Maryville NURS330 Week 6 Assignment Latest 2022 May

NURS330 Individual Assessment

Week 6 Assignment

Musculoskeletal and Peripheral Vascular System Assessment Case Study

This case study provides the opportunity to apply what you have learned about assessment of the musculoskeletal and peripheral vascular system to a simulated patient situation.

Ms. Edith V. is an 85-year-old, slim, white woman who lives with her daughter. Because you work as a visiting nurse, you go to her home to assess her status after her discharge from the hospital the previous day. Ms. V. had been hospitalized for an exacerbation of congestive heart failure (CHF). She has a long-standing history of diabetes mellitus, chronic arterial insufficiency, and hyperlipidemia. She also has a history of smoking a pack of cigarettes a day for 42 years. She tells you about the foot pain that accompanies the reasons for her hospital admission, which includes intensive management of a foot ulcer and evaluation of peripheral circulation.

Foot UlcerYou examine the affected limb. Experience helps you assess whether the physical findings match the subjective report, or whether the situation warrants more investigation. Look at the image to the right of Ms. M's feet.

Upon discharge, she had been given a prescription for oral lasix, which she has been taking on and off for the last 8 years. Ms. V. also has a 30-year history of rheumatoid arthritis and can ambulate around the house only with the assistance of a walker. Her daughter meets you at the door and takes you into the kitchen where her mother is sitting at the kitchen table. You ask Ms. V. how she is doing today, and she responds, "My breathing is much better now, but I'm having a lot of pain from the arthritis in my hands.”

ArthritisWhen you inspect Ms. V.'s left hand, which she tells you is causing her pain, you note that her fingers appear similar to the image to the right.

How would you describe the swelling Ms. V.'s finger joints?

What caused the pain in Ms. V.’s hands?

How would you document the general appearance of her foot (not the ulcer)? Make sure you examine all the skin in the photo, including the other foot.

Which type of ulcer is Ms. M's legion consistent with? (Chronic arterial ulcer, acute venous disease, or chronic venous ulcer?)

What patient and family education can you provide regarding the patient’s rheumatoid arthritis, arterial insufficiency, history of diabetes and life style practices of smoking?