Analyze the disorder addressing the following elements: pathophysiology, signs/symptoms, progression trajectory, diagnostic testing, and treatment options. Differentiate the disorder from normal development.
The case study that this essay needs to be done on is incuded in the
instructions. I could not send a word document for some reason. Please
following the grading criteria, thank you
Criteria:
Case Study Evaluation
Analyze the disorder addressing the following elements: pathophysiology, signs/symptoms, progression trajectory, diagnostic testing, and treatment options.
Differentiate the disorder from normal development.
Discuss the physical and psychological demands the disorder places on the patient and family.
Explain the key concepts that must be shared with the patient and family to achieve optimal disorder management and outcomes.
Identify key interdisciplinary team personnel needed and how this team will provide care to achieve optimal disorder management and outcomes.
Interpret facilitators and barriers to optimal disorder management and outcomes.
Describe strategies to overcome the identified barriers.
Care Plan Synthesis
Designed a comprehensive and holistic recognition and planning for the disorder.
Addresses how the patient’s socio-cultural background can potentially impact optimal management and outcomes.
Demonstrated an evidence-based approach to address key issues identified in the case study.
Formulates a comprehensive but tailored approach to disorder management.
HPI
A 40-year-old Asian American male, who works as a roofer, complains that three days ago he was lifting a heavy object at work, following which he got low back pain. The pain is in the middle of the back near his waist. The pain increases when he bends forward and he is experiencing numbness and tingling in the toes of his right foot. He has had similar symptoms before, but it has not been so bad in the past. This is the worst he has had because in the earlier instances, he has never had the tingling sensation in his right foot before. In the past, he got better with rest and some Ibuprofen. He is worried that he will not be able to continue his work and make money. He is out of work as a result of the pain. He
has a lot of difficulty getting sleep at night. He has started taking some of his friend’s medication and it seems to help. He has pain in the mid lumbar area, which radiates to the right buttock. He also has numbness and tingling down the back of his right thigh to his toes. The pain and numbness has been increasing since the problem started three days ago. He has tried over-the-counter Ibuprofen and some stretching exercises, but it does not seem to help.
He has not sought any medical care yet. In the past, the pain had just gone away, but this time the pain is persistent. There is a gradual worsening of his symptoms and he is concerned about the pain that has been increasing steadily over the past three days. He is wondering whether he has a herniated disc. His major concern is that he has no health insurance and will be missing work.
PMH
He has had similar pain in the past, but it was not so severe. He saw a chiropractor around two or three years ago and that gave him some relief. Otherwise, the patient has no chronic medical problems. He does not seek medical care on a routine basis. He has had no diagnostic measures in the past. He has never had any blood work reports, CT scan reports, X-ray reports and so forth done in the past. He has been gaining weight over the past few years and does not do any stretching exercises before work. Patient does not have any other risk factors. There are no records of any past surgeries. He has neither had any significant illnesses in the past nor any hospitalizations.
ROS
Pain in the mid lumbar area radiating to the right buttock. There is a tingling sensation that goes down the back of his right thigh to the toes. He does not have urinary or bowel incontinence. No nausea, vomiting, or fever. He denies abdominal pain and pain with urination. There is no gross hematuria.
MEDICATIONS
Patient does not take any prescription medications, only over-the-counter Ibuprofen. He is using 800mg of Ibuprofen every four hours. Patient is compliant with the prescribed regimen; in fact, he could be using too much. Patient is seeking care because of the increasing pain. He has tried chiropractic manipulations in the past for low back pain.
ALLERGIES/REACTIONS
He is allergic to Penicillin. It has caused a rash in the past.
SOCIAL HISTORY
This patient works for a local roofing company and makes $30,000.00 per year, which is just a little over the minimum wage. He has a high school education certificate and makes just enough money to get by. He has no health insurance. The patient feels that the last thing that he wants to do is spend money on healthcare. He feels his body will get better on its own, and so he can just keep working. He made the appointment at this outpatient clinic because his friends told him about it. He was not sure where to go fo rhelp. He has decreased access to healthcare because he is not aware of the services
available. The patient has had essentially no healthcare to date. The patient states that he is starting to realize that his body will not last forever at his current position as a laborer. The patient is divorced and thinks he was a failure as a husband. He is behind in alimony payments. His wife is alive and well without any medical problems. They do not communicate anymore. They have no children. He would like to try and get back together with her, but she refuses to speak to him. He has been holding himself back from expressing the amount of stress he has in life for many years. He thinks he is becoming depressed as a result of this. His parents still live in the area and he sees them every weekend. He has friends from work and they do social things together. The patient has not sought any emotional support from anybody. There is no element of family dysfunction. He becomes easily stressed out. He lives in social isolation from his
community. The patient has always taken his health for granted and not thought much about it in the past.
