Question

Jane Wagner, a 22-year-old patient with no previous medical history, presents to the emergency department with complaint of low back pain after slipping on a wet floor at work and falling. The patient states that the pain is constant aching and radiates down both legs (sciatica). The MRI shows pulled muscles and ligaments surrounding the L4-L5 area. The emergency physician provides the following discharge orders: Bedrest with bathroom privileges for 2 days. Apply ice pack to lower back for 20minutes several times a day for the first 48hours, and then starting 3 and on, apply a heating pad for 20minutes and 20 minutes off several times per day for the next several days, as needed, to relieve pain. Take 400mg of Ibuprofen every 6 hours and 5mg cyclobenzaprine (Flexiril) three times a day. Limit sitting to 30 minutes at one time. Ambulate around home and yard, as tolerated, gradually increasing activity. Avoid twisting, bending, and reaching for objects. Avoid lifting anything more than 5 pounds of weight for 1 week. See physician in 1 week for further evaluation. (Learning Objective 1).

a. Explain the rationale for the administration of ice for 48hours followed by the application of heat.

b. Explain the rationale for the administration of the ibuprofen and muscle relaxer.

c. What are the expected patient outcomes for the patient in this case study

Answer 1

a.rationale for Ice and Heat;

Rationale for The administration of ile : so Ice helps is reducing blood flow to The area by constructing the blood vessels supply to This region & It helps & decrease The Inflammation on The affected area, by reducing Blood flow to the lower Back o mainly helps is reducing The Inflammation and reducing pair, Increase your healing speed cold, Burning. Aching sensation you get from The ice Rationale for The administration & heat & Mainly after The Inflammatory phase, introduce the heat to the affected area . *It Dreases The Blood flow by dialating The blood vessels, & Two types of heat Therapy, dy heat and moist heat. . * Dey heat conducted heat Therapy, easy to apply, in hospital , we get as heating pad and dry heat packs moist heat convection heak Therapy, more Effective, take less time, gek as moist heak packs steamed towels and hot baths

b.rationale for ibuprofen and muscle relaxer;

6 Rationale fox Ibuprofenir Ibuprofen is an NSAID (Non. steroidal anti-inflammatory drugs, non selective cox Inhibitors - Cox is an enzyme responsible for The synthesis of prostaglandins, cox-2 erduud during Inflammation, responsible for the Production Peostanoid mediator for Indlammeation » Ibuprofen Inhibit the cor enzyme Finally decreases prostaglandiss syntheses - It produus anti-Inflammatory effect, supress Sign and symptoms o Inflammation, such as pain, tandurness and swelling - It also produus analgesic effect by relieving muscle pair by periphual Inhibition of prostaglandes production Rationale for Muscle relancer & mainly helps is relasing The muscles by less tense a stiff, so that it reduus pair and disconfort. - It acto by depolarization of muscle fibres, - mainly relleves muscle spasms Through entral actions

C.expected patient outcomes;

* Increase your healing speed, is flammation and pais gek reduced * patient get free from muscle pain a stiffness by heak. * The patient will remain free from injury Thoughout Therapy by cyclobenzaprire