Question

J.C. is a 41-year-old man who comes to the emergency department (ED) 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. He admits to having had a similar episode of back pain "after I lifted something heavy at work." J.C. has a past medical history (PMH) of peptic ulcer disease (PUD) related to NSAIDs use, non-insulin dependent diabetes, and hypertension. His is 6' tall, weighs 265 pounds, and has a prominent "potbelly."

Answer 1

Form the case study

1. Celicoxib causes an increase risk of serious gastrointestinal adverse events included bleeding,ulcerations and proliferation of stomach or intestine which can be fatal. Duodenal ulcer is side effect of celecoxib.

Signs and symptoms of ulcer.:Dull pain in the stomach,nausea vomiting,bloating,heart burn,acid reflex .

2.Observable characteristic make patient highly susceptible to low back ache:

BMI of patient is 35.8 patient was obese .obesity is risk factor for low back ache.

Patent's with Diabetes having 35% risk for low back pain. These are observable factors.

3.Appropriate questions to ask with JC to evaluate extent of back pain

a.do you fallen from height.

b.do you have any urinary problems ? (Kidny infection and disease are indicator or back ache)

c.what are the pain characters ? (Dull,tightness of muscles,anypulling effects,feel hot)

d.having any liver problems (Liver pain confused by back ache some times.

4. The Wong Baker's Face rating scale

By using facial expressions .0- No hurt,1- Hurts little,2-hurts little more,3-hurts even more,4-hurts whole lot,5-hurts worst.

Roland -morris disability questioner with questions related to back ache discomfort.