HABITS
Smoking: Non smoker
Alcohol: Drinks at bars on weekends to excess with his friends
Substance abuse: He smokes marijuana.
DIET HABITS
He skips breakfast and eats at fast food restaurants twice every day. He sips coffee and caffeinated beverages throughout the day. The patient feels that his job gives him enough exercise and so he need not do anything else. He plans to go on a “diet” soon to lose the weight he has gained over the past few years, but is not sure about the diet he is going to follow.
WORK HABITS
The patient works as a roofer. He has had other labor-intensive jobs in the past that do not require an educational background. He does not enjoy his job. He knows it is a dead end job and wants to go to school. He is originally from United States and lives in a suburban community where resources are easily accessible, but he is not aware of them.
FAMILY HISTORY
Both parents have hypercholesterolemia. His 65-year-old father has prostate cancer. Both parents are being treated with medications for their high cholesterol levels. He has no siblings. There is a remote history of heart disease in his relatives.
Vital Signs: Ht: 6'; Wt: 220; WC: 40; BP: 120/78; T: 97 po; P: 92 and regular; R: 18 nonlabored
HEENT: WNL
Lymph Nodes: None
Lungs: Clear
Heart: RRR without murmur
Carotids: Not examined
Abdomen: Android obesity, otherwise benign
Rectum: Not examined
Genital/Pelvic: NA
Extremities, Including Pulses: 2+ pulses in the lower extremities
Neurologic:
Mental Status: Alert and oriented
Cranial Nerves: II – XII intact
Motor Strength: Upper extremities equal strength 5/5.
Lower extremities: decreased strength of right leg with resisted extension; patient
complains of pain in posterior thigh.
Sensation (light touch, pin prick, vibration, and position): Decreased sensation of right
leg along L5 : S 1 dermatome to pin prick stimulation compared with the left.
Criteria:
Case Study Evaluation
Analyze the disorder addressing the following elements: pathophysiology, signs/symptoms, progression trajectory, diagnostic testing, and treatment options.
Differentiate the disorder from normal development.
Discuss the physical and psychological demands the disorder places on the patient and family.
Explain the key concepts that must be shared with the patient and family to achieve optimal disorder management and outcomes.
Identify key interdisciplinary team personnel needed and how this team will provide care to achieve optimal disorder management and outcomes.
Interpret facilitators and barriers to optimal disorder management and outcomes.
Describe strategies to overcome the identified barriers.
Care Plan Synthesis
Designed a comprehensive and holistic recognition and planning for the disorder.
Addresses how the patient’s socio-cultural background can potentially impact optimal management and outcomes.
Demonstrated an evidence-based approach to address key issues identified in the case study.
Formulates a comprehensive but tailored approach to disorder management.
HPI
A 40-year-old Asian American male, who works as a roofer, complains that three days ago he was lifting a heavy object at work, following which he got low back pain. The pain is in the middle of the back near his waist. The pain increases when he bends forward and he is experiencing numbness and tingling in the toes of his right foot. He has had similar symptoms before, but it has not been so bad in the past. This is the worst he has had because in the earlier instances, he has never had the tingling sensation in his right foot before. In the past, he got better with rest and some Ibuprofen. He is worried that he will not be able to continue his work and make money. He is out of work as a result of the pain. He
has a lot of difficulty getting sleep at night. He has started taking some of his friend’s medication and it seems to help. He has pain in the mid lumbar area, which radiates to the right buttock. He also has numbness and tingling down the back of his right thigh to his toes. The pain and numbness has been increasing since the problem started three days ago. He has tried over-the-counter Ibuprofen and some stretching exercises, but it does not seem to help.
He has not sought any medical care yet. In the past, the pain had just gone away, but this time the pain is persistent. There is a gradual worsening of his symptoms and he is concerned about the pain that has been increasing steadily over the past three days. He is wondering whether he has a herniated disc. His major concern is that he has no health insurance and will be missing work.
