NUR 643 Health Assessment Topic Reflection 4 Paper

NUR 643 Health Assessment Topic Reflection 4 Paper

NUR 643 Health Assessment Topic Reflection 4 Paper

Health Assessment Topic Reflection 4
A 74-year-old female presented with complaints of stiff and painful hand and knee joints in the morning and when performing house chores. When completing this assessment, we asked the patient about the onset of her symptoms and how they have progressed over time. She reported experiencing mild hand joint pain three years ago, which aggravated when she was working. The pain advanced from mild to moderate, and six months ago, she started experiencing joint stiffness when walking, working, and in the morning. In addition, we conducted a focused musculoskeletal physical exam which revealed muscle strength of 4/5 and reduced ROM of interphalangeal and knee joints with crepitus. Interphalangeal joints were tender and enlarged on palpation, and joints were warm to touch. Furthermore, we ordered an X-ray of the knee joint and interphalangeal joints, which revealed a narrowing of joint space and osteophytes. This led us to a diagnosis of osteoarthritis.

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Difficulties can arise in identifying the specific joint disorder in patients with joint pain and stiffness. Clinicians may encounter challenges differentiating osteoarthritis from rheumatoid arthritis (RA). The examiner should ask the patient to describe when they feel stiffness to overcome these difficulties. The examiner should also ask where the patient feels stiffness and how long stiffness lasts (Yunus et al., 2020). In joint disorders that cause inflammation like RA, stiffness is prolonged for longer than an hour, whereas in disorders that do not cause inflammation like osteoarthritis, stiffness is short-lived for about 10 minutes even though it may be severe and pain may persist (Yunus et al., 2020). The examiner should also look for signs of inflammation like warm, swollen, and tender joints to differentiate the two joint disorders.
References
Yunus, M., Nordin, A., & Kamal, H. (2020). Pathophysiological Perspective of Osteoarthritis. Medicina (Kaunas, Lithuania), 56(11), 614. https://doi.org/10.3390/medicina56110614

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Think about an experience you have encountered when viewing or completing an assessment of the musculoskeletal body system and extremities. Then, complete a written reflection (250–350 words) on what you learned during this topic. Include the following in your reflection, considered through the lens of a nurse educator.

Describe the steps you took when completing this particular assessment.

Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.

Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing the particular assessment.