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!
4. NCLEX-STYLE The article suggests that it might also be possible that Tamara’s pain is due to the lack of the usual inhibition of transmission of pain signals through Tamara's spinal cord. Which of these statements best describes how a postsynaptic neuron is inhibited by a presynaptic neuron?
a. The frequency of action potentials in both the presynaptic and postsynaptic neurons decreases.
b. The presynaptic neuron becomes more negatively charged when it fires instead of becoming more positively charged.
c. The presynaptic neuron stops releasing its neurotransmitter.
d. The neurotransmitter from the presynaptic neuron causes a local hyperpolarization in the postsynaptic neuron, which reduces the likelihood that the postsynaptic neuron fires an action potential.
Want to see the full answer?
Check out a sample textbook solutionChapter 11 Solutions
Modified Mastering A&P with Pearson eText -- Standalone Access Card -- for Human Anatomy & Physiology (11th Edition)
- 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_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_forwardHistory of patient: “A 12 year old girl presented to the A&E department at a weekend, with pain on movement of the left shoulder. Initially there was no history of trauma. Although when seen in clinic, she mentioned having played rugby a few days before the onset of pain.” Physical examination: “…revealed minimal tenderness above the clavicle and painful shoulder movement.” Imaging: Radiography was performed, see Figure 1. “The initial radiograph was reported as no bony injury, the ‘fracture’ diagnosed [by the radiologist] as an anomalous articulation.” Treatment: a collar and cuff (Figure 2) and analgesia. Follow up: “Another radiograph [Fig 3] six weeks later showed callus around the ‘anomalous articulation’, which supported our earlier diagnosis of fracture [of the first rib]. She…has had an uneventful recovery.” In other words, the radiologist got this wrong, when s/he diagnosed an “anomalous articulation” on the first x-ray. This patient did not break any…arrow_forward
- Nonearrow_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
- A 43-year- old man is brought to the emergency department 1 hour after forcible eversion of his left foot while jogging on uneven ground. Walking is limited by pain. He rates the pain as 7 on a 10-point scale. His vital signs are within normal limits. Physical examination shows tenderness and swelling over the lateral malleolus. An x-ray of the left lower extremity shows a fracture of the fibula just above the distal tibiofibular articulation. Contraction of which of the following muscles most likely caused this patient's pain at the fracture? A ) Extensor digitorum longus B ) Fibularis (peroneus) longus C) Fibularis (peroneus) tertius D) Flexor digitorum longus E) Tibialis anterior F) Tibialis posteriorarrow_forwardHello good day, I hope today has been kind to you. So I am having a problem answering this question and I need your help. Hoping for a response and thank you so much. Instruction: The answer must be in 2 paragraphs and each paragraph must have a minimum of 4 sentences.Thank you so much. Question: How does histology help diagnose an injury or disease?arrow_forwardClient 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_forward
- Mr. Anwari, age 73, is brought to the physician’s office by his daughter, Lucy, who is a licensed practical nurse (LPN). She states her concerns about her father: During the past 2 months he has been found wandering in the neighborhood because he forgets where he lives. Neighbors see him, note that he appears confused, and bring him home. Lucy is worried that her father is showing signs of early Alzheimer’s disease.1. Describe the physical changes that occur in the cortex of the brain.2. Describe the stages of Alzheimer’s disease.3. Describe the physiological and psychological changes that occur during Alzheimer’s dementia.4. What are the functions of the frontal lobe of the cerebral cortex?5. What parts of the limbic system may be affected in Alzheimer’s disease?6. What would be the concerns of the family when a person is diagnosed with this disease?arrow_forwardnursing care plan for patient diagnosed with fibromyalgia syndrome.arrow_forwardAn older patient has severe osteoporosis and a collapsed vertebra. She is in constant pain and receives relief only from taking a narcotic painkiller four times a day, which is addictive. For your initial post, please answer the following 2 questions: 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? Think this through and formulate questions that might help you decide what stance to take. Which medical and legal requirements will you need to fulfill as a medical assistant or medical biller?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