Respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Student # 1 Christelle Franck St Thomas University NUR 418 Professor Rojas  9/11/2022 Gastrointestinal and Musculoskeletal Systems Gastrointestinal  Abdominal pain may present as a major symptom or cause for a wide range of pathologies. As a result, assessing abdominal pain requires the collection of relevant information to reach a proper diagnosis. According to Mehta (2016), demographic information, including gender and age, are significant history points for information that should be collected when assessing abdominal pain. Consequently, information regarding a description of the pain should be collected. This includes a description of the site, radiation, character, intensity, onset, frequency, associated features, time duration and precipitating or relieving factors (Mehta, 2016). Other complaints related to the gastrointestinal system should be considered during the assessment of abdominal pain. Such complaints include back pain, anorexia, vomiting, nausea and altered bowel habits, among others. Other complaints such as thoracic complaints including breathlessness, genitourinary problems including foul discharge and constitutional symptoms such as weight loss are relevant information when assessing abdominal pain (Mehta, 2016). Additionally, past history information, including similar episodes and admissions, pre-existing illnesses such as diabetes, heart disease and liver disease, as well as surgical history, obstetric history for women and medication history and allergies present as relevant information when assessing abdominal pain (Mehta, 2016). Masses in the abdomen can be assessed through physical examination or through the use of imaging modalities such as a CT scan and ultrasound. During a physical examination, the abdomen is inspected for obvious masses such as pregnancy, hernia and distended bladder, among others, and on confirmation, such masses should be examined. Additionally, one can assess masses in the abdomen through palpation, auscultation, and percussion (Reuben, 2016). A digital rectal examination can also be used to assess masses in the abdomen. Findings from an assessment of masses in the abdomen can be documented as bruits and rubs on auscultation, normal or abnormal abdomen contour on inspection, and resonance, tympany and dullness sounds on percussion (Reuben, 2016). Additionally, findings can be documented as palpable organomegaly on palpation. I previously encountered a patient presenting with abdominal pain where I palpated a mass. My findings were that there was a tender mass on the right lower quadrant of the abdomen. Tenderness and rebound tenderness on application and release of pressure was evident. Involuntary guarding was also evident on deeper palpation of the mass. The findings on palpation were consistent with acute appendicitis. Musculoskeletal According to Mohammed et al. (2020), r ...

1. Respond to at least two of your peers by extending,
refuting/correcting, or adding additional nuance to their posts.
Student # 1
Christelle Franck
St Thomas University
NUR 418
Professor Rojas
9/11/2022
Gastrointestinal and Musculoskeletal Systems
Gastrointestinal
Abdominal pain may present as a major symptom or cause for a
wide range of pathologies. As a result, assessing abdominal pain
requires the collection of relevant information to reach a proper
diagnosis. According to Mehta (2016), demograp hic
information, including gender and age, are significant history
points for information that should be collected when assessing
abdominal pain. Consequently, information regarding a
description of the pain should be collected. This includes a
description of the site, radiation, character, intensity, onset,
frequency, associated features, time duration and precipitating
or relieving factors (Mehta, 2016). Other complaints related to
the gastrointestinal system should be considered during the
assessment of abdominal pain. Such complaints include back
pain, anorexia, vomiting, nausea and altered bowel habits,
among others. Other complaints such as thoracic complaints
including breathlessness, genitourinary problems including foul
discharge and constitutional symptoms such as weight loss are
relevant information when assessing abdominal pain (Mehta,
2016). Additionally, past history information, including similar
episodes and admissions, pre-existing illnesses such as diabetes,
heart disease and liver disease, as well as surgical history,
obstetric history for women and medication history and
allergies present as relevant information when assessing

