
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “M5Assgn+last name+first initial.(extension)” and click Open. 
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. 
  • Click on the Submit button to complete your submission. 

Grading Criteria 

 

To access your rubric: 

Module 5 Assignment Rubric 

 

Check Your Assignment Draft for Authenticity 

 

To check your Assignment draft for authenticity: 

Submit your Module 5 Assignment draft and review the originality report. 

 

Submit Your Assignment by Day 7 of Week 8 

 

To participate in this Assignment: 

Module 5 Assignment 

 

 

What’s Coming Up in Module 6? 

 

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images 

In Module 6, you will identify processes related to psychological disorders. You will also examine the neurobiology of various psychological issues and consider variables that may impact physiological functioning and altered physiology. 

Week 9 Knowledge Check: Psychological Disorders 

 

In the Week 9 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 6. This Knowledge Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly. 

Next Module 

 

To go to the next Module: 

Module 6 

 

Week 8: Concepts of Neurological and Musculoskeletal Disorders – Part 2 

As homeowners know all too well, there is a continuous need for maintenance and repair. Some efforts are precautionary in nature, while others are the result of issues that surface over time. 

Similarly, musculoskeletal disorders can develop over time. For some disorders, such as osteoporosis, precautionary treatments are a potential option. But much like issues that surface in a home over time, many musculoskeletal issues can be very serious concerns, and they can have a significant impact on patients’ lives. 

This week, you continue to examine fundamental concepts of neurological and musculoskeletal disorders. You explore common disorders that impact these systems and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.  

Learning Objectives 

Students will: 

  • Analyze processes related to neurological and musculoskeletal disorders 
  • Identify racial/ethnic variables that may impact physiological functioning 
  • Evaluate the impact of patient characteristics on disorders and altered physiology  

 

Learning Resources 

Note: The below resources were first presented in Week 7. If you have previously reviewed them, you are encouraged to read or view them again here.  

 

Required Readings (click to expand/reduce)  

 

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier. 

  • Chapter 15: Structure and Function of the Cardiovascular and Lymphatic Systems (stop at Aging and the nervous system) 
  • Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review 
  • o   Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function; pp. 504–511, pp. 516–530 (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review 
  • Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review 
  • Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review 
  • Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review  

 

Chin, L. S. (2018). Spinal cord injuries. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4 

 

 

Required Media (click to expand/reduce)  

 

 

Khan Academy. (2019b). Ischemic stroke. Retrieved from ttps://www.khanacademy.org/science/health-and-medicine/circulatory-system-diseases/stroke/v/ischemic-stroke 

Note: The approximate length of the media program is 8 minutes. 

 

Osmosis.org. (2019, June 12). Osteoporosis – causes, symptoms, diagnosis, treatment, pathology [Video file]. Retrieved from https://www.youtube.com/watch?v=jUQ_tt_zJDo 

Note: The approximate length of the media program is 9 minutes. 

 

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children 

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 15, 16, 18, and the sections of Chapters 44 and 45 that relate to the neurological and musculoskeletal systems. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/ 

Rubric Detail  

Select Grid View or List View to change the rubric’s layout.  

Content 

Name: NURS_6501_Module5_Case Study_Assignment_Rubric 

  Excellent   Good   Fair   Poor  
Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:

Explain both the neurological and musculoskeletal pathophysiologic processes of why the patient presents these symptoms.  

Points Range: 28 (28%) – 30 (30%)  

The response accurately and thoroughly describes the patient symptoms.

The response includes accurate, clear, and detailed explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by evidence and/or research, as appropriate, to support the explanation. 

Points Range: 25 (25%) – 27 (27%)  

The response describes the patient symptoms.

The response includes accurate, explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by evidence and/or research, as appropriate, to support the explanation. 

Points Range: 23 (23%) – 24 (24%)  

The response describes the patient symptoms in a manner that is vague or inaccurate.

