Musculoskeletal Disease: Causes, Symptoms, and Treatment

Question 1 

Diagnosis among patients with patterns of arthritis is the beginning point towards the success of any treatment plan. According to Aletaha and Smolen (2018) , one should first consider the performing physical examination to determine the symptoms that the patient manifests. The healthcare professional can check if the patient is experiencing loss of motion, swollen joints, increased temperature, or if there are warmth and redness, among other health abnormalities. This will ensure that the swelling and pain are minimized. It will also ensure that the patient continues with her activities or work (Wasserman, 2011). In their study, Long, Koyfman, and Gottlieb (2019) mention that septic arthritis to be an infection on the joints that is associated with the red, hot, swollen joint as well as pain on palpation. 

Question 2 

Some causes can differentiate septic arthritis. For example, septic arthritis is connected to the invasion of fungi, viruses, or bacteria inside the synovial membrane of body joints ( Teparrukkul et al., 2017) . The invasion occurs when the microorganisms spread through the bloodstream following an injury since the case study asserts that the patient likes to travel to Martha's Vineyard annually or to walk on the beach. 

Question 3 

Various infections cause shingles, Bell’s palsy, and Lyme disease. Even though they share common clinical signs and symptoms such as headache, fever, and muscle twitches or pain, there are critical differences between the three clinical conditions. For example, the signs Bell’s Palsy disease can be manifested from one to three weeks after infection. Some of the signs include a drooping appearance on the affected side of the face, sensitivity to sound, inability to open or close the eye if the side of the face is affected, and pain at the back of the ear ( Holland & Bernstein, 2014) . On the other side, Cohen et al. (2013) note that Shingles disease is associated with sensitivity to light, rash, burning sensation and itching, fluid-filled lesions, numbness, sensitivity to touch, and itching. Finally, Lyme disease is marked by muscle itching, facial paralysis, heart palpation, chills, and it occurs three to thirty days after infection ( Hatchette, Davis, & Johnston, 2014) . 

Question 4 

Although the case study notes that the patient does not remember any bite by the tick, some facts can explain and support Lyme disease. The case study demonstrates that the patient has neurologic and cardiac problems. According to the study conducted by Murray and Shapiro (2010) , Lyme disease is manifested through arthritis that affects the knee. In this case study, the patient has a swollen knee, experiences pain, and the affected knee is somehow painful when walking. These are some of the symptoms that Long, Koyfman, and Gottlieb (2019) believe are connected to arthritis. 

Question 5 

Doctors use laboratory tests to identify antibodies responsible for Lyme disease. Western blot and enzyme-linked immunosorbent assay (ELISA) tests are two methods that can be used to confirm the presence of Lyme disease. ELISA is used to detect the presence of antibodies of B. burgdorferi . In addition, the western blot is used to confirm if the ELISA test was done correctly. Western blot is used to detect the presence of antibodies of B. burgdorferi proteins ( Waddell et al., 2016) . 

Question 6 

The synovial fluid analysis showed a white count of 35,000. There are, however, other tests that can be performed on synovial fluid. Therefore, the health care practitioner will be in a position to conclude if there is an infection affecting the functionality of joints or not. One of these tests is the chemical test that is used to determine if there are changes in chemical constituents of the synovial fluid. The other test that can be used is the infectious disease test that reveals the presence of microbes causing the infection ( De Vecchi et al., 2016) . 

Question 7 

Correct nursing diagnosis prevents the adverse effects of the disease. There are five nursing interventions that should be considered. The nurse will assess the joints, any signs of swelling, difficulties when the patient is walking, and the pain experienced by the patient. The rationale behind this is that physical activity is connected to the swelling or inflammation of the affected area. As the second intervention, the nurse will encourage the patient and ensure that she takes about eight glasses of water. This will assist in eliminating uric acid in the body. Thirdly, the nurse will help the patient walk since this will assist in strengthening her muscles and improve joint functions. The nurse will also ensure that the patient takes her bed rest from time to time by providing adequate rest periods as well as night sleeps that are not interrupted. This will improve her strength and prevent any occurrences of fatigue. Finally, the nurse will ensure and encourage the patient to uphold erect posture or upright position when walking, sitting, or standing because this will ensure the optimal functioning of her knee of joint. 

References 

Aletaha, D., & Smolen, J. S. (2018). Diagnosis and management of rheumatoid arthritis: a review.  Jama ,  320 (13), 1360-1372. 

Cohen, K. R., Salbu, R. L., Frank, J., & Israel, I. (2013). Presentation and management of herpes zoster (shingles) in the geriatric population.  P & T : a peer-reviewed journal for formulary management ,  38 (4), 217–227. 

De Vecchi, E., Villa, F., Bortolin, M., Toscano, M., Tacchini, L., Romanò , C. L., & Drago, L. (2016). Leucocyte esterase, glucose and C-reactive protein in the diagnosis of prosthetic joint infections: a prospective study.  Clinical Microbiology and Infection ,  22 (6), 555-560. 

Hatchette, T. F., Davis, I., & Johnston, B. L. (2014). Lyme disease: clinical diagnosis and treatment.  Canada communicable disease report = Releve des maladies transmissibles au Canada ,  40 (11), 194– 208. doi:10.14745/ccdr.v40i11a01 

Holland, N. J., & Bernstein, J. M. (2014). Bell's palsy.  BMJ clinical evidence ,  2014 , 1204. 

Long, B., Koyfman, A., & Gottlieb, M. (2019). Evaluation and Management of Septic Arthritis and its Mimics in the Emergency Department.  Western Journal of Emergency Medicine ,  20 (2), 331. 

Murray, T. S., & Shapiro, E. D. (2010). Lyme disease.  Clinics in laboratory medicine ,  30 (1), 311–328. doi:10.1016/j.cll.2010.01.003 

Teparrukkul, P., Nilsakul, J., Dunachie, S., & Limmathurotsakul, D. (2017). Clinical Epidemiology of Septic Arthritis Caused by  Burkholderia pseudomallei  and Other Bacterial Pathogens in Northeast Thailand.  The American journal of tropical medicine and hygiene ,  97 (6), 1695–1701. doi:10.4269/ajtmh.17-0288 

Waddell, L. A., Greig, J., Mascarenhas, M., Harding, S., Lindsay, R., & Ogden, N. (2016). The Accuracy of Diagnostic Tests for Lyme Disease in Humans, A Systematic Review and Meta-Analysis of North American Research.  PloS one ,  11 (12), e0168613. doi:10.1371/journal.pone.0168613 

Wasserman, A. M. (2011). Diagnosis and management of rheumatoid arthritis.  American family physician ,  84 (11), 1245.