CASE STUDY 1: LOW BACK PAIN J .C. is a 41-year-old man who comes to...

Question Answered step-by-step CASE STUDY 1: LOW BACK PAIN J .C. is a 41-year-old man who comes to… CASE STUDY 1: LOW BACK PAINJ .C. is a 41-year-old man who comes to the emergency department with complaints of acute low back pain. He states that he did some heavy lifting yesterday, went to bed with a mild backache, and awoke this morning with terrible back pain, which he rates as a “10” on a 1 to 10 scale. He admits to having had a similar episode of back pain years ago “after I lifted something heavy at work.” J.C. has a past medical history of peptic ulcer disease (PUD) related to nonsteroidal anti-inflammatory drug (NSAID) use. He is 6 feet tall, weighs 265 pounds, and has a prominent “potbelly.”1.What questions would be appropriate to ask J.C. in evaluating the extent of his back pain and injury? 2.What observable characteristic does J.C. have that makes him highly susceptible to low back injury? 3. J.C. used to take piroxicam (Feldene) 20 mg until he developed his duodenal ulcer. What is the relationship between the two? What signs and symptoms would you expect if an ulcer developed? CASE STUDY PROGRESS All serious medical conditions are ruled out, and J.C. is diagnosed with lumbar strain. The nurse practitioner (NP) orders a physical therapy consult to develop a home stretching and back-strengthening exercise program and a dietary consult for weight reduction. J.C. is given prescriptions for cyclobenzaprine (Flexeril) 10 mg tid×3 days only, and celecoxib (Celebrex) 100 mg/day for 3 months. He receives the following instructions: heat applications to the lower back for 20 to 30 minutes four times a day (using moist heat from heat packs or hot towels), no twisting or unnecessary bending, and no lifting more than 10 pounds. J.C. is instructed to rest his back for 1 or 2 days, getting up only now and then to move around to relieve muscle spasms in his back and strengthen his back muscles. He is given a written excuse to stay off work for 5 days and, when he returns to work, specifying the limitation of lifting no more than 10 pounds for 3 months. He is instructed to contact his primary care provider if the pain gets worse. 4. J.C. looks at the prescription for cyclobenzaprine (Flexeril) and states, “I’m glad you didn’t give me that Valium. They gave me Valium last time and that stuff knocked me out.” How would you respond to J.C.? 5.Why do you think that cyclobenzaprine was prescribed instead of diazepam (Valium)?6.J.C. states, “Well, I’m glad I’ll still be able to take my sleeping pill.” True or False? Explain. J.C. asks, “What is Celebrex? I hope it won’t do what that Feldene did to me years ago.”7.Why do you think it was prescribed for J.C., considering his GI history? 8.You know that it has been over 5 years since his last episode of GI bleeding. Are there any other conditions that you need to assess for before J.C. begins to take the celecoxib? Explain. 9.Why would the NP prescribe an NSAID rather than acetaminophen for J.C.’s pain? 10. A physical therapist teaches J.C. maintenance exercises he can do on his own to promote back health. Identify two common exercises that would be included. Describe ach of the following. Single knee-to-chest : Abdominal curl : Pelvic tilt : Hamstring stretch: Health Science Science Nursing NURS 450 Share QuestionEmailCopy link Comments (0)