The following is a case study with four questions. You are required to respond to all four questions.
Response to each question should not exceed 125 words and the length of the entire assignment is 500 words.
Assignments are due at midnight. Any assignment submitted after midnight NT time incurs a
10% penalty per working day i.e. 10% penalty is incurred 5 minutes past midnight for every day it is late.
After five days (taken from midnight) the assignment receives a ‘zero’.
Assignment 1 – Case study.
Joshua was a 65-year-old mango farmer lives in Humpty Doo, Northern Territory. Eight years ago, he was diagnosed gastric cancer and subsequently a partial gastrectomy (30% resection) was performed. He underwent a complete course of radiotherapy and chemotherapy afterwards. Seven months later, the abdominal pain reappeared. On investigation metastatic tumors were identified in Joshua’s urinary bladder and urethra. Joshua was readmitted to hospital and in subsequent weeks his pain increased progressively until eventually it could only be controlled with high doses of intravenous morphine. Joshua had a midline myelotomy in the mid-thoracic region of the spinal cord after 10 months the onset of the pain. The success of the operation enabled Joshua to live pain-free until his death four years later.
- 1 Explain the physiology of Joshua’s abdominal pain.
- 2 Discuss how morphine controls acute pain.
- 3 List the strategy for pharmacological management of pain.
- 4 Outline the aim of a midline myelotomy.
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