W8_CaseStudy2_Guirguis_Mira

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University of Tampa *

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Chemistry

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May 8, 2024

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1 Week 7 Case Study 2 Mira Guirguis South University NSG5003 Advanced Pathophysiology Dr. Sandi Dr. McDermott March 29 th , 2024
2 1. Possible diagnoses for the patient's low back pain include lumbar disc herniation, radiculopathy of the lumbar spine, lumbar facet discomfort in the joints, a condition called spondylolysis, spondylolisthesis, lumbar stenosis of the spine, and lumbar muscle strain. These results are consistent with the patient's subjective observations, which include the sudden onset of low back discomfort after lifting a box that was 35 pounds, pain extending along the back of his leg to his right ankle, and expressed an 8 out of 10 pain assessment. The primary findings that corroborate these sensations include the patient's positive straight leg raise and the existence of right paraspinal pain at L4–L5.  (Dlugasch & Story, 2019). 2. Considering the history of the patient, the physical exam findings, and various diagnoses, imaging should be considered to confirm the diagnosis. In this case, lumbar spinal imaging, such as a magnetic resonance imaging (MRI) or computed tomography (CT) scan would be the recommended tests. This is because the patient's positive straight leg lift, right paraspinal tenderness at L4–L5, and sudden onset of low back pain are all significant causes which should not be ignored for long since they can become a chronic issue which may lead to permanent damage. Imaging can identify the exact origin of pain in a number of diseases, including disk herniation,  lumbar radiculopathy, lumbar facet joint discomfort, spondylolisthesis, spondylolysis, lumbar spinal stenosis, and lumbar muscle strain (Patel, 2022). 3. There are certain warning indicators of low back discomfort that require further investigation. These consist of fever, pain at night, recent trauma, sudden weight loss, a
3 history of cancer, and discomfort that gets worse when you sit or lie down for a long period of time (Dlugasch & Story, 2019). Any signs of neurological abnormalities, including paresthesia, neuromuscular weakness, or bowel/bladder malfunction, should also be further investigated. Waiting long or ignoring these symptoms could lead to permanent damage. 4. Treatment for the patient's lower back discomfort should be based on the specific diagnosis. However, a number of general therapy strategies can be tried initially. These include relaxing and resting, using heat or cold compressions, stretching, and taking medications such as pain medications, ibuprofen or other anti-inflammatory medications. Additionally, the patient should be taught preventive measures to keep themselves from getting injured in the future, such as safe object lifting techniques, avoiding prolonged sitting, and taking regular breaks from activities. It is also important to encourage the patient to continue with their current activity level and take part in low-impact activities like walking or swimming (Patel, 2022). 5. If a combination of ice, heat, stretching, ice and medicine are ineffective in improving the patient's low back pain, a referral to a specialist should be recommended. A neurologist, orthopedic surgeon, or physical therapist may be involved, depending on the specifics of the case. The referral to the specialist will help narrow down the issue regarding the pain and allow the patient more detailed responses to their discomfort which will hopefully lead to a solution. 
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