2. abdominal pain (Mehta, 2016).
Masses in the abdomen can be assessed through physical
examination or through the use of imaging modalities such as a
CT scan and ultrasound. During a physical examination, the
abdomen is inspected for obvious masses such as pregnancy,
hernia and distended bladder, among others, and on
confirmation, such masses should be examined. Additionally,
one can assess masses in the abdomen through palpation,
auscultation, and percussion (Reuben, 2016). A digital rectal
examination can also be used to assess masses in the abdomen.
Findings from an assessment of masses in the abdomen can be
documented as bruits and rubs on auscultation, normal or
abnormal abdomen contour on inspection, and resonance,
tympany and dullness sounds on percussion (Reuben, 2016).
Additionally, findings can be documented as palpable
organomegaly on palpation.
I previously encountered a patient presenting with abdominal
pain where I palpated a mass. My findings were that there was a
tender mass on the right lower quadrant of the abdomen.
Tenderness and rebound tenderness on application and release
of pressure was evident. Involuntary guarding was also evident
on deeper palpation of the mass. The findings on palpation were
consistent with acute appendicitis.
Musculoskeletal
According to Mohammed et al. (2020), rheumatoid arthritis and
osteoarthritis are the two common forms of arthritis, a disease
of the joints. On one hand, rheumatoid arthritis occurs after the
joints are attacked by the immune system, causing
inflammation, hence the thickening of the tissues that line the
joints. The consequent symptoms are pain and swelling at and
around the joints, causing permanent disability. Environmental
and genetic factors have been identified as the common
etiological factors for rheumatoid arthritis (Mohammed et al.,
2020). For instance, women have been found to be more likely
to develop rheumatoid arthritis than men, and advanced age,
between the age of 40 and 60 years, increases one’s likelihood

3. of developing rheumatoid arthritis. Additionally, the presence
of smoking and family history are environmental factors that
predispose one to rheumatoid arthritis (Mohammed et al., 2020).
In contrast, osteoarthritis is a degenerative disease
characterized by the breaking down of cushions or cartilages at
the joints, consequently leading to stiffness, swelling and pain.
Some etiological factors of osteoarthritis include gender, age,
genetics, race, obesity and overuse of or injury at the joint
(Mohammed et al., 2020). Physical examination by assessing
the range of motion of the joints is used to diagnose
osteoarthritis, and this diagnosis can be confirmed through
imaging modalities such as MRI or X-ray. Additionally, while
rheumatoid arthritis mostly affects the small joints of the feet
and hands, osteoarthritis mostly affects weight-bearing joints
such as those of the hips and knees (Mohammed et al., 2020).
References
Mehta, H. (2016).
Clinical Pathways in Emergency Medicine, 329–345.
https://doi.org/10.1007/978-81-322-2710-6_26 (Links to
an external site.)
Mohammed, A., Alshamarri, T., Adeyeye, T., Lazariu, V.,
McNutt, L., & Carpenter, D. O. (2020). A comparison of risk
factors for osteo- and rheumatoid arthritis using NHANES data.
Preventive Medicine Reports,
20, 101242.
https://doi.org/10.1016/j.pmedr.2020.101242 (Links to
an external site.)
Reuben, A. (2016). Examination of the abdomen.
Clinical Liver Disease,
7(6), 143-150.
https://doi.org/10.1002/cld.556
Student # 2
Aimee Alonso
St Thomas University
NUR-418-AP2
Rafael Rojas

4. 9/12/2022
Part 1 GI system:
The gastrointestinal system is formed by a group of organs
which objective is to digest the aliments and transform it into
energy sources and substances essential for the body function.
The digestive system also gets rid of the substance that the body
no longer need. This system is composed by, mouth, pharynx
(throat), esophagus, stomach, small intestine, large intestine,
rectum, and anus. In addition, it includes the salivary glands,
liver, gallbladder, and pancreas, which produce digestive jui ces
and enzymes used during digestion.
In nursing, it is important to know how to assess the
digestive system since is different from the rest of the body.
When a patient conducting a physical assessment in a patient
complaining of pain, the first step is to find the location of the
pain severity and aggravating factors. Next we have to find
valuable information about patient present and past medical
history, surgery history, hernias, previous diagnosis. We ask
about bowel and urinary habits and if the patient is a female in
the child-bearing age it is important to discard a pregnancy or if
pregnancy is present, we need to rollout any rupture of
membranes or any complication. Make a comprehensive list of
relevant information to gather when assessing abdominal pain
(Wahila et al.,2018).
After we complete the chief complaint, we proceed to inspect
the abdomen looking for any redness bruise, swelling etc. the
following step is to auscultate following by percussion. Right
after we do palpation starting for the forest quadrant were the
pain is located, we feel for any mass that might indicate hernia
or malignancy. In case that a mass is found we assess the
supraclavicular and inguinal nodes, inspect for any scar or
indication of past surgeries, asymmetrical movement to the eye
level etc. After, we proceed to refer the patient for other exams
like abdominal CT scans, ultrasounds, Mantoux test and any

