NURS 6521: Advanced Pharmacology
Week 6: Neurologic and Musculoskeletal Disorders
Sabrina is a 26 year old female who has just been diagnosed with multiple sclerosis. She has scheduled an appointment for a follow up with her physician but has several questions about her diagnosis and is calling the Nurse Helpline for her hospital network. As she talks with the advanced practice nurse, she learns that her diagnosis also impacts her neurologic and musculoskeletal systems. Although multiple sclerosis is an autoimmune disorder, both the neurologic and musculoskeletal systems will be affected by adverse symptoms that Sabrina needs to be aware of and for which specific drug therapy plans and other treatment options need to be decided on.

As an advanced practice nurse, what types of drugs will best address potential neurologic and musculoskeletal symptoms Sabrina might experience?
-SAMPLE ANSWER-
As an advanced practice nurse, it is important to be aware of the potential neurologic and musculoskeletal symptoms that a patient with multiple sclerosis, such as Sabrina, may experience and to recommend appropriate drug therapy options to address these symptoms.
For neurologic symptoms, some common drug therapy options include disease-modifying drugs, which are used to slow the progression of multiple sclerosis and reduce the frequency of exacerbations. These drugs include interferons, glatiramer acetate, teriflunomide, dimethyl fumarate, fingolimod, and natalizumab. Additionally, symptomatic drugs, such as muscle relaxants, antispasmodics, and anticonvulsants can be used to manage muscle spasms, spasticity, and neuropathic pain.
For musculoskeletal symptoms, physical therapy and occupational therapy can be beneficial to help improve muscle strength, coordination, and balance. Additionally, drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants may be used to help alleviate pain, stiffness and muscle spasms that commonly present in MS.
It’s important to note that each patient is unique and the symptoms experienced may vary from one individual to another, thus it’s very important to work with the patient’s physician to tailor the treatment to the patient’s specific needs and preferences. Additionally, there may be other treatments such as surgery, Helpive devices, and rehabilitation that may also be helpful for Sabrina’s case depending on the severity of her symptoms.
This week, you will evaluate patients for the treatment of neurologic and musculoskeletal disorders by focusing on specific patient case studies through a decision tree exercise. You will analyze the decisions you will make in the decision tree exercise and reflect on your experiences in proposing the recommended actions to address the health needs in the patient case study.

Learning Objectives
Students will:

Evaluate patients for treatment of neurologic and musculoskeletal disorders
Analyze decisions made throughout the diagnosis and treatment of patients with neurologic and musculoskeletal disorders
Justify decisions made throughout the diagnosis and treatment of patients with neurologic and musculoskeletal disorders
Learning Resources
Required Readings (click to expand/reduce)
Required Media (click to expand/reduce)
Assignment: Decision Tree for Neurological and Musculoskeletal Disorders
For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.

To Prepare
Review the interactive media piece assigned by your Instructor.
Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

By Day 7 of Week 8
Write a 1- to 2-page summary NURS 6521: Advanced Pharmacology paper that addresses the following:

Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.
-STUDY NOTES-
general information on how an advanced practice nurse would approach a patient with a neurologic and musculoskeletal disorder such as multiple sclerosis.
To address potential neurologic symptoms such as muscle weakness, spasticity, and balance problems, the advanced practice nurse may recommend medications such as muscle relaxants, antispasticity medications, and anti-inflammatory drugs, as well as physical therapy or occupational therapy to help improve muscle strength, coordination, and mobility.
To address potential musculoskeletal symptoms such as pain and stiffness, the advanced practice nurse may recommend medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids, as well as physical therapy or occupational therapy to help improve range of motion and alleviate pain.
In addition to drug therapy, the advanced practice nurse may also recommend other treatment options such as low-impact exercise and physical therapy, rehabilitation, and Helpive devices such as canes, crutches, or wheelchairs as appropriate to help the patient manage the symptoms associated with multiple sclerosis.
It is also important to note that these treatment recommendations would be tailored to the individual patient, taking into account factors such as comorbidities, co-existing medication usage and other considerations.
An advanced practice nurse would approach a patient with multiple sclerosis by assessing the patient’s symptoms and recommending drug and non-drug therapies that are most likely to be effective in addressing the patient’s neurologic and musculoskeletal symptoms. These recommendations are generally supported by evidence-based literature, and the goal is to help the patient manage symptoms and improve quality of life.
You will submit this Assignment in Week 8.

Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:

Please save your NURS 6521: Advanced Pharmacology Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.

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