TEACH FOR NURSES LESSON PLAN
Chapter 23: Musculoskeletal System
CHAPTER OBJECTIVES
1. List the functions of the musculoskeletal system.
2. List the three types of muscles and their movements.
3. Differentiate between synovial and nonsynovial joints.
STUDENT RESOURCES
understand
• Textbook Chapter 23
• Sherpath for Medical-Surgical Nursing*
• Animations (Evolve website)
• Answer Keys: Study Guide & Lab Manual
• Audio glossary (Evolve)
23-2
apply
• Case Studies (Evolve)
synthesize
• SimChart*
• Simulation Learning System*
INSTRUCTOR RESOURCES
before class
• Nursing Curriculum Standards (below)
in class
• PowerPoint Presentations (Evolve)
* Sold separately from textbook.
TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
MUSCULOSKELETAL
COMPONENTS
Review how the cells of
the bone are continually
turning over and
• Activity: Have students create flash cards with the movements of the body on one side and the
definition of the term on the other. Each word needs to become part of the working vocabulary of
the health care provider.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Shoulder
Elbow
DEVELOPMENTAL
COMPETENCE
Infants and Children
The Pregnant Woman
listed in the chapter and
pictured in Figure 23.2.
Have students act out the
movements as you discuss
them.
Point out the group of four
muscles and tendons that
encloses the shoulder
joint. Use Figures 23.7 and
23.8. Have the students
find their own acromion
groups.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
in the body and compare it
with the hip in terms of
size and complexity.
Review how long bones
grow in length and width.
Show pictures of the
growth plate and explain
how it works.
Review the positive
physical effects of exercise
on osteoporosis and on
quality of life.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Additional History for
Infants and Children
questions, allowing
students to choose several
on which to elaborate.
Emphasize sports
assessments for
adolescents and note that
many adolescents will try
to “tough it out.”
that is directed toward both teenagers and older adults. If possible, make arrangements for students
to present the programs in the community.
OBJECTIVE DATA
ORDER OF THE
EXAMINATION
Emphasize the importance
of the patient’s comfort by
ensuring privacy and using
gentle movements.
• Group Activity: Assign students to work in groups of three: one to follow the checklist and textbook,
one to perform the examination, and one to act as patient. Allow sufficient time for students to
rotate roles so that each has an opportunity to be the examiner. Instruct students to document the
results of the previous examination, using appropriate descriptions for the location of any unusual
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
Muscle Testing
TEMPOROMANDIBULAR
JOINT
CERVICAL SPINE
Wrist and Hand
LOWER EXTREMITY
Hip
Knee
Ankle and Foot
injury or infection.
Encourage students to
feel, using the top of the
hand, where the skin is
thin.
differences in ROM.
Review the grading system
for muscle testing,
discussing how to grade
accurately.
Explain that shoulder pain
could be stress related and
referred from the neck
muscles.
• Discussion Topic: Discuss how much weight the hips and knees support and how each extra pound
adds 6 psi to the hip joint and 4 psi to the knee joint.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
COMPETENCE
Infants
Preschool-Age and School-
muscular or obese patients
with heavy limbs or
decreased mobility.
Have student volunteers
remove their shirts and
allow fellow students to
assess their spine for
spinal curvature, marking
the spine as instructed in
the text.
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TEACHING STRATEGIES
Content Focus
Content Highlights
Learning Activities
adolescents and in aging
adults.
IN-CLASS/ONLINE CASE STUDY
S.P. is a 3-year-old female toddler who presents to the pediatrician’s office for a yearly well visit. The child complains that her leg hurts.
Subjective Data
PMH of otitis media
Immunizations: Up to date
Objective Data
Vital signs: T 37 P 92 R 18 BP 100/70
Lungs: clear in all fields
Heart rate and rhythm regular
Moving all extremities
+ Range of motion (ROM) legs and arms
Strength 5/5 in all extremities
Questions
1. What other questions should the nurse ask?
2. What techniques are helpful to incorporate in assessing a patient in this age group?
3. What other assessments should the nurse make for this clinical presentation?
4. What are a few of the major differences in the musculoskeletal assessment of a child?
5. What should be included in the plan of care?
6. Based on the readings, what is the most likely cause of leg pain for this patient?
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Answers
1. Ask the patient or parent the following questions:
2. A 3-year-old child will most likely be active. Observe the child at play to assess ROM. Make a game out of assessing muscle strength, such as
23–10
NURSING CURRICULUM STANDARDS
QSEN/NLN COMPETENCIES
• Patient-Centered Care/Human Flourishing
o Objective Data
o Subjective Data
• Evidence-Based Practice/Spirit of Inquiry
o Culture and Genetics
NURSING CONCEPTS
The following conceptual themes and specific concepts match those presented in Giddens, J. F. (2017). Concepts for nursing practice (2nd ed.).
St. Louis: Elsevier. The specific exemplars chosen and listed below for each concept have been tailored specifically to correspond to the Jarvis
textbook.
A full Concept-Based Curriculum Map covering the entire book can be found in the “Download by Resource Type” folder on Evolve.
THEME: Care Competencies
• Concept: Evidence
o Exemplar: Infants and Children
BSN ESSENTIALS
• Essential III: Scholarship for Evidence-Based Practice
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o Culture and Genetics
o Adolescents
o Infants and Children
ANSWERS TO QUESTIONS IN THE STUDY GUIDE
Note: Answers to these questions can be found on Evolve site. Click here.