NUR231 Case Study: Analysis of Four Spinal Cord Injury Treatments

This assignment presents a nursing case study centered around a 68-year-old construction worker named Jack who presented with lower back pain, eventually diagnosed with metastatic lesions in his thoracic and lumbar vertebrae. The case study explores the initial misdiagnosis and treatment with NSAIDs, highlighting the potential adverse effects in older adults, and the subsequent referral to a rheumatologist for MRI scans. The assignment answers two key questions: the impact of aging on pain threshold and behavioral responses to pain, and the various treatment options available for spinal cord injuries, including intravenous methylprednisolone, immobilization, surgery, and other advanced techniques. The analysis emphasizes the crucial role of rheumatologists in determining the most appropriate treatment plan for spinal injuries, considering the complexity of spinal bone treatments.

Nursing assignment: Case Study

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TREATMENTS RELATED TO SPINAL CORD INJURIES
Table of Contents
Answer (1)..................................................................................................................................1
Answer (2)..................................................................................................................................1
References..................................................................................................................................3

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TREATMENTS RELATED TO SPINAL CORD INJURIES
Answer (1)
As discussed with the case study ‘John’ who is a construction worker was suffering
from lower back pain. His GP gave prescribed NSAIDs, after finding acute tenderness over
T12- L1. The pain becomes worst because NSAIDs may sometimes give adverse effect over
elder people like gastrointestinal bleeding, cardiovascular and other side effects (Clinic,
2020).
Elder people are more sensitive to pain management medicines. NSAIDs are most
commonly known medicines which are very frequently prescribed for managing the pain. In
the first check-up the GP could not diagnose the exact cause of pain and that is why he
suggested the NSAIDs to reduce the pain whenever required. But in reality the position of
the pain becomes severe and threshold because of improper diagnosis and ignoring the side
effect of the suggested medicines (Supakanya Wongrakpanich, 2018).
It is very imperative for having the correct knowledge about using NSAIDs specially
treating with elder people because sometimes it may provide drastic effect over elder
persons (Supakanya Wongrakpanich, 2018).
Answer (2)
According to the case study, Mr Jack was diagnosed by’ metastatic lesions in thoracic
and lumbar vertebrae’ that is a very severe form of cancer. The MRI report used in this
diagnosis and Mr Jack was invited to immediately consult with the rheumatologist (Karl-
Stefan Delank, 2020).
The treatment of this disease is related to chemotherapy, surgery, radiotherapy and
many other latest techniques. Mr Jack was suffering from a severe lower back pain and he
diagnosed with this life taking disease (D Ananthakrishnan, 2020). This disease is related to
abnormal growth of the tissues of vertebrae, which can be related to the injury in spinal
cord or may be related to the tumour which can be spread into the other body parts (Soo-
Ryu Kim, 2013).

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TREATMENTS RELATED TO SPINAL CORD INJURIES
As discussed with the case, Mr Jack is more prone to suffer with injury in his spinal
cord and that is why he was suffering from a constant and threshold lower back pain. It was
also stated that he was a construction worker that is why there are huge chances for getting
spinal cord injury for him (Rose PS, 2011).
IV (Intravenous) methylprednisolone (Solu-medrol) is used for treating the patients
of spinal cord injury. Immobilisation and surgery option are also used to treat the patients of
the spinal cord injuries (Karl-Stefan Delank, 2020). However, there are many mew
techniques have been invented to treat the patients of spinal cord effectively. The
treatment of the bones of the spine is very crucial and critical that is why the most suitable
treatment is depends upon the rheumatologist (Clinic, 2020).

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TREATMENTS RELATED TO SPINAL CORD INJURIES
References
Clinic, M. (2020, April 2). Spinal cord injury. Retrieved from The official website of mayo
clinic: https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/diagnosis-
treatment/drc-20377895
D Ananthakrishnan, G. C. (2020). Trauma of the Spine and Spinal Cord. Global Orthopedics,
251-260.
Karl-Stefan Delank, C. W. (2020, April 2). The Treatment of Spinal Metastases. Retrieved
from The official website of NCBI:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036978/
Rose PS, B. J. (2011). Metastatic disease in the thoracic and lumbar spine: evaluation and
management. The Journal of the American Academy of Orthopaedic Surgeons, 37-48.
Soo-Ryu Kim, M.-J. L.-J.-S.-H.-H. (2013). Thoracolumbar Junction Syndrome Causing Pain
around Posterior Iliac Crest: A Case Report. Korean Journal of family medicine, 152-
155.
Supakanya Wongrakpanich, A. W. (2018). A Comprehensive Review of Non-Steroidal Anti-
Inflammatory Drug Use in The Elderly. Aging and diseases, 143-150.