13.4 Musculoskeletal Assessment
Open Resources for Nursing (Open RN)
Now that you reviewed the anatomy of the musculoskeletal system and common musculoskeletal conditions, let’s discuss the components of a routine nursing assessment.
Subjective Assessment
Collect subjective data from the patient and pay particular attention to what the patient is reporting about current symptoms, as well as past history of musculoskeletal injuries and disease. Information during the subjective assessment should be compared to expectations for the patient’s age group or that patient’s baseline. For example, an older client may have chronic limited range of motion in the knee due to osteoarthritis, whereas a child may have new, limited range of motion due to a knee sprain that occurred during a sports activity.
If the patient reports a current symptom, use the PQRSTU method described in the “Health History” chapter to obtain more information about this chief complaint. If the patient is experiencing acute pain or recent injury, focus on providing pain relief and/or stabilization of the injury prior to proceeding with the interview. Use information obtained during the subjective assessment to guide your physical examination. Sample focused interview questions to include during a subjective assessment of the musculoskeletal system are contained in Table 13.4a. The first question of the musculoskeletal interview is based on the six most common symptoms related to musculoskeletal disease.[1]
Table 13.4a Focused Interview Questions Related to the Musculoskeletal System
| Interview Questions | Follow-up |
|---|---|
| Are you experiencing any current musculoskeletal symptoms such as muscle weakness, pain, swelling, redness, warmth, or stiffness? | Describe your concern today.
How is it affecting your ability to complete daily activities? P: Does anything bring on the symptom such as activity, weight-bearing, or rest? If activity brings on the symptom, how much activity is required to bring on the symptom(s)? Does it occur at a certain time of day? Is there anything that makes it better or go away? Q: Describe the characteristics of the pain (aching, throbbing, sharp, dull). R: Is the pain localized or does it radiate to another part or area of the body? S: How severe is the pain on a scale of 0-10? T: When did the pain first start? Is it constant or does it come and go? Have you taken anything to relieve the pain? |
| Have you ever been diagnosed with a chronic musculoskeletal disease such as osteoporosis, osteoarthritis, or rheumatoid arthritis? | Please describe the conditions and treatments. |
| Have you ever been diagnosed with a neurological condition that affected the use of your muscles? | Please describe. |
| Have you had any previous surgeries on your bones or muscles, such as fracture repair or knee or hip surgery? | Please describe. |
| Are you currently taking any medications, herbs, or supplements for your muscles, bones, or the health of your musculoskeletal