Decision Tree for Neurological and Musculoskeletal Disorders

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Decision Tree for Neurological 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?

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.Decision Tree for Neurological and Musculoskeletal Disorders

Assignment: Decision Tree for 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.

According to prior research it is revealed mental disorders are characterized with series of disturbances causing distraction while performing day to day activities. Some of the affected human behaviors include mood, thinking, and mood. This paper will expound on presented case study that involves a 26-year-old female by the name Sabrina. This client is diagnosed with multiple sclerosis. More so, with efforts to reach out a physician she discovers that sclerosis impacts her neurologic and musculoskeletal system. Lastly, the paper will make possible clinical assessments and treatment for the patient. Still, it will answer three decisions concerning the patient treatment and diagnosis.


In the presented case study, the patient will be assessed by the provider to diagnose the patient with probable illnesses. For instance, the patient is likely to have dementia or Alzheimer’s disease. Dementia condition requires presence of two cognitive functions that are likely to completely affect individuals’ daily activities such as memory loss and virtual perception (Lindeza et al., 2020). In fact, there is no distinctive medical test and therefore medics will perform various assessment such as neurophysiological examination and cognitive test (Feinstein et al., 2020). More so, neurological evaluation can be applicable in testing balance, skill and problem solving. In addition, the provider will conduct brain test for signs such as tumor and CT scan can be used to show signs of Alzheimer’s disease Decision Tree for Neurological and Musculoskeletal Disorders

Decision one: start taking Donepezil (Aricept) 5 mg during bed time

My initial step is to start taking Donepezil (Aricept) 5 mg during bed time. This proposal was critically arrived since it is used as a treatment remedial for dementia linked with Alzheimer disease. The main aim choosing decision was primarily to improve awareness, memory, and ability to function. In this case, the Donepezil medication act as an enzyme blocker that aid in restoring balance in neurotransmitters found in the brain (Kabir et al., 2019). Importantly, the patient is recommended to take Donepezil drug before going to bed since it may cause slow heartbeat that may lead to fainting (Benek, Korabecny & Soukup, 2020). In fact, when taken during this time the patient will be able to sleep well without experiencing such side effects.

Decision two: increase Donepezil (Aricept) 5 mg to 10 mg during bed time

My second decision to the patient is to increase Donepezil (Aricept) 5 mg to 10 mg during bed time. At this time the patient revealed positive result as anticipated while taking the medication. My primary aim proposing this decision is to maintain and manage patient condition to come to normal range. However, an increase in dosage will improve the condition without creating much side effects as well as allowing the patient to regain mental stability. Even though this decision is critically arrived in regard to medical grounds assessed to the patient to optimize significant outcome in treatment.

Decision three: maintain Donepezil (Aricept) 10 mg during bed time

In my third decision the patient will maintain Donepezil (Aricept) 10 mg during bed time. After patient return to the clinic, there is a continues progress and achieving normal condition. My aim at issuing this decision is to enable the patient receive complete dosage since the client does not complain persistent side effects caused by the drug. This remains an outstanding decision towards patient recovery allowing to have normal neurotransmitters responses in the brain.

My reflection to the presented case is to recommend Donepezil (Aricept) 5 mg at the beginning. Thereafter, the patient will get an increase dosage since the medication does not create effects to patient experience. In this case, the initial dosage revealed positive outcome. Then, following a follow up the patient will stick to the medication for a complete recovery. In fact, after responding treatment as per the highlighted decisions the patient will get ability to remember and communicate as well as conducting daily activities.Decision Tree for Neurological and Musculoskeletal Disorders


Feinstein, A., Amato, M. P., Brichetto, G., Chataway, J., Chiaravalloti, N., Dalgas, U., … & CogEx Research Team. (2020). Study protocol: improving cognition in people with progressive multiple sclerosis: a multi-arm, randomized, blinded, sham-controlled trial of cognitive rehabilitation and aerobic exercise (COGEx). BMC neurology, 20, 1-16.

Kabir, M. T., Uddin, M., Begum, M., Thangapandiyan, S., Rahman, M., Aleya, L., … & Ashraf, G. M. (2019). Cholinesterase inhibitors for Alzheimer’s disease: multitargeting strategy based on anti-Alzheimer’s drugs repositioning. Current pharmaceutical design, 25(33), 3519-3535.

Benek, O., Korabecny, J., & Soukup, O. (2020). A perspective on multi-target drugs for Alzheimer’s disease. Trends in Pharmacological Sciences.

Lindeza, P., Rodrigues, M., Costa, J., Guerreiro, M., & Rosa, M. M. (2020). Impact of dementia on informal care: a systematic review of family caregivers’ perceptions. BMJ Supportive & Palliative Care.Decision Tree for Neurological and Musculoskeletal Disorders