NR 603 Week 6 Musculoskeletal Conditions In Primary Care

NR 603 Week 6 Musculoskeletal Conditions In Primary Care

NR 603 Week 6 Musculoskeletal Conditions In Primary Care

NR 603 Week 6 Orthopedic and Musculoskeletal Conditions in Primary Care

Week 6 Case Study Discussions 
Part 1, Part 2 & Part 3 (Summary in SOAP Format)

Child with Fever and Respiratory or Skin Issues

Kayla brings Riley, now 17 months, in for complaint of fever and rash.  The fever began “a couple of days ago” and is of normal levels in the morning then gets as high as 103 to 104 degrees in the afternoons.  Riley has also had clear rhinorrhea and in the last 24 hours he has developed a red, diffuse rash to the torso and abdomen that does not itch and a dry cough in the last day. Mother reports he is drinking, but not as well as usual.  He did have a good wet diaper this morning, but is not really eating much and is not playing. NR 603 Week 6 Musculoskeletal Conditions In Primary Care

Medications: Mother is giving OTC Robitussin cough and cold at 1 tsp last night and this morning.  Liquid Tylenol ½ a tsp last night and this morning.
She is very concerned about the level of the fever and the fact that after 3 days he is not improving.
Discussion Questions Part One

We will begin by focusing on gathering history in an ill child.

What ‘red flags’ did you note in the historical data?
What data is most important to include in this particular case and which historical data that might be gathered on a well-child exam can be left out of this ill visit?
What are your differential diagnoses
What parts of the physical exam will you focus on today to rule in or out your differentials?
Discussion Part Two (graded) NR 603 Week 6 Musculoskeletal Conditions In Primary Care

Physical Examination Riley:
V/S:  Height: 81 cm (31.89 in), Weight: 13 kg (28.66 lbs), B/P: 94/60, T: 100.6, HR: 114 BMP/reg., Resp: 28, reg, non-labored, SpO2: 97%
17 months old, Height 51st percentile, Weight 87th percentile (CDC, 2016)

General: somewhat lethargic and cries some throughout exam. SKIN: Diffuse erythemamtous rash in fine popular patches across the torso and very erythematous to the cheeks.  HEENT: Head normocephalic atraumiatic.  Conjuctiva clear, non-icteric, but mildly injected PERRL.  Unable to complete fundoscopic exam. Tympanic membranes intact with scant clear fluid posteriorly bill and mild injection. NR 603 Week 6 Musculoskeletal Conditions In Primary Care

EAC unremarkable. Pinna/tragus w/o tenderness. Nares patent, mucosa mildly injected with sl. edema to the inferior and medial turbinates bill, moderate clear rhinorrhea. Pharynx with mild slight erythema, tonsils 2/4 bill.  Oral exam unremarkable.  Neck supple w/mild anterior cervical lymphadenopathy bill. Thyroid small, firm, equal bill. CARDIOPULMONARY: Heart RRR w/o murmur. Lungs with mild expiratory wheeze in posterior bases. Respirations even and unlabored.  Abdomen rounded normative bowel sounds throughout, soft, non-tender, no masses or organomegaly.  NR 603 Week 6 Musculoskeletal Conditions In Primary Care

Lab: WBC 6.9, Lymph 50%, Neutrophils 40%, Monocytes 6%, Eosinophils 3%

Discussion Questions Part Two

After reviewing the physical exam.
What were your ‘red flags’ on physical exam?


1. Review the case studies and answer all questions relating to each.

2. Read the entire case study and familiarize yourself with each of the questions first.

3. Sources of research may include, but are not limited to:

o Prescribed textbook and other textbooks

o Reputable online resources such as the National Library of Medicine, Centers for Disease Control and Prevention, American Heart Association, Journal of Emergency Medical Services, and so on.

4. Ensure that all references are current and preferably not more than five years old

5. Do not use your textbook alone – Work that is not based on a variety of different sources is unacceptable.

6. If you directly quote a source the quoted portion must be in enclosing quotation marks and the source must be cited. Try to limit the number of quotes and rather use your own words. NR 603 Week 6 Musculoskeletal Conditions In Primary Care

7. Your answers must be comprehensive. Short answers will not be accepted. You must discuss in detail the reasons for your answers. If, for example, you are asked “what body systems are involved, “it is not sufficient to simply say, “respiratory, endocrine, and nervous.” You must explain WHY you have determined that these systems are involved and HOW they are involved.

8. If there are multiple parts to a question, you must answer each part.

9. Write your answers in the blue text boxes provided. Every box must contain an answer. Do not use the size of the text box to determine how much should be written – write as much as needed. The text box will grow to accommodate your answer. NR 603 Week 6 Musculoskeletal Conditions In Primary Care

10. The keywords for this paper are WHAT, WHY, AND HOW! Cover those bases and you will do well.

11. Demonstrate your critical thinking skills as fully as possible. There may or may not be “right” answers to all questions. Look for plausible answers and explain your reasons.

12. Justify your answers with WHAT, WHY, AND HOW explanations.

13. The more complete your discussion is, the better your grade will be. You will have an opportunity to revise your paper before a final grade is issued. NR 603 Week 6 Musculoskeletal Conditions In Primary Care