[Verified Answer]: JC is a 41yrs old man who comes to the ER…

JC is a 41yrs old man who comes to the ER with complain of acute low back pain. He stated that he did some heavy lifting yesterday went to bed with a mild backache and awoke this morning with a terrible back pain, which he rates as a 10 on a 0-10 scale . He admit having had a similar episode of back pain years ago “I lifted some heavy box at work” JC has a medical history of peptic ulcer disease related to NSAID use. He is 6 ft weighs 265lbs and has a prominent “potbelly” 1. What questions would be appropriate to ask JC in evaluating the extent of his high back pain and injury? 2. What observable characteristics does JC have that make him highly susceptible to low back injury? 3. JC used to take piroxicam(Feldene) 20mg until he developed his duodenal ulcer. What is the relationship between the two? What signs and symptoms would you expect if an ulcer developed? All serious medical condition are ruled out and JC is diagnosed with lumbar strain. The NP orders PT consultation to develop a home stretching and back strengthening exercise program and dietary consultation for weight reduction. JC is given prescription for cyclobenzaprine (Flexeril) 10mg tid x3days only and celecoxib 100mg/day for 3months. He received the following instruction of heating application to lower back 20 to 30 min four times a day. No twisting or unnecessary bending and no lifting more than 10lbs . JC is instructed to rest is back for 1 or 2 days and getting up only now and then to move around to relieve muscle spasms in the back . He is to stay off work for 5days and limitation to lifting more than 10lbs for 3 months. 4. JC looks at his prescription for cyclobenzaprine and state, : I am glad you didnt give me Valium. The gave me Valium last time and that stuff knocked me out.” How will you respond to JC? 5. Why is cyclobenzaprine prescribed instead of diazepam (Valium)? 6. JC stated “Well I am glad i will still be able to take my sleep pill”. True or False? Explain 7. JC ask what is celebrex? I hope it wont do what feldene did to me years ago? Why was celebrex prescribed, considering GI history? 8. It has been 5yrs ago since his last episode of GI bleeding, are there any that needs to be assess before taking celecoxib? Explain 9. Why would the NP prescribed NSAID rather than acetaminophen for JC ? 10. PT teaches JC maintenance exercise he can do to promote back health. Identify two common exercise that would be included.