Below I have 2 posts please provide a response for both. 150 words each with reference.
Part 1
Your response to your peers by extending, refuting/correcting, or adding additional nuance to their posts.
Gastrointestinal and Musculoskeletal Assessment
GI
Make a comprehensive list of relevant information to gather when assessing abdominal pain
When assessing abdominal pain, patients should be asked about the severity, onset, quality, and duration of pain as well as worsening and relieving factors. . Information on the location of the pain is useful at the start of the interview as it guides in further evaluations (Hall, 2017). Also, information about associated signs and symptoms should be gathered as it helps in predicting certain causes of abdominal pain. Information on the pain’s radiation and movement should also be gathered to help rule out some conditions. For example, abdominal pain that is associated with appendicitis usually moves from the periumbilical area of the abdomen to the right lower quadrant of the abdomen. Patients should also be asked whether they have been taking nonsteroidal anti-inflammatory drugs recently.
How do you assess for masses in the abdomen and how you would document such findings?
The sequence of assessing a patient’s abdomen is inspection, auscultation, percussion, and palpation the sequence should be followed during assessment since changing the order could lead to altering bowel sounds frequency. The patient should empty his or her bladder and lie supine with his or her abdomen exposed. The first step should be to observe the abdomen from the xiphoid process to the symphysis pubis and from the side and from above and assess for any visible mass (Hall, 2017). All the four quadrants of the abdomen should then be lightly percussed and large dull areas may indicate mass or tumor. If the assessment is normal then it would be documented as Abdomen is soft, symmetric, and non-tender without distention.
Describe your findings on a previous patient that you have encountered where you have palpated a mass in the abdomen
I once encountered a patient who complained of abdominal pain. Upon abdominal assessment, a mass was palpated in her abdomen. The patient had visible bulging in her abdomen. During light percussion, dull sounds were heard over solid abdominal structures like the liver and air-filled areas like the stomach-produced tympany. A large dull area was present in the right upper quadrant, and this indicated a mass or a tumor.
Musculoskeletal
Define, Compare, and Contrast the following conditions: Osteoarthritis and Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a long-term immune disorder, and it mainly affects joints (Firestein & McInnes, 2017). It is characterized by warm, painful, stiff, and swollen joints. Pain and stiffness aggravate after a rest and the condition mainly affects the joints in the wrists and the hands and its effects are experienced bilaterally. Osteoarthritis (OA) is a common form of arthritis that occurs when flexible tissues at the end of bones wear down over time. The wearing-down process occurs gradually and gets worse with time. OA is characterized by joint pain in the lower back, hands, hips, knees, and neck.
OA and RA have basic symptoms such as stiff and painful joints, warmth and tenderness, and increased intensity of symptoms in the morning. RA and OA are also similar in that they are common in women than in men (Roth, 2020).
The main difference between RA and OA is their causation. While RA is an immune disorder that causes fluid to accumulate within joints causing swelling, pain, stiffness, and inflammation, OA is a degenerative joint disorder where the cartilage that cushion joints break down causing bones to rub each other hence exposing small veins and causing pain (Roth, 2020). Also, RA and OA differ in that OA is more prevalent in old adults while RA can develop at any age and RA is a systemic disease that can affect the entire body causing symptoms such as muscle aches, fever, excess fatigue, and lumps underneath the skin near joints if the condition is advanced while the symptoms of OA are restricted to joints.
References
Firestein, G. S., & McInnes, I. B. (2017). Immunopathogenesis of rheumatoid arthritis. Immunity, 46(2), 183-196.
Hall, C. (2017). Back to basics: Abdominal assessments. Australian Midwifery News, 17(2), 17.
Roth, E. (2020, August 6). Is it rheumatoid arthritis? The differences between RA and OA. Healthline. Retrieved September 13, 2021, from https://www.healthline.com/health/rheumatoid-arthritis/ra-vs-oa.
Below I have 2 posts please provide a response for both. 150 words each with reference.
Part 2
Your response to your peers by extending, refuting/correcting, or adding additional nuance to their posts.
Gastrointestinal and Musculoskeletal
Gastrointestinal:
Q1:
There are many causes of abdominal pain, and hence it is necessary to obtain comprehensive patient history and do a physical examination to gather information for an appropriate diagnosis. The information to be collected include location, intensity, quality, onset, alleviating factors, relieving factors, radiation of the pain, timing, and any other associated symptoms such as fatigue or fever (Dunlap & Patterson). It is also critical to inquire about urinary and bowel habits. For female patients, it is essential to inquire about their sexual and menstrual history (Dunlap & Patterson). In addition to this medical and social history, medications, hospitalizations, and surgery are needed in assessment (Dunlap & Patterson).
Q2:
Four techniques are used to assess for abdominal masses. They include inspection, percussion, auscultation, and palpation. Inspection is done when the patient is in a supine position. The abdomen is observed at different angles to determine the presence and location of intraabdominal masses (Reuben, 2016). Auscultation is done using a stethoscope. It is used to hear rubs that indicate abdominal masses (Reuben, 2016). Palpation involves gently touching the abdomen using fingertips. Palpation is used to determine the location, size, tenderness, and mobility of intraabdominal masses (Reuben, 2016). Percussion is used to determine the presence of abdominal masses. It looks for dull sounds, which are an indicator of abdominal masses (Reuben, 2016). An example of documentation is the abdomen is soft, symmetrical, non-tender. No masses present. Bowel sounds are normal on all quadrants.
Q3:
A large mass was palpated on the left lower quadrant. The abdomen was tender and distended.
Musculoskeletal
Definition
Osteoarthritis is a form of arthritis in which there is a gradual degeneration of the protective cartilage, which cushions bone ends (Roy et al., 2019). It is “wear and tear” arthritis. It mostly occurs in the knees, hands, and hips (Roy et al., 2019). On the other hand, rheumatoid arthritis is an autoimmune condition in which the body produces an inflammatory activity against its cells (Roy et al., 2019). This inflammation damages joints such as the wrists, hands, and knees (Roy et al., 2019).
Comparison
Both infections affect the joints. They have some similar symptoms, such as joint pain and stiffness in the affected joints.Both diseases do not have a cure, but some medications can be given to ease the symptoms.
Contrast
In rheumatoid arthritis, there is an abrupt onset of symptoms, while osteoarthritis has a gradual onset (Arve, 2021). The second difference is that osteoarthritis affects individuals at the later stages of life, while rhumatoid arthritis can affect a person at any stage of life. Osteoarthritis is limited only to the affected joints, while rheumatoid arthritis affects the entire body and other organs such as the eyes (Arve, 2021). Individuals with osteoarthritis have little or no swollen joint while rheumatoid presents with swollen joints.In osteoarthritis, the morning stiffness typically lasts for an hour, returning after physical activity or the end of the day (). In RA, the stiffness lasts for more than one hour, with the symptoms of fatigue and tiredness being present throughout the day (Arve, 2021)
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