please I need help lete the Critical Thinking Exercise below: John Brown is a 76
ID: 265297 • Letter: P
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please I need help
lete the Critical Thinking Exercise below: John Brown is a 76-year old black widowed male. He is schedule repair. During your intake assessment, you notice the Mr. Brown at he has haated or as he climbed onto the exam table. Upon questioning, you lea mid-back pain for about a week. He denies having fallen or in aggravated with movement, straining, coughing, sneezing, a Brown appear to unsteady as he stand to walk to the exam table. legs" and "I do feel a bit light-headed sometimes". He has a history of p hypertension. The cancer was diagnosed ten years ago and trea three months. He takes Terazos winces when he changes positions injuring himself. The pain is initiated or He says "I am a little weak in my ted with Lupron injections every in 1 mg every hs and Furosemide 40 mg every morning. His vital that he has had a constant dull and sitting. He states that it radiates. Mr. signs are: T-97.8 F, AP-92, R-16, BP 116/80 (left arm/sitting). Mr. Brown lives a floor apartment. He has meals on wheels delivered three days a week. 1. What further assessments would you conduct and why? 2. What labs would you expect to be ordered for Mr. Brown and why?Explanation / Answer
Answer 1. Mr. Brown should be suggested MRI for his lower back pain examination, as it will provide a clear picture. His pain at back increases with coughing, sneezing etc. These may act as strains for his back muscles and leads to tearing of the tissues which is causing pain. To these muscles various nerves are also attached, if problem persists then the normal function of these nerves will also be affected. Thus, MRI of the paining region at the back will provide the correct diagnosis.
As Mr. Brown also had the history of the prostate cancer, thus regular prostate tests should be done to check the relapse of this cancer. These tests are the Prostate specific antigen or PSA test, Transrectal ultrasound or TRUS and Prostate biospy.
Answer 2. Magnetic resonance imaging or MRI of the back which provide the conclusions of muscle tearing or the nerve pressing. If this comes out to be positive for these ailments, then regular exercises are suggested by the physiotherapist plus cold fomentation through ice packs also provides relief.
If the value of the Prostate specific antigen blood test comes more then 4 nanograms per millilitres then Mr. Brown has relapsed the cancer and may be the pain is due to this.
If the test results of PSA blood test comes positive then he should be done with the Transrectal Ultrasound. This test lasts for just 10 minutes and in this some probe is inserted at the back and the region is numbed before insertion. This provides information on the size of the prostate cancer.
Core needle biopsy is specifically suggested for the prostate cancer, it is done by the urologist. In this needles are pierced into the prostate gland and tissue is collected, this piercing step is repeated many a times to collect more and more tissue. Examination of these tissues is done through culturing them for 10-15 days, if the culturing pattern resembles the cancerous cells, then Mr. Brown has relapsed the cancer. Proper prescription by oncologist provides helpful in this case.
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