Age is an essential bearing factor in clinical care, both in diagnosis and management of medical conditions. A clinician needs to factor in the age of the patient when interpreting complaints to establish potential conditions. In the instant case, the 55-year old patient has back pain. The cause of the pain will depend on whether it is acute, subacute, or chronic. Further, the patient has a history of urinary tract infection (UTI), which might bear on the diagnosis. However, if the pain is simply acute, the most probable cause of a sprain, based on the relatively advanced age of the patient (Colangelo et al., 2016). Nonsteroidal anti-inflammatory drugs (NSAIDs) would be adequate to control the pain as the sprain heals on its own (Enthoven et al., 2016). Further care would depend on the condition of the patient on follow up.
Recommend for him that Would be Effective for his Symptoms
Advil 800 mg PO q6-8hr for 10 days
(Do not exceed 3200 mg/day)
Necessary Patient Education
I have given the prescription above on the basis that the patient only has a minor sprain. The painkiller will not aid in the healing of the sprain, but it will manage the pain until the healing happens (Enthoven et al., 2016). Therefore, the patient needs to rest and avoid any kind of stain on the back. If possible, the patient can use support when moving to avoid exacerbating the sprain. Secondly, the prescription is only for ten days, but the pain may not have ended by that time. The patient can call for directions on whether to buy more painkillers as they are available on the counter. Further, the prescription leaves an option of between 6 to 8 hours. The patient can take medication between the said times, depending on the pain. However, under no circumstances should the patient take the medication over four times a day. Finally, the patient needs to take regular meals while taking the medication.
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Nausea and Alternatives
Nausea is a possible side effect of taking NSAIDs such as Advil. Further, nausea can be an issue since taking Advil without food can create complications in the patient’s gastrointestinal tract. If the nausea is mild and does not result in vomiting, the patient can persevere. However, if the nausea is persistent, the patient can purchase promethazine over the counter and take 25 mg when needed but not more than four times a day. If nausea persists, alternative pain medication such as 325 mg of Acetaminophen every six hours.
Back Pain and UTI
The fact that the patient had a previous UTI that also involved a back pain could complicate his diagnosis. Back pain in a UTI means that the infection had spread beyond the urinary tract and affected the back. The current back pain can reflect a recurrence of the UTI, although such an eventuality is uncommon in men. However, due to the age of the patient, a UTI can reoccur due to an enlarged prostate (Homma et al., 2017). The patient is right to be worried about the potential connection between the back pain and the previous UTI, more so if there are other signs of a UTI. A would recommend that the patient gets a digital rectal exam and a urine test urgently.
Conclusion
As reflected by the case study analysis, age is an essential factor in the clinical care of patients. The initial prescription above stems from the age-related factor of the propensity for sprains. For a younger patient, back pain would have necessitated a more intense evaluation. Further, the issue of UTI reoccurrence due to an enlarged prostate is also age-related. However, clinicians should be careful to avoid making wrong diagnostic assumptions due to age-based biases
References
Colangelo, T., Koerner, J. D., & Vaccaro, A. R. (2016). Chapter 2: Lower Back Pain in Adults. In Differential Diagnosis in Spine Surgery . EBook
Homma, Y., Gotoh, M., Kawauchi, A., Kojima, Y., Masumori, N., Nagai, A., ... & Yamanishi, T. (2017). Clinical guidelines for male lower urinary tract symptoms and benign prostatic hyperplasia. International Journal of Urology , 24 (10), 716-729.
Enthoven, W. T., Roelofs, P. D., Deyo, R. A., van Tulder, M. W., & Koes, B. W. (2016). Non‐steroidal anti‐inflammatory drugs for chronic low back pain. Cochrane Database of Systematic Reviews , (2).
