Musculoskeletal and neurologic disorders can present complications for pediatric patients from infancy to adolescence. These disorders affect patients physically and emotionally and often impact a patient’s ability to participate in or carry out everyday activities. Patients with these disorders frequently need long-term treatment and care requiring extensive patient management and education plans. Musculoskeletal and neurologic disorders present various symptoms because they affect multiple parts of a patient’s body. Consider treatment, management, and education plans for the patients in the following three case studies.

Case Study 1:

Clay is a 7-year-old male who presents in your office with complaints of right thigh pain and a limp. The pain began approximately 1 week ago and has progressively worsened. There is no history of trauma. Physical examination is negative except for pain with flexion and internal rotation of the right hip and limited abduction of the right hip. Limb lengths are equal.

Case Study 2:

Trevon is an 18-month-old with a 3-day history of upper-respiratory-type symptoms that have progressively worsened over the last 8 hours. His immunizations are up to date. Mom states he spiked a fever to 103.2°F this morning and he has become increasingly fussy. He vomited after drinking a cup of juice this afternoon and has refused PO fluids since then. Pertinent physical exam findings include negative abdominal exam, marked irritability with inconsolable crying, and he cries louder with pupil examination and fights head and neck assessment. You are unable to elicit Kernig’s or Brudzinski’s signs due to patient noncompliance.

Case Study 3:

Molly is a 12-year-old who comes to your office after hitting her head on the ground during a soccer game. Her mother reports that she did not lose consciousness, but that she seems “loopy” and doesn’t remember what happened immediately following her fall. She was injured when she collided with another player and fell backward, striking her head on the ground. She has no vomiting and denies diplopia but complains of significant headache. Physical examination is negative except for the presence of slight nystagmus. All other neurologic findings including fundoscopic examination are normal.

To prepare:

• Review “Neurologic Disorders” and “Musculoskeletal Disorders” in the Burns et al. text.
• Review and select one of the three provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the musculoskeletal or neurologic disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the musculoskeletal or neurologic disorder.

Saving Our Fiscal ShipI have created a long and complex assignment that puts you in charge of attending to the long-term health and wellbeing of the United States of America (!). Utilizing a simulation created for the Brookings Institution called The Fiscal Ship you will learn about the relationships that exist between federal decision-makers and the myriad policy decisions they make. Given the dire condition of the federal debt and ongoing levels of deficit spending you are tasked with no less than saving the country by mid-century!(Spend a few minutes examining the federal debt by clicking on this link:http://www.usdebtclock.org/(Links to an external site.)Links to an external site.)(Links to an external site.)Links to an external site.(Links to an external site.)Links to an external site.BackgroundThe interplay of governing institutions and the making of public policy is at the heart of what we study in Module 2. As we will see typically what we know about politics and policymaking is pretty far removed from the actual practices of politics. Separation of powers with checks and balances produces the executive legislative and judicial branches of government; while it does not create coequal branches of government it does prevent any one branch from dominating the others. These governing institutions are inherently political. They produce policies that allocate relative advantage and disadvantage meaning that there are winners and losers with every decision government makes. It makes sense then that there are forces pressuring these institutions to maximize advantages or to minimize disadvantages.Americans are raised with a naive kind of assumption that government should do whats best for the people a notion that ignores the role of political parties interest groups powerful stakeholders and ideological preferences in the policymaking processes. It is true that the American political system works more effectively when bipartisan compromises can be reached. This is so because a sizable portion of the governed feels better represented when such compromises are made. However todays political environment offers few opportunities for bipartisan responses to important public policy priorities. The political divide in Washington DC is wider today than at any other time in the modern era.For decision makers the tool by which they shape policy outcomes is the federal budget. In general the president of the United States proposes a budget. This proposal pays homage to the promises made on the campaign trail and is broadly reflective of the preferences he or she brings to office. In general the Congress disregards this proposal and offers up its own preferences for federal spending. Congressional proposals are shaped by the preferences that dominate the House and the Senate. Every federal agency weighs in on proposals to increase or cut budgets as do interest groups and individuals attached to the spending proposals. Passing a federal budget is a long complex and heavily negotiated process but there is little regard to its impact on short-term deficits and the long-term debt.The impact of public policy decisions and non-decisions can be felt in the general health of the economy trade relations international relations defense arrangements social wellbeing and much much more.About the GameThe Fiscal Ship (http://fiscalship.org/(Links to an external site.)Links to an external site.) challenges you to put the federal budget on a sustainable course. Measured as a share of gross domestic product the federal debt is higher than at any time since the end of World War II and projected to climb to unprecedented levels. America is looking at a permanent growing mismatch between revenues and spending and policymakers are faced with difficult decisions about how to reconcile important government prioritiesincluding retirement and health benefits promised to the growing number of old folkswith the tax revenues that the current tax code will yield. Todays tax code wont yield enough revenue to pay for basic services of government plus the retirement and health benefits promised to the growing number of old folks. So your mission is to pick from a menu of tax and spending options to reduce the debt from projected levels over the next 25 years. Small changes to spending and taxes wont suffice. The choices are difficult but the goal is achievable.But budget decisions arent only about fiscal sustainability. They also shape the kind of country we live in. To win the game you need to find a combination of policies that match your values and priorities AND set the budget on a sustainable course.Inside the Game you will find the categories in which most significant public policies can be organized:According to the Game the goals of public policies include:Fight Climate ChangeRein in EntitlementsShrink GovernmentTax CutterFiscal HawkProtect the ElderlyInvest in the FutureReduce inequalityStrengthen National DefenseStrengthen Social Safety NetInstructionsFor purposes of this assignment you are to run the simulation three separate times so that you can observe the outcomes through the lenses of the three broad policy preferences provided in the game. They are:The centrists: strengthen national defense invest in the future rein in entitlementsThe conservatives: rein in entitlements shrink government tax cutterThe progressives: reduce inequality invest in the future strengthen the social safety netUse these policy preferences to make budgetary decisions. For example make your first run centrist where your three goals are to strengthen national defense invest in the future and rein in entitlements. Make your second run conservative and your goals rein in entitlements shrink government and tax cutter. Finally for your third run choose the progressive goals to reduce inequality invest in the future and strengthen the social safety net. Each time you run the simulation look for changes in the budget projections. You will notice these as you tinker with policy decisions.To complete this assignment prepare an essay in which you respond to each of the prompts listed below. I recommend answering each prompt in its own paragraph. This structure provides you with a 6-paragraph format in which you can meet or exceed the minimum word count requirement.You will prepare a 540 word (minimum) essay in which you respond to the prompts listed above. Your response must be written in academic English. You will use your own voice and write in your own wordsno quotes or paraphrases allowed.To earn full points you must follow all instructions carefully proofread for writing errors and submit on time.PSFor specific reference purposes considering reviewing the information in the American Government textbook found on these pages: