NURS-6501-WEEK 8 Case Study: a 45-year-old male who presents with acute onset lower back pain after bending to lift a light object at home.
NURS-6501-WEEK 8
CASE STUDY – MSK
PATIENT CASE SCENARIO
Patient: A.T.
Age: 45 years
Sex: Male
Date of Birth: 05/14/1980
Date of Injury (DOI): 04/10/2026
Date of Visit: 04/12/2026
Chief Complaint
“Severe lower back pain after lifting.”
History of Present Illness
The patient is a 45-year-old male who presents with acute onset lower back pain after bending to lift a light object at home. He reports hearing a “pop” followed by immediate sharp pain localized to the mid-lower back. He denies any fall, direct trauma, or heavy lifting at the time of injury.
Over the past 6–8 months, he reports:
• Progressive back stiffness
• Diffuse bone pain
• Fatigue and decreased strength
• Reduced exercise tolerance
• Noted height loss
He states:
“This didn’t feel like a normal lifting injury.”
Past Medical History
• Chronic moderate-to-severe asthma
Medications
• Long-term oral corticosteroids (prednisone)
• Intermittent inhaled corticosteroids
• OTC supplements
Social History
• Recreational power lifting
• Sedentary outside of training
• Limited sun exposure (indoor occupation)
• Low intake of calcium-rich foods
• Former smoker
Family History
• Father with fracture in his 50s
REVIEW OF SYSTEMS (ROS)
General:
Fatigue, decreased endurance, unintentional height loss
Musculoskeletal:
Back pain, stiffness, diffuse bone aches
Neurological:
Denies numbness, tingling, weakness, or bowel/bladder dysfunction
Endocrine:
Reports fatigue and decreased strength
Respiratory:
History of asthma, no acute distress
Cardiovascular:
Denies chest pain or palpitations
PHYSICAL EXAMINATION
General:
Alert, appears uncomfortable with movement
Vital Signs:
BP: 128/82
HR: 74
RR: 16
Temp: 98.6°F
BMI: 30
Musculoskeletal:
• Point tenderness over thoracolumbar region
• Pain with spinal flexion and extension
• Limited range of motion due to pain
• No visible deformity
Neurological:
• Strength 5/5 bilateral lower extremities
• Sensation intact
• Reflexes normal
• No focal neurological deficits
CLINICAL CONCERN
The presentation is concerning for a low-impact vertebral compression fracture, suggesting underlying bone fragility rather than mechanical injury.
*Follow the rubric and check again before you submit your final work
1. Describe the primary pathophysiological mechanisms contributing to this patient’s
fracture.
2. Explain how the patient’s symptoms support bone fragility rather than isolated
mechanical injury.
3. Identify the most likely underlying condition and justify your reasoning.
“Describe the role genetic mutations play in the development of the disease and the risk factors that make
the patient more susceptible”
1. Discuss the role of genetic predisposition in bone density and fracture risk.
2. Identify and explain patient-specific risk factors, including corticosteroid use, nutrition,
and lifestyle.
3. Explain how these factors contribute to the patient’s condition.
Rubric Criterion 3 – History/Lifestyle and Clinical Differentiation (25 points)
Rubric language:
“Explain any racial/ethnic variables that may impact physiological functioning AND explain factors in
the patient’s history and lifestyle that could have contributed to the development of the disease process”
1. Analyze how lifestyle factors contributed to decreased bone integrity.
2. Discuss how population-level variables may influence bone health.
3. Distinguish between:
o Osteoporosis vs mechanical injury
o Osteoporosis vs osteoarthritis
The Assignment (1- to 2-page case study analysis)
Develop a 1- to 2-page case study analysis by answering the questions provided following the case scenario.
By day 7 of Week 8
Submit your Case Study Analysis Assignment by Day 7 of Week 8.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templatesLinks to an external site.). All papers submitted must use this formatting.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK8Assgn2_LastName_Firstinitial
Develop a 1-2 page case study analysis, examining the patient signs and symptoms presented in the case study. Discuss the primary pathophysiological processes and the significance for symptom development and diagnosis.
