Question Answered step-by-step J. C. is a 41-year old man who comes to the ED c/o acute low backpain. He states that he did some heavy lifting yesterday, went to bed with a mild backache, and awoke this morning with terrible back pain. He admits to having had several episodes of similar back pain each year over the last 10 years. In the past, the pain has been treated by diazepam, codeine, and several weeks of bed rest. J. C. has a PMH of duodenal ulcer and takes Prilosec for symptom relief. He is 6 ft. tall, weighs 265 lbs. and has a prominent “pot belly”. The ED admitting clerk calls J. C.’s insurance company to authorize payment for treatment at your facility. J. C.’s HMO has identified him as a consumer of “high cost care” with poor prior outcome. The ED is authorized to perform emergency treatment only and the case manager will make a home visit within 24 hours to devise a treatment plan. The ED physician diagnoses muscular strain of the lower back and orders the following: cyclobenzaprene (Flexeril) 10 mg QID, Feldene 20 mg QD; bed rest for 2 days then gradually increase activity; ice packs to the lower back 30 minutes out of every hour.If you are the case manager and you make your visit to J.C.’s residence. His wife lets you in and you find J. C. lying on the sofa with his knees flexed and watching videos. 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 and chronic pain? 3. Why do you think that cyclobenzaprine was prescribed instead of diazepam? 4. What does J. C. need to know concerning Feldene considering his PMH? You determine that J. C. needs an interdisciplinary approach to treatment and rehabilitation for his chronic back problem. Your goal is to minimize J. C.’s long-term health care costs by rehabilitating his back, helping him reduce his weight to reduce stress on his back, and treating his current injury. You coordinate referrals for J. C. to see four healthcare experts on your team. 5. You refer J. C. to a physiatrist. What is a physiatrist, and what can a physiatrist do to help J. C.? 6. What expert would work with J. C. to help him lose weight? What are her/his credentials? 7. What kind of expert will work with J. C. using exercise and various treatment modalities to restore his back muscles? 8. What kind of expert will work with J. C. on body mechanics and strengthening him for occupational and home-related work? 9. A physical therapist teaches J. C. maintenance exercises he can do on his own to promote back health. What 3 common exercises would be included?  Health Science Science Nursing NURSING VN111 Share QuestionEmailCopy link Comments (0)

Question Answered step-by-step J. C. is a 41-year old man who comes to the ED c/o acute low backpain. He states that he did some heavy lifting yesterday, went to bed with a mild backache, and awoke this morning with terrible back pain. He admits to having had several episodes of similar back pain each year over the last 10 years. In the past, the pain has been treated by diazepam, codeine, and several weeks of bed rest. J. C. has a PMH of duodenal ulcer and takes Prilosec for symptom relief. He is 6 ft. tall, weighs 265 lbs. and has a prominent “pot belly”. The ED admitting clerk calls J. C.’s insurance company to authorize payment for treatment at your facility. J. C.’s HMO has identified him as a consumer of “high cost care” with poor prior outcome. The ED is authorized to perform emergency treatment only and the case manager will make a home visit within 24 hours to devise a treatment plan. The ED physician diagnoses muscular strain of the lower back and orders the following: cyclobenzaprene (Flexeril) 10 mg QID, Feldene 20 mg QD; bed rest for 2 days then gradually increase activity; ice packs to the lower back 30 minutes out of every hour.If you are the case manager and you make your visit to J.C.’s residence. His wife lets you in and you find J. C. lying on the sofa with his knees flexed and watching videos. 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 and chronic pain? 3. Why do you think that cyclobenzaprine was prescribed instead of diazepam? 4. What does J. C. need to know concerning Feldene considering his PMH? You determine that J. C. needs an interdisciplinary approach to treatment and rehabilitation for his chronic back problem. Your goal is to minimize J. C.’s long-term health care costs by rehabilitating his back, helping him reduce his weight to reduce stress on his back, and treating his current injury. You coordinate referrals for J. C. to see four healthcare experts on your team. 5. You refer J. C. to a physiatrist. What is a physiatrist, and what can a physiatrist do to help J. C.? 6. What expert would work with J. C. to help him lose weight? What are her/his credentials? 7. What kind of expert will work with J. C. using exercise and various treatment modalities to restore his back muscles? 8. What kind of expert will work with J. C. on body mechanics and strengthening him for occupational and home-related work? 9. A physical therapist teaches J. C. maintenance exercises he can do on his own to promote back health. What 3 common exercises would be included?  Health Science Science Nursing NURSING VN111 Share QuestionEmailCopy link Comments (0)