Read all Instructions Carefully – Interpretation of Musculoskeletal Issues.

In this discussion forum, you will address special considerations of the older adult presenting with conditions related to the musculoskeletal system.

Review the case scenario.

You are working in the emergency room, and you must conduct a history and physical assessment on a 60-year-old client.

The subjective information indicates the following:

The client has had pain and tenderness in the joints of her fingers bilaterally.

This occurs especially after playing the piano, as the client is a music teacher and piano instructor.

The onset has been gradual.

She also reports that her joints look a bit swollen and seem stiff when she wakes up and that it takes awhile before she is able to fully move them.

She reports pain in both hands currently at a 4/10 on the numeric pain scale, but it has been as high as 8/10. Objective findings include the following notations:

Assessment of the client’s hands reveal enlargement of some of the proximal interphalangeal joints (Bouchard’s nodes) and some of the distal interphalangeal joints (Heberden’s nodes). Squaring at the bases of both thumbs at the carpometacarpal joints is also noted.

In your response, address each of the following questions:

Explain the special considerations, such as the symptoms in the scenario above, that nurses should be aware of when assessing the musculoskeletal system, interpreting findings, and planning nursing care for clients.

How would you interpret your findings in relation to the case scenario? What nursing diagnoses are indicated related to the musculoskeletal system?

Incorporate at least two professional, current (less than five years), evidence-based resource to support your response (include citations and references for sources using correct APA format).

The second source can be your textbook.

Share your personal experiences with the history taking, physical assessment, and interpretation of findings related to the musculoskeletal system in clients with special considerations:

What were the challenges?

How did you overcome these challenges?

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