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.
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.
Assignment (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.
Scenario: 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 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.
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.
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%63Total Score: High riskJadiam Lopez
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Module 5
Assignment: Case Study Analysis
Jadiam Lopez
MSN, Walden University
NURS-650
1
Dr. Katese Rutherford DNP, FNP-
BC
01/18/2022
Both the neurological and musculoskeletal pathophysiologic processes would account for the patient presenting these symptoms. Gout takes place when uri-
nate crystals accumulate in the joints, thus causing inflammation as well as excessive pain of the gout attack. Urate crystals can form when one has high degrees of
uric acid in the blood. Majorly, uric acid dissolves in the blood and passes through the kidneys into the urine. However, at the time, either the body generates ex-
cessive uric acid, the kidneys produce minimal levels of uric acid, or the kidney produces minimal uric acid. When this takes place, uric acid tends to accumulate, thus
creating sharp, needle-based urate crystals in the joint as well as surrounding tissue which leads to inflammation as well as swelling (Roddy, & Choi, 2014). Gout
mainly impacts the large joint of the big toe, though it can as well occur in the joint. Other joints which can be impacted include the ankles, knees, elbows, wrists
as well as fingers. The pain is prevalent in the first 4-12 hours after it starts. Any racial/ethnic variables that may impact physiological functioning. Gout has
major impacts on physical function, productivity, health-based quality of life (HRQOL), and health care expenses. Uncontrolled gout is as well related to the major uti-
lization of emergent care services. Ladies are less likely to have gout in comparison to men; however, with postmenopausal years, the gender difference in disease in-
cidence reduces. Women may have more delay in diagnosis with gout since the illness tends to be male dominant. In comparison to whites, racial/ethnic minori-
ties, mainly blacks, have a high prevalence of gout. In contrast, black people have a low possibility of receiving quality gout care, resulting in disproportionate morbid-
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ity. The racial/ethnic minorities tend to have a higher burden of gout as a result of a high prevalence of comorbidities, the use of predisposing treatment, for in-
stance, diuretics, as well as the delay in diagnosis. In the US, the prevalence of gout is 3 in 1000 individuals years in African Americans and 2 in1000 individuals years
in whites; the excess risk can be partially described using high frequency of incident high blood pressure.
How these processes interact to affect the patient.
Gout has a major negative impact on the patient’s quality of life. Gout has the ability to lead to psychological as well as emotional issues. Chronic gout may lead to
chronic and, at times, constant pain. Gout can affect the ability to walk, work as well as to conduct normal roles. Living with pain tends to be emotionally distress-
ing. This condition may as well lead to Tophi, which are clumps of urate crystals that harden under the skin. They can develop on the majority of the joints as well as
cartilage, including the fingers, hands, feet, as well ankles. They can damage the joints, bones as well as cartilage if left untreated. This condition can as well cause
joint damage as well as deformity. When one has chronic gout, they have sold in the joints frequently. Chronic inflammation and tophi can result in permanent
joint damage, deformity as well as stiffness. In the worst case, one may require surgery to deal with the damage or even replace the joints (Hirsch et al., 2010). This
condition may as well affect gout on patients living above and beyond acute pain, as well as a functional limitation with gout flares. This may impact sleep functions,
sleep, social life, emotional health, hobbies as well as footwear. People found with gout are 25% more likely to die prematurely in comparison to people without gout.
The maximized mortality rate has not reduced in the last 16 years.
References
Hirsch, J. D., Terkeltaub, R., Khanna, D., Singh, J., Sarkin, A., Shieh, M.,… & Lee, S. J. (2010). Gout disease-specific quality of life and the association with gout
characteristics. Patient-related outcome measures, 1, 1. Roddy, E., & Choi, H. K. (2014). Epidemiology of gout. Rheumatic Disease Clinics, 40(2), 155-
175.
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Module
5
Assignment: Case Study Analysis
Jadiam Lopez
MSN, Walden University
NURS
–
6501
Dr. Katese Rutherford DNP, FNP
–
BC
01/18/2022
1
Module 5 Assignment: Case Study Analysis
Jadiam Lopez MSN, Walden University NURS-6501 Dr.
