1. Jane Wagner, a 22-year-old patient with

1. Jane Wagner, a 22-year-old patient with no previous medical history, presents to the emergency department with complaint of low back pain after slipping on a wet floor at work and falling. The patient states that the pain is a constant aching and radiates down both legs (sciatica). The MRI shows pulled muscles and ligaments surrounding the L4–L5 area. The emergency provider gives the following discharge orders: bed rest with bathroom privileges for 2 days; apply ice pack to lower back for 20 minutes several times a day for the first 48 hours; and then starting day 3 and on, apply a heating pad for 20 minutes on and 20 minutes off several times per day for the next several days, as needed, to relieve pain. Take 400 mg of ibuprofen every 6 hours and 5 mg cyclobenzaprine three times a day. Limit sitting to 30 minutes at one time. Ambulate around home and yard, as tolerated, gradually increasing activity. Avoid twisting, bending, or reaching for objects. Avoid lifting anything more than 5 pounds of weight for 1 week. See primary provider in 1 week for further evaluation. a. Explain the rationale for the administration of ice for 48 hours followed by the application of heat. b. Explain the rationale for the administration of the ibuprofen and muscle relaxer. c. What are the expected patient outcomes for the patient in this case study?

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