Prioritization rationale for neuro v. musculoskeletal assessment...

[ICUchick]

Hello everyone!

I am working on a paper for health assessment and am having some trouble with the area where I have to give a detailed rationale for why I would perform one assessment before the other. The scenario is as follows:

Our patient today is a pleasant 28 year old well groomed female of African American descent with a strong connection to her Jehovah Witness faith. Patient is alert, oriented and presenting with complaints of frequent headaches that are sometimes accompanied by dizziness. During the interview patient also mentioned that for the past couple of weeks she has experienced pain and stiffness in her legs when waking in the morning.

I have decided it is necessary to perform a neuro and musculoskeletal assessment and have come up with my list of age and cultural considerations. I have also prepared subjective questions for each system to be assessed and determined that the neuro should be a priority.

My hold up is explaining why in professional terms. I know neuro should be first...I know that my patient is young and not likely at risk for a stroke or something of that nature but pain and dizziness could indicate a more serious problem. I'm supposed to relay why it is more important than the musculoskeltal but simply I just dont feel that the pain and stiffness is anything life threatening and headaches could potentially have very severe consequences!

Can anyone help me put this together?

Thanks in advance...I truly appreciate it!

[Esme12, ASN, BSN, RN]

You are correct with the thought of a neurological diagnosis....but stroke are not the only neurological/muscular diseases to be aware of. The is Multiple Sclerosis, ALS (Amyotrophic Lateral Sclerosis), Lupus, meningitis, brain tumors, AVM (Arterial/Vensous malformations) and aneurysms....etc Does the pateints race have any involvement in the thought process.

For priority think what can kill the patient first. What do you think??