The response includes explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms and is supported by explanations that are vague or based on inappropriate evidence/research. 

Points Range: 0 (0%) – 22 (22%)  

The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing.

The response does not include explanations of both the neurological and musculoskeletal pathophysiologic processes of patients who present these symptoms, or the explanations are vague or based on inappropriate evidence/research. 

Explain how the highlighted processes interact to affect the patient.   Points Range: 28 (28%) – 30 (30%)  

The response includes an accurate, complete, detailed, and specific explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation. 

Points Range: 25 (25%) – 27 (27%)  

The response includes an accurate explanation of how the highlighted processes interact to affect the patient and is supported by evidence and/or research, as appropriate, to support the explanation. 

Points Range: 23 (23%) – 24 (24%)  

The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate evidence/research. 

Points Range: 0 (0%) – 22 (22%)  

The response includes a vague or inaccurate explanation of how the highlighted processes interact to affect the patient, with explanations that are based on inappropriate or missing evidence/research. 

Explain any racial/ethnic variables that may impact physiological functioning.   Points Range: 23 (23%) – 25 (25%)  

The response includes an accurate, complete, detailed, and specific explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation. 

Points Range: 20 (20%) – 22 (22%)  

The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning and is supported by evidence and/or research, as appropriate, to support the explanation. 

Points Range: 18 (18%) – 19 (19%)  

The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, and/or explanations that are based on inappropriate evidence/research. 

Points Range: 0 (0%) – 17 (17%)  

The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning, or the explanations are based on inappropriate or no evidence/research. 

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.  
Points Range: 5 (5%) – 5 (5%)  

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 

Points Range: 4 (4%) – 4 (4%)  

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

The purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. 

Points Range: 3.5 (3.5%) – 3.5 (3.5%)  

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

The purpose, introduction, and conclusion of the assignment are vague or off topic. 

Points Range: 0 (0%) – 3 (3%)  

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided. 

Written Expression and Formatting – English Writing Standards:
Correct grammar, mechanics, and proper punctuation  
Points Range: 5 (5%) – 5 (5%)  

Uses correct grammar, spelling, and punctuation with no errors. 

Points Range: 4 (4%) – 4 (4%)  

Contains a few (1 or 2) grammar, spelling, and punctuation errors. 

Points Range: 3.5 (3.5%) – 3.5 (3.5%)  

Contains several (3 or 4) grammar, spelling, and punctuation errors. 

Points Range: 0 (0%) – 3 (3%)  

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. 

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.   Points Range: 5 (5%) – 5 (5%)  

Uses correct APA format with no errors. 

Points Range: 4 (4%) – 4 (4%)  

Contains a few (1 or 2) APA format errors. 

Points Range: 3 (3%) – 3 (3%)  

Contains several (3 or 4) APA format errors. 

Points Range: 0 (0%) – 3 (3%)  

Contains many (≥ 5) APA format errors. 

Total Points: 100  

Name: NURS_6501_Module5_Case Study_Assignment_Rubric 

 

A Sample Answer For the Assignment: NURS 6501 Module 5 Case Study Analysis

Title: NURS 6501 Module 5 Case Study Analysis

Concepts of Neurological and Musculoskeletal Disorders

The case analysis is based on a 67 years old man who presents to the HCP with chief complaints of arm tremors. The patient has some tremors in the leg. According to the son, the father was stiff, taking him longer to perform simple tasks. Based on a physical examination, the patient hand was at rest, and the fingers exhibited movement. He exhibited a mask-like appearance since his face was not mobile while his gaits were uneven. In addition, the patient shuffled when he walked while his knees and hips flexed forward. Therefore, he exhibited a cog wheeling movement. The patient also identified that he had extreme sweating when engaging in activities. The paper will provide the neurological and musculoskeletal pathophysiologic process based on the patient’s symptoms.