Katese Rutherford DNP, FNP-BC
01/18/2022
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Case Study Analysis
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Case Study Analysis
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MSN, Walden University
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MSN, Walden University
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Both the neurological and musculoskeletal pathophysiologic processes would account for
the patient presenting these symptoms.
Original source
Both the neurological and musculoskeletal pathophysiologic processes would account for
the patient presenting these symptoms
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Majorly, uric acid dissolves in the blood and passes through the kidneys into the urine.
Original source
“Normally, uric acid dissolves in your blood and passes through your kidneys into your
urine
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Other joints which can be impacted include the ankles, knees, elbows, wrists as well as
fingers.
Original source
Other common sites include the midtarsal joints, ankles, knees, fingers (Figure 2), wrists,
and elbows
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Any racial/ethnic variables that may impact physiological functioning.
Original source
· Any racial/ethnic variables that may impact physiological functioning
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Gout has major impacts on physical function, productivity, health-based quality of life
(HRQOL), and health care expenses. Uncontrolled gout is as well related to the major uti-
lization of emergent care services.
Original source
Gout has significant impact on physical function, productivity, health-related quality of life
(HRQOL) and health care costs Uncontrolled gout is also associated with significant uti-
lization of emergent care services
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In comparison to whites, racial/ethnic minorities, mainly blacks, have a high prevalence of
gout.
Original source
Compared to Whites, racial/ethnic minorities, especially blacks, have higher prevalence of
gout
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The racial/ethnic minorities tend to have a higher burden of gout as a result of a high
prevalence of comorbidities, the use of predisposing treatment, for instance, diuretics, as
well as the delay in diagnosis.
Original source
Due to a higher prevalence of comorbidities (hypertension, obesity, renal failure, etc.), the
use of predisposing medications such as diuretics, and delays in diagnosis and/or treat-
ment, racial/ethnic minorities may bear a greater burden of gout
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How these processes interact to affect the patient.
Original source
· How these processes interact to affect the patient
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biomedcentral 73%
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Living with pain tends to be emotionally distressing. This condition may as well lead to
Tophi, which are clumps of urate crystals that harden under the skin. They can develop
on the majority of the joints as well as cartilage, including the fingers, hands, feet, as well
ankles. They can damage the joints, bones as well as cartilage if left untreated.
Original source
Living with pain can be emotionally distressing Tophi Tophi are clumps of urate crystals
that harden under your skin They can form on most joints and cartilage including your
fingers, hands, feet, and/or ankles Tophi may not cause pain, but can damage your joints,
bones, and cartilage if left untreated
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Chronic inflammation and tophi can result in permanent joint damage, deformity as well
as stiffness.
Original source
Chronic inflammation and tophi can lead to permanent joint damage, deformity, and
stiffness
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D., Terkeltaub, R., Khanna, D., Singh, J., Sarkin, A., Shieh, M.,…
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D., Terkeltaub, R., Khanna, D., Singh, J., Sarkin, A., Shieh, M.,
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Gout disease-specific quality of life and the association with gout characteristics.
Original source
Gout disease-specific quality of life and the association with gout characteristics
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Patient-related outcome measures, 1, 1.
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Patient related outcome measures, 2010, 1
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Roddy, E., & Choi, H.
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Roddy E, Choi HK
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Epidemiology of gout.
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Epidemiology of gout
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Case Study Analysis
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Case Study Analysis
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MSN, Walden University
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MSN, Walden University
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Katese Rutherford DNP, FNP
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Katese Rutherford DNP, FNP
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Module 5 Assignment:
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Assignment – Module 5
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Case Study Analysis
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Case Study Analysis
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Jadiam Lopez MSN, Walden University NURS-6501 Dr.
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Jadiam Lopez MSN, Walden University NURS-6501 Dr
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Katese Rutherford DNP, FNP-BC 01/18/2022
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Katese Rutherford DNP, FNP-BC
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