MN555 unit 9 discussion 1

Group A: Last name A-L 

Class members with a last name A-L will respond to Discussion Topic #1 and class members with the last name M-Z will respond to Discussion Topic #2. 

Topic 1: Low Back Pain 

A 55-year-old man presents with a history of dull low back pain that began about 10 days ago and is getting worse. It is present all day, is accompanied by some stiffness, but it does not radiate to any other location. It seems associated with prolonged sitting and/or bending. Ibuprofen helps relieve the pain and he is most comfortable lying down. He has experienced an episode of this type of pain in the past and it resolved spontaneously. The pain was not associated with any specific precipitating event. His employer insisted that the patient be evaluated before returning to work. 

CC: “I’m tired of this back pain.”

The physical exam reveals no visible abnormalities of the back, but he does have some paraspinal tenderness to palpation in the L3–L5 region. Lumbar flexion is markedly diminished because of pain, but otherwise his range of motion is almost normal.

1. List at least 3 differential      diagnoses.
2. What are some specific exam      techniques that should be used when examining this patient? What is the      rationale behind some of these assessment techniques? What information is      supplied? (Think anatomy and physiology.)
3. Should you order x-ray films or      other imaging exams?
4. What are the “red flags” of low      back pain?
5. How would you manage the      patient with low back pain? Address pharmacologic and physical measures as      well as other advanced practice nursing interventions.
6. What health promotion      strategies are especially important for this patient at this point in time      and WHY?
7. What complementary therapies      might help this patient at this point in time?