Neurological and Musculoskeletal Pathophysiology Processes

The patient is diagnosed with Parkinson’s disease. Parkinson’s disease affects movement; thus, a progressive nervous

NURS 6501 Module 5 Case Study Analysis
NURS 6501 Module 5 Case Study Analysis

system disorder (McCance & Huether, 2019). Therefore, Parkinson’s disease is caused by degeneration of the brain, causing the impairment or death of the neurons in the body (McCance & Huether, 2019). This leads to the depletion of dopamine due to the formation of the substantia nigra. Notably, when the neurons are normal, dopamine production takes place. Patients with Parkinson’s disease lack dopamine, which effectively improves the blood flow in the body (Taylor et al., 2020).
Therefore, the patient experienced tremors, stiffness, and difficulties walking due to dopamine insufficiency in the body. This shows that dopamine is effective in achieving smooth muscle movement. In addition, a patient with depleted dopamine is also likely to experience other nonmotor symptoms such as autonomic –neuroendocrine changes (Chung et al., 2018).

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Moreover, patients who have Parkinson’s disease lose the nerve endings responsible for producing the norepinephrine. The chemical helps control the main function in the body, such as blood pressure and heart rate, thus a messenger to the sympathetic nervous system (Chung et al., 2018). The patient with Parkson’s has a brain cell that consists of Lewy bodies that impact the movement, mood, or behavior (Chung et al., 2018). Lewy bodies are abnormal clumped proteins that develop in the nerve cells and are located in the substantia nigra of a person’s brain.

Racial/Ethnic Variables

Parkinson’s disease is common to neurodegenerative disease among the elderly. The large insurance database identifies that the most affected ethnicity is the Hispanic, with the highest incidence, followed by the black with the lowest (Hayes, 2019). Based on gender, males experience Parkinson’s disease more than women, while the number of patients diagnosed increases with age (McCance & Huether, 2019). The main reason for the increase in the risk of Parkinson’s among men is due to the toxicant exposure, head trauma, and the X linkage of the genetic risk factors (Hayes, 2019).

Interaction of the Processes

A patient with Parkinson’s disease suffers limited movement. This is due to degeneration of the basal ganglia, which causes a decline in level of dopamine that is inhibited in acetylcholine (Yaday & Kumar, 2022). However, levels of acetylcholine remain active, leading to imbalance in inhibitory neuronal activity and excitatory (Yaday & Kumar, 2022). Therefore, excess neurons cause the ability to generate the voltage of the rapid membrane, whose response is a very small stimulus.

Conclusion

Parkinson’s disease affects a person’s movement since it is a progressive nervous system disorder. Several factors increase the risk of developing Parkinson’s disease, including age, ethnicity, and gender. Men are most likely to suffer from the disease, which can also be hereditary. The early signs of the disease include tremors and trouble in movement.

References

Chung, S. J., Yoo, H. S., Oh, J. S., Kim, J. S., Ye, B. S., Sohn, Y. H., & Lee, P. H. (2018). Effect of striatal dopamine depletion on cognition in de novo Parkinson’s disease. Parkinsonism & related disorders, 51, 43-48. https://www.sciencedirect.com/science/article/pii/S1353802018301147 Hayes, M. T. (2019). Parkinson’s disease and parkinsonism. The American journal of medicine, 132(7), 802-807. https://www.sciencedirect.com/science/article/pii/S0002934319302359 McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier. Taylor, J. P., McKeith, I. G., Burn, D. J., Boeve, B. F., Weintraub, D., Bamford, C., … & T O’Brien, J. (2020). New evidence on the management of Lewy body dementia. The Lancet Neurology, 19(2), 157-169. https://www.sciencedirect.com/science/article/pii/S147444221930153X Yadav, D., & Kumar, P. (2022). Restoration and targeting of aberrant neurotransmitters in Parkinson’s disease therapeutics. Neurochemistry International, 105327. https://www.sciencedirect.com/science/article/pii/S0197018622000523