5. other exam indicated by the physician to discard malignancy or
further investigation. Physical examination is very important
because we are able to see and feel what the patient might not
tell you. Not to long ago I had a patient being evaluated for
kidney transplant that denied any concerned medical history and
malignant diagnosis when being screened for transplant and
when I brought him to the office I was able to find an
abdominal mass located on his left upper quadrant and turned
out to be malignant. Unfortunately, this patient was unable to
continue with transplant evaluation until he get that issue taking
care of and confirm benign.
Part 2 Musculoskeletal:
Osteoarthritis (OA) is the most common form of arthritis. It
occurs most frequently in the hands, hips, and knees. With OA,
the cartilage within a joint begins to break down and the
underlying bone begins to change. These changes usually
develop slowly and get worse over time. OA can cause pain,
stiffness, and swelling. In some cases, it also causes reduced
function and disability; some people are no longer able to do
daily tasks or work.
Rheumatoid arthritis is a disease in which the joints become
inflamed, causing pain, deformity and difficulty in movement,
although it can also affect other parts of the body. It is a
chronic disease, with a low frequency of spontaneous healing,
although with proper treatment good control of the disease is
achieved in most cases.
While OA usually develops after years of wear and tear on
cartilage, people with RA may have it earlier in life due to
causes such as sports injuries that result in damage to the
cartilage, joints, or ligaments (2021).

6. References
Wahila, R., Odimba, E., & Ngoma, C. (2018). Developing a
pain assessment tool for patients after major abdominal surgery.
British Journal of Nursing (Mark Allen Publishing), 27(9), 503–
507.
https://doi.org/10.12968/bjon.2018.27.9.503 (Links to
an external site.).
June,2022. What's the Difference Between Rheumatoid Arthritis
and Osteoarthritis?,
Healthline https://www.healthline.com/health/rheumatoid-
arthritis/ra-vs-oa#treatment
Respond to at least two of your peers by extending,
refuting/correcting, or adding additional nuance to their posts.
Student # 1
Arronte George
NUR-416: Nursing Research & Evidence-Based Practice
St. Thomas University
Instructor: Lisbet Henriquez
September 14, 2022
Your Experience & Weekly Research Articles
Searching for articles has been a significant experience that has
exposed me to the knowledge of how research has been rich in
the field of psychiatric nursing. That is because at first, I
assumed that it was a field that was not prioritized in research
and not many articles were published regarding the area field.
However, upon researching every week I have realized more

7. articles are investigating various aspects or issues of psychiatric
nursing than I could ever imagine. I have been using various
databases for the search process. For instance, I have used the
NCBI, PubMed, Ebsco, and Wiley Online Library, among other
databases to aid in the search. One thing that I have discovered
with the search is to e more specific on the search words used to
ensure that the research articles found address the issue one
wish to explore. The databases also provide the option of
discovering more articles related to the one found.
Additionally, I have also found that many of the articles have
almost similar findings when researching similar issues. For
instance, all the articles I have reviewed so far address the
issues or challenges faced by psychiatric nurses in their work
environment. The findings in all the articles were similar. For
instance, all the articles found that violence and assault was risk
factor for psychiatric nurses. So far, I would say that all the
articles provided useful information for my clinical practice.
For instance, one of the articles I found useful for my clinical
was an investigation by Shahrour et al. (2022). In this article,
the researchers investigated how healthcare institutions could
participate in reducing stress levels and violence among
psychiatric nurses. This information is useful for my nursing
practice because it provides a foundation that could be used by
fellow psychiatric nurses to advocate for changes in the clinical
practice.
The article suggested that health institutions should provide
support services for psychiatric nurses (Shahrour et al., 2022).
This is important information for my clinical practice because it
informs of the changes that I could propose for organizational
change. Also, helping psychiatric nurses cope with stress and
violence in the workplace is important because it would reduce
turnover rates and also improve interest in working in
psychiatric wards.
Besides that, I also came across various articles that were not
helpful for my clinical practice. However, this was not often
based on the criteria I have adopted for the research of articles.