30 to >27.0 pts
Excellent
The response discusses the primary pathophysiological processes, and the significance for symptom development and diagnosis in detail. The pathophysiology is accurate and responses show in depth critical thinking.
27 to >24.0 pts
Good
The response discusses the primary pathophysiological processes, significance for symptom development and the diagnosis in some detail. The pathophysiology is accurate and the responses show come critical thinking.
24 to >22.0 pts
Fair
The response discusses the primary pathophysiological processes, significance for symptom development and diagnosis in a manner that is vague or inaccurate. The response is supported with explanations that are vague or based on inappropriate evidence or research.
22 to >0 pts
Poor
The response discusses the primary pathophysiological processes, the significance for symptom development and diagnosis in a manner that is vague and/or inaccurate or the description is missing. The response does not include rationales, has vague explanations or is based on inappropriate or no evidence or research.
30 pts
This criterion is linked to a Learning OutcomeDescribe the role genetic mutations play in the development of the disease and the risk factors that make the patient more susceptible to the disease.
30 to >27.0 pts
Excellent
The response includes an accurate, complete, detailed and specific analysis of the genes/risk factors that are associated with the development of the disease.
27 to >24.0 pts
Good
The response includes an accurate analysis of the genetics and risk factors that may be associated with the development of the disease. Response does not fully address all factors.
24 to >22.0 pts
Fair
The response includes a vague or inaccurate analysis of the genetics/risk factors that are associated with the development of the disease.
22 to >0 pts
Poor
The response includes a vague or inaccurate analysis of the genetics/risk factors that are associated with the development of the disease and/or portions are missing.
30 pts
This criterion is linked to a Learning OutcomeExplain any racial/ethnic variables that may impact physiological functioning. Explain factors in the patient’s history and lifestyle that could have contributed to the development of the disease process.
25 to >22.0 pts
Excellent
The response includes an accurate, complete, detailed and specific explanation of racial/ethnic variables that may impact physiological functioning. Explain factors in the patient’s history and lifestyle that could have contributed to the development of the disease. Content is supported by evidence and/or research, as appropriate, to support the explanation.
22 to >19.0 pts
Good
The response includes an accurate explanation of racial/ethnic variables that may impact physiological functioning. Explains factors in the patient’s history and lifestyle that could have contributed to the development of the disease. Content is supported by evidence and/or research, as appropriate, to support the explanation.
19 to >17.0 pts
Fair
The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning. A vague or inaccurate explanation of factors in the patient’s history and lifestyle that could have contributed to the development of the disease and/or explanations based on inappropriate evidence/research.
17 to >0 pts
Poor
The response includes a vague or inaccurate explanation of racial/ethnic variables that may impact physiological functioning. A vague or inaccurate explanation of factors in the patient’s history and lifestyle that could have contributed to the development of the disease, or the explanations are based on inappropriate or no evidence/research.
25 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. Content is supported by at least 3 current evidence-based sources. Body of paper is no more than 2 pages in length.
5 to >4.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. Content is supported by 3 current evidence-based sources which have been submitted with the assignment. Body of the paper is no more than 2 pages in length.
4 to >3.0 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Some content is supported by 3 current evidence-based sources. Body of paper is no more than 2 pages.
3 to >2.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity and clarity 60%-79% of the time. Some content is supported by at least 2 current evidence-based sources. Body of paper is longer than 2 pages.
2 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors.
4 to >3.0 pts
Good
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
3 to >2.0 pts
Fair
Contains several (3 or 4) grammar, spelling, and punctuation errors.
2 to >0 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
5 to >4.0 pts
Excellent
Uses correct APA format with no errors.
4 to >3.0 pts
Good
Contains a few (1 or 2) APA format errors.
3 to >2.0 pts
Fair
Contains several (3 or 4) APA format errors.
2 to >0 pts
Poor
Contains many (≥ 5) APA fo
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