The patient was discharged to a skilled nursing facility and is receiving physical therapy and occupational therapy 6 days each week.
Current Meds: Aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily, heparin 5000 units twice daily until discharged home, hydrocodone/acetaminophen 5/325 mg every 6 hours as needed for pain.
Pain Assessment: Patient reports pain of 7 out of 10; worse with movement.
Physical therapy notes indicate patient is unable to complete therapy goals due to complaints of pain.
I would recommend opioids to optimise pain control as it will help to reduce pain fast and also the patient would be able to do work himself and make him or her feel independent .
#. Steps to identify signs of dependence and abuse :-
Assessment Step 1: Engage the Client
Assessment Step 2: Identify and Contact Collaterals (Family, Friends, Other Providers) To Gather Additional Information
Assessment Step 3: Screen for and Detect Co-Occurring Disorders
Assessment Step 4: Determine Quadrant and Locus of Responsibility
Assessment Step 5: Determine Level of Care
Assessment Step 6: Determine Diagnosis
Assessment Step 7: Determine Disability and Functional Impairment
Assessment Step 8: Identify Strengths and Supports
Assessment Step 9: Identify Cultural and Linguistic Needs and Supports
Assessment Step 10: Identify Problem Domains
Assessment Step 11: Determine Stage of Change
Assessment Step 12: Plan Treatment
#. Education that can be provided to the patient regarding the negative effects of medications misuse are :-
1. Overdose toxicity
an adverse effect appearing after the administration of doses definitely higher than therapeutic doses
*the most frequent cause of overdose toxicity is the interaction with drug receptors
*one of the most common causes of iatrogenic disease (brought about by medical intervention)
Overdose toxicity - 2
- Incidence is low
- Seriousness can be very high
- Dose-dependent
- Mechanism is interaction with drug receptors or cellular damage
- Treat by reducing the dosage
2. Idiosyncrasy
a genetically based, abnormal physical reaction of a person to a drug
- Incidence is low
- Seriousness can be high
- Dose-dependent (usually)
- Drug-receptor interaction (usually)
- Treat by stopping the drug or use antagonists (if available)
*prophylaxis is of utmost importance - ie. detailed history taking minimizes the risk for idiosyncratic drug reactions
3. Drug Allergy/hypersensitivity
An unwanted drug effect resulting from previous sensitization to the same drug or a closely related one. PENICILLIN is the most common allergenic drug on the market.
- Incidence is generally low
- Occurs with many drugs,
- chemical structure, route of administration, frequency of exposure of a patient to a drug are especially important
The patient was discharged to a skilled nursing facility and is receiving physical therapy and occupational...
The patient was discharged to a skilled nursing facility and is receiving physical therapy and occupational therapy 6 days each week. Current Meds: Aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily, heparin 5000 units twice daily until discharged home, hydrocodone/acetaminophen 5/325