8. For instance, I came across an article about a prospective study
conducted by Doedens et al. (2021) that claimed that there were
higher rates of seclusion of mental health patients when female
nurses were on shift than when male nurses were on shift. I
would say that this information was not useful in my practice
because I have witnessed that violence from mental health
patients is not determined by the gender of a nurse. That is
because every nurse is at risk of violence, either verbal or
physical.
References
Doedens, P., Ter Riet, G., Vermeulen, J., Boyette, L. L., Latour,
C., & de Haan, L. (2021). Influence of nursing staff
characteristics on seclusion in acute mental health care-A
prospective two-year follow-up study. Archives of Psychiatric
Nursing, 35(5), 491–498.
https://doi.org/10.1016/j.apnu.2021.07.003
(Links to an external site.)
Shahrour, G., Taha, I., Ali, A. M., & Alibrahim, M. (2022). The
moderating role of social support on workplace violence and
stress among psychiatric nurses. Nursing Forum.
https://doi.org/10.1111/nuf.12792

9. Student # 2
Milaine Garcia
St. Thomas University
NUR 416 AP 2
Instructor Lisbet Henriquez
September 15, 2022
My Experience & Weekly Research Articles
Research is an essential component of the healthcare
industry, particularly the nursing profession. High-quality,
evidence-based nursing care is founded on research. As a health
insurance case manager, my job entails interacting with
members and providers. I have to educate my members and help
coordinate their care. My job is to provide the members with a
smooth transition and assist in meeting their healthcare needs.
To give the best care possible, I must stay current on the newest
medical findings and recommendations. I continuously strive to
gather data that will assist me to perform services more
effectively in addition to being accurate. To stay current, I rely
on research publications and nursing journals.
My experience looking for research articles has been
positive. I believe these assignments have helped me become a
more informed nurse. In the beginning, it was difficult to find
articles that relate to my practice and met the requirements set
by STU. With time, I began to learn which databases were
factual and accurate, and which keywords to utilize to facilitate
my search. I now use Google Scholar, STU library database, and
PubMed to locate the articles of interest. Since starting to use
those sites, I have been able to locate articles more easily and
efficiently. There are several guidelines I have set in place
when looking for an article. These guidelines include the
publication date, the setting in which the article was written,
clinical importance, and how it will influence my role as a
nurse. Since the healthcare field is constantly evolving, it is

10. important that the articles selected are written no more than 5
years ago. This ensures the findings learned from the article are
current and appropriate for use in my practice.
Even though all the articles I have read while completing
my assignments have contained at least one thing that has been
beneficial to my practice, the article I chose for my first article
summary has been the most beneficial. This one discussed the
sociodemographic and clinical factors that were associated with
diabetes mellitus type 2 patients' adherence to self-care
activities (Portela et al., 2022). Since the population I work
with has a high incidence of diabetes mellitus type 2, it is
important for me to understand what makes them adhere the
most to self-care activities. I learned from this article that
individuals were less consistent with their diet, exercise, and
blood glucose monitoring. I also learned that persons were
particularly devoted to their foot care and medication regimens.
This information benefits my practice since I now know which
activities to focus my teachings on and emphasize their
importance. I believe an article that has not been helpful is the
one I chose for my article 3 summary. This article discusses the
effectiveness of case management in blood pressure reduction
(Mantovanil et al., 2021). Even though the results of the article
demonstrated that case management has an effect on blood
pressure reduction, I did not learn any new information that can
be applied to my practice. Overall, the weekly article summaries
have helped me develop my skills as a researcher and a nurse.
References
Mantovanil, M. D. F., Kalinke, L. P., Da Silva, N. T. M., Perez
Arthur, J., Radovanovic, C. A. T., & Bortolato-Major, C. (2021,
March 3). Effectiveness of nursing case management versus
usual care for blood pressure control in adults with
hypertension: A systematic review. Investigación Y Educación
En Enfermería, 39(1).
https://doi.org/10.17533/udea.iee.v39n1e04

11. Portela, R. D. A., Silva, J. R. S., Nunes, F. B. B. D. F., Lopes,
M. L. H., Batista, R. F. L., & Silva, A. C. O. (2022). Diabetes
mellitus type 2: Factors related to adherence to self-
care. Revista Brasileira de Enfermagem, 75(4).
https://doi.org/10.1590/0034-7167-2021-0260