Question

The Musculoskeletal System

1. A community nurse is managing the care of an older adult. In an attempt to maximize the patient’s musculoskeletal health and minimize the risk of physical injury, the nurse is preparing educational information to be delivered at the next home visit.

1. What areas of concern should the nurse include in the patient’s information regarding osteoporosis?
2. What areas should be discussed to best address risk reduction and health promotion strategies to reduce musculoskeletal injuries and disease?

2. A worker comes to the pain clinic following a back injury at work while lifting a heavy object. He is complaining of low back pain and leg pain. The nurse practitioner is suspecting a herniated disc.

1. What are the possible causes of low back and leg pain?
2. What assessment findings would confirm the possibility of a herniated disc?

Answer 1

1.Osteoporosis is a condition where there is a decline in the strength of the bones and thereby increases the probability of fractures and related issues.

Patient Information regarding Osteoporosis

a)Since people with osteoporosis are at an increased probability for fractures , thereby it is most important for the patient to reduce falls which includes highlighting of precautionary steps like avoiding slippery surfaces,tripping and walking in areas with dim light.

b) Next is the educating the patient to increase the intake of calcium containing diet as it helps in strengthening the bones.Also taking Vitamin D supplements for maintaining and improving the bone health should be included.As per the guidelines, an intake of 1000- 1250 mg of calcium is recommended for geriatric population.

c) Lifestyle modifications : Exercise is a important factor to boost the muscle and bone strength.Also while on medications the patient should be educated to reduce the consumption of alcohol and restrain from smoking.

Risk Reduction and Promotion Strategies:

a) The most vital part is to undertake and consider steps to increase the muscle mass in the patient which includes the performing of the weight bearing physical movements and activities.

b)Prevent the factors that can worsen the disease conditions mainly to reduce the consumption tobacco containing products and make the necessary diet adjustment as mentioned.

c) Being aware of the risk factors to take precautionary steps at an early stage and keep the disease not progressing to further complications .

2. Herniated disc is a condition where the vetebral disc are projected from their position.

Possible causes of low back and leg pain:

The main etiological factors are as follows:

a)Advancing age which will often result in the declining or the degeneration of these disc resulting in the losing of the strength of these disc.

b) Heavy falls or lifting heavy objects that affect the back can disturb the anatomical integrity and can lead to herniated disc

c) Obesity is an other factor .The more pressure exerted to the leg and back of the patients can result in these condition.

Findings to confirm a herniated disc :

a)Physical Examination: This includes checking for reflexes and the sensitivity of the regions as an intial step.

b) Imgaing tests: X rays or CT scan may be conducated to visualise the herniated part and compare the alignments and the related anatomy.