Nursing Student with Neuropathic Pain
Tamara Costa broke her right tibia and has undergone two separate surgeries to repair it. Although the bone has healed, she suffers increasing pain around the incision sites. The painful area covers the lateral surface of her right leg. She can't stand wearing anything over it or even having a sheet touch it. Her diagnosis is postsurgical neuropathic pain. Pain medication has not helped.
Tamara is a second-year nursing student and has done some reading to try to understand her problem and perhaps find a solution. She has found an article that says neuropathic pain may be caused by a decreased threshold for action potential generation in pain-detecting neurons. However, she has forgotten some of her physiology and needs some help in understanding what she is reading. She has logged into the “Ask a Nurse" chat line–and she got you!
5. You’ve found a copy of the same article, and see that it identifies other ways pain inhibition could decrease. Explain each of them:
a. A decrease in the number of receptors for the inhibitory neurotransmitter GABA.
b. A local decrease in the amount of Cl-outside the cell. (Hint: GABA opens Cl–channels, allowing Cl– influx into the postsynaptic cell.)
Want to see the full answer?
Check out a sample textbook solutionChapter 11 Solutions
HUMAN ANATOMY+PHYSIOLOGY-PKG.
- The recovery time for internal fixation surgery is shorter than that following a total hip replacement. The surgery is also less expensive and has a less strenuous recovery period; however, Mrs. Gwynn probably will not be able to walk again. Given the patients condition, and the limited dollars available for health care, which procedure should be performed?arrow_forwardInpatient admission: The patient fell from a tree that he was pruning on his farm. He was able to drive himself to the hospital, but it was apparent on admission that his left arm was fractured. He underwent an open reduction and internal fixation of a fracture of the proximal humerus and open reduction and Internal fixation of the comminuted fractures of the radial and ulnar shaft. He recovered without incident and was discharged to follow up in one week. Discharge diagnosis: Comminuted left radius and ulnar shaft fractures, 2) displaced left proximal humerus fracture. 7 total codes (4 of the 7 are external cause codes)arrow_forwardMrs. Thomas was on vacation out of state when she stepped off a curve and injured her left ankle. Due to severe pain she was seen at an urgent care center where she underwent a left ankle x-ray, which was negative. She was diagnosed with a left sprained ankle. A walking boot was provided to stabilize and protect her left ankle. She was provided with appropriate discharge instructions and instructed to follow up with her primary care physician upon returning home. When she presented her BlueCross BlueShield insurance card at check out, Mrs. Thomas was informed that the physician who provided treatment is a nonparticipating provider (nonPAR) and that the urgent care center accepts credit cards for payment in full. The total due was $1,500, and Mrs. Thomas assured the office staff that her insurance company would reimburse the urgent care center for services provided. The office staff further explained that their providers had not signed a contract with her insurance, and thus Mrs. Thomas…arrow_forward
- An older patient has severe osteoporosis and a collapse vertebra. She is in constant pain and receives relief only from taking a narcotic painkiller, four times a day, which is addictive. Answer the following a. Should the physician supply enough medication to provide relief or only enough pills for the patient to take when she is experiencing pain that she absolutely cannot bear? B. Also, what medical and legal requirements will you need to fulfill as a omedical assistant or medical biller?arrow_forward12. Pathophysiology of Hip Fractures. Please at least 6 to 10 sentences!arrow_forwardMrs. Thomas was on vacation out of state, stepped off a curve, and sustained a left ankle injury. Due to severe pain, Mrs. Thomas was seen at an urgent care center where a left ankle x-ray was performed, which was negative. Mrs. Thomas was diagnosed with a left sprained ankle. A walking boot was provided to stabilize and protect the left ankle. Mrs. Thomas was provided with appropriate discharge instructions and instructed to follow up with the primary care physician upon returning home. When presenting the BlueCross BlueShield insurance card at check out, Mrs. Thomas was informed that the physician who provided treatment is a nonparticipating provider (nonPAR) and that the urgent care center accepts credit cards for payment in full. The total due was $1,500, and Mrs. Thomas assured the office staff that the insurance company would reimburse the urgent care center for services provided. The office staff further explained that their providers had not signed a contract with that…arrow_forward
- What are the short term and long term outcome this nursing diagnosis? NURSING DIAGNOSIS:Impaired physical mobility related to decreased muscle control as evidenced by swollen and restricted joint movements.arrow_forwardA patient who has suffered a left hemisphere stroke to the brain.The patient has limited right side mobility and needs assistance to sit,stand, walk and lay down how to been assignedarrow_forwardWrite an explanation for what has happened to your friend.arrow_forward
- Client Profile: Mrs. Giammo is a 59-year-old woman who was brought to the emergency department by her husband. Mr. Giammo noticed that all of a sudden, his wife “was slurring her speech and her face was drooping on one side.” Mrs. Giammo told her husband that she felt some numbness on the right side of her face and in her right arm. Mr. Giammo was afraid his wife was having a stroke so he brought her to the hospital.Case Study: In the emergency department, Mrs. Giammo is alert and oriented. Her vital signs are temperature 98.28F (36.78C), blood pressure 148/97, pulse 81, and respiratory rate 14. An electrocardiogram (ECG, EKG) monitor shows a normal sinus rhythm. Mrs. Giammo is still complaining of “numbness” of the right side of her face and down her right arm. Her mouth is noted to divert to the right side with a slight facial droop when she smiles. Her speech is clear. She is able to move all of her extremities and follow commands. Her pupils are round, equal, and reactive to light…arrow_forwardIdentifying the painarrow_forwardMrs. Norma Jean is a 65-year-old female. She was getting up to walk to the bathroom in the middle of the night when she tripped over a throw rug and fell onto an outstretched hand. In the ER the doctors noted that she sustained a distal radius fracture. She was placed into a sugar tong plaster splint that included the elbow joint. At her next follow up 1 week later, she was then transitioned to a short arm cast. She was followed up weekly by her physician for repeat radiographs, which demonstrated acceptable healing without secondary displacement or collapse of the fracture. Now 8 weeks have passed and she is referred to your outpatient hand clinic with orders to “Evaluate and Treat”. You notice that Norma is generally stiff but has a marked loss of passive extension of her radiocarpal joint. Motor, sensory, and pulses are intact. Please complete the following questions. There are supplementary articles to help you complete this discussion. . 1) Norma has a lot of questions for…arrow_forward
- Comprehensive Medical Assisting: Administrative a...NursingISBN:9781305964792Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy CorreaPublisher:Cengage LearningMedical Terminology for Health Professions, Spira...Health & NutritionISBN:9781305634350Author:Ann Ehrlich, Carol L. Schroeder, Laura Ehrlich, Katrina A. SchroederPublisher:Cengage Learning
- Understanding Health Insurance: A Guide to Billin...Health & NutritionISBN:9781337679480Author:GREENPublisher:Cengage