PMH
He has had similar pain in the past, but it was not so severe. He saw a chiropractor around two or three years ago and that gave him some relief. Otherwise, the patient has no chronic medical problems. He does not seek medical care on a routine basis. He has had no diagnostic measures in the past. He has never had any blood work reports, CT scan reports, X-ray reports and so forth done in the past. He has been gaining weight over the past few years and does not do any stretching exercises before work. Patient does not have any other risk factors. There are no records of any past surgeries. He has neither had any significant illnesses in the past nor any hospitalizations.
ROS
Pain in the mid lumbar area radiating to the right buttock. There is a tingling sensation that goes down the back of his right thigh to the toes. He does not have urinary or bowel incontinence. No nausea, vomiting, or fever. He denies abdominal pain and pain with urination. There is no gross hematuria.
MEDICATIONS
Patient does not take any prescription medications, only over-the-counter Ibuprofen. He is using 800mg of Ibuprofen every four hours. Patient is compliant with the prescribed regimen; in fact, he could be using too much. Patient is seeking care because of the increasing pain. He has tried chiropractic manipulations in the past for low back pain.
ALLERGIES/REACTIONS
He is allergic to Penicillin. It has caused a rash in the past.
SOCIAL HISTORY
This patient works for a local roofing company and makes $30,000.00 per year, which is just a little over the minimum wage. He has a high school education certificate and makes just enough money to get by. He has no health insurance. The patient feels that the last thing that he wants to do is spend money on healthcare. He feels his body will get better on its own, and so he can just keep working. He made the appointment at this outpatient clinic because his friends told him about it. He was not sure where to go fo rhelp. He has decreased access to healthcare because he is not aware of the services
available. The patient has had essentially no healthcare to date. The patient states that he is starting to realize that his body will not last forever at his current position as a laborer. The patient is divorced and thinks he was a failure as a husband. He is behind in alimony payments. His wife is alive and well without any medical problems. They do not communicate anymore. They have no children. He would like to try and get back together with her, but she refuses to speak to him. He has been holding himself back from expressing the amount of stress he has in life for many years. He thinks he is becoming depressed as a result of this. His parents still live in the area and he sees them every weekend. He has friends from work and they do social things together. The patient has not sought any emotional support from anybody. There is no element of family dysfunction. He becomes easily stressed out. He lives in social isolation from his
community. The patient has always taken his health for granted and not thought much about it in the past.
HABITS
Smoking: Non smoker
Alcohol: Drinks at bars on weekends to excess with his friends
Substance abuse: He smokes marijuana.
DIET HABITS
He skips breakfast and eats at fast food restaurants twice every day. He sips coffee and caffeinated beverages throughout the day. The patient feels that his job gives him enough exercise and so he need not do anything else. He plans to go on a “diet” soon to lose the weight he has gained over the past few years, but is not sure about the diet he is going to follow.
WORK HABITS
The patient works as a roofer. He has had other labor-intensive jobs in the past that do not require an educational background. He does not enjoy his job. He knows it is a dead end job and wants to go to school. He is originally from United States and lives in a suburban community where resources are easily accessible, but he is not aware of them.
FAMILY HISTORY
Both parents have hypercholesterolemia. His 65-year-old father has prostate cancer. Both parents are being treated with medications for their high cholesterol levels. He has no siblings. There is a remote history of heart disease in his relatives.
Vital Signs: Ht: 6'; Wt: 220; WC: 40; BP: 120/78; T: 97 po; P: 92 and regular; R: 18 nonlabored
HEENT: WNL
Lymph Nodes: None
Lungs: Clear
Heart: RRR without murmur
Carotids: Not examined
Abdomen: Android obesity, otherwise benign
Rectum: Not examined
Genital/Pelvic: NA
Extremities, Including Pulses: 2+ pulses in the lower extremities
Neurologic:
Mental Status: Alert and oriented
Cranial Nerves: II – XII intact
Motor Strength: Upper extremities equal strength 5/5.
Lower extremities: decreased strength of right leg with resisted extension; patient
complains of pain in posterior thigh.
Sensation (light touch, pin prick, vibration, and position): Decreased sensation of right
leg along L5 : S 1 dermatome to pin prick stimulation compared with the left.
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