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Posted: January 31st, 2023

Musculoskeletal and Neurologic System Diagnosis of Osteoporos

Musculoskeletal and Neurologic System
Diagnosis of Osteoporos
Project description
To support your work, use your course and text readings and also use outside sources. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Musculoskeletal and Neurologic System

Using the Internet, research the conditions affecting the musculoskeletal and the neurologic systems. Based on your research and understanding, respond to one of the following scenarios:

A 58-year-old female is admitted for a work up for a complaint of neck and low back pain. During admission, you discover that she underwent a renal transplant six years ago. The patient also had blood work collected. When you review the findings, you notice that her serum calcium is elevated at 13.9 (Normal values range from 8.5 to 10.2 mg/dl), her CBC shows a hematocrit of 33%, and hemoglobin of 11.1 g/dl (normal adult female hematocrit Range: 37-47%, normal adult female hemoglobin range: 12-16 g/dl).

What does this mean and what could be the underlying cause of her pain and her abnormal lab values?

What other assessments would be helpful?

A 12-year-old female is admitted with severe pain in her spine. While checking history, the patient and her mother state that several weeks ago the patient was treated for an upper respiratory infection. The infection subsided after several days of taking antibiotics. However, several days later, the child complained of joint swelling and pain in her right elbow, which subsided, but then seemed to migrate to her left knee. A week later, today, the child began to complain of worsening back pain. The mother has been treating the pain with over the counter pain medication and heat and ice packs, but this did not seem to help.

What are the possible causes of the pain and how you would proceed?

A 33-year-old Hispanic male is admitted and complains of a tingling sensation in his left leg, vertigo, and loss of balance. When you begin to perform intake history, you notice that his speech is slurred, his teeth are in need of repair, and he seems to be very drowsy.

What other findings may you find in this individual?

What would you think is the underlying cause of this patient’s complaint?

How would you proceed with your assessment specifically for this patient?

A patient is admitted to the unit. He is a diabetic on chronic hemodialysis. He has an Arteriovenous (A-V) graft, which is annulated each time he undergoes dialysis treatments. You notice an area on his graft arm that is red and warm to the touch. He states that he has had this on his arm for several weeks. He asked the dialysis staff about the area, but they told him to apply warm compresses to the site. The staff at the dialysis center continues to use the graft, but they are careful to avoid the area when they cannulate for his treatments. Now the patient presents with extreme low back pain, fever, nausea, and swelling of his lower extremities. On checking his fasting serum glucose, you notice that the reading is 159 (Normal fasting blood glucose range 64 to 110 mg/dl), and his white blood cell count is 36,000 (normal range is 4,500-10,000 white blood cells/mcl). He states that his sugars were normally well controlled, but in the past ten days he seems to be requiring more insulin.

How would you proceed with this patient?

What could be the underlying problem?
Citations should conform to APA guidelines. You may use this APA Citation Helper as a convenient reference for properly citing resources or connect to the APA Style website through the APA icon below.
Musculoskeletal and Neurologic System
The signs and the symptoms described by the 58-year old women are precisely an indication that the woman could be suffering from osteoporosis. Osteoporosis is a condition of the musculoskeletal and neurologic system in which the density of the bones of the patients become low making their vertebral bone susceptible to bone fractures. It is common among the old women especially those ones who have aged passed the menopausal stage.
The back and the neck pain is caused by the fractures of the vertebra. It usually begins as a back pain but radiates to the body on all sides. With time repeated bone fractures can lead to severe lower back pain which usually leads to curving of the spine due to collapse of the spine. As a consequence, the patients serving from this condition usually have their height drooping, as explained by Lata and Elliott (2007). This commonly seen in elderly women as compared to men.
The renal transplant that the 58-year old woman underwent six months ago could have been as a result of extended effects of osteoporosis in the pulmonary system. Elderly women sometimes develop blood clots in the blood veins that ultimately reaches their pulmonary systems. The blood clots in the veins results prolonged bed rests usually after the victims suffer hip bone fracture.
Following recommendations of Kanis, Johnell, Oden, Dawson, De Laet and Jonsson (2001), the presence of elevated calcium levels of 13.9 mg/dl above the normal range of 8.5 to 10.2 mg/dl in the blood is an indication of reduced rate of absorption of calcium. Calcium is poorly absorbed from the blood due to lack of enough vitamin D. An individual could be taking a lot of calcium but if they are poorly absorbed into the body from the blood stream, then their blood would show high calcium concentration levels. This seems to have been the case with this patient.
Low hemoglobin levels of 11.1 g/dl well below the adult female hemoglobin range of 12-16 g/dl have been found to be risk factors for bone loss. In older women, the likelihood of the case of this patient, the bone mass and density are related to the hemoglobin level and anemia. Anemia and low hemoglobin levels are usually independently and negatively associated with bone mass and density. Women with lower hemoglobin levels indicate higher bone loss levels. Equally, lower hematocrit levels of 33% well below the normal adult female range of 37-47% has a direct connection with the hemoglobin levels and hence have a relationship with the bone mass and bone densities (Kanis, Johnell, Oden, Dawson, De Laet & Jonsson, 2001). Therefore, this woman is likely anemic too. Low hemoglobin and hematocrit levels indicate low bone densities and mass that usually the precursors of osteoporosis. It is the low bone mass and density which makes the people suffering from osteoporosis to have a weakened bone structure that causes their bones to fracture.
According to Lata and Elliott (2007), additional assessments that could be helpful in this case, include thyroids tests of t4 and TSH to establish the presence of thyroid disease, parathyroid hormone to screen hyperparathyroidism, follicle-stimulating hormone to check for menopause, protein electrophoresis to screen various types of proteins produced by bone cancer, multiple myeloma, are a result of bone breakdown and increased levels of alkaline phosphatase.

References
Kanis, J. A., Johnell, O., Oden, A., Dawson, A., De Laet, C., & Jonsson, B. (2001). Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporosis International, 12(12), 989-995.
Lata, P. F., & Elliott, M. E. (2007). Patient assessment in the diagnosis, prevention, and treatment of osteoporosis. Nutrition in Clinical Practice, 22(3), 261-275.

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