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February 2012, Volume 42 Number 2 , p 72 - 72


  • Stephanie M. Lucas MSN, RN, OCN


MS. L, 63, ARRIVES in the outpatient chemotherapy clinic for her scheduled treatment. During your assessment, she tells you her back has been aching for the last 2 days. She's been taking acetaminophen at home with no relief. Ms. L was diagnosed with multiple myeloma 10 months ago and a recent bone scan revealed several new lesions. She's been coming to the clinic once a month for chemotherapy.Ms. L says her back pain woke her up during the night about 2 days ago. She denies any recent falls or trauma. The back pain originates in the lower thoracic region of her spine. She describes it as a constant ache that radiates to both legs and is exacerbated by ambulation or other movement. Ms. L also reports decreased sensation and tingling in both feet. Her gait appears ataxic. On exam, she has 3/5 muscle strength and decreased deep tendon reflexes in both legs. She denies any recent changes in bowel or bladder function.Multiple myeloma can cause skeletal destruction from the formation of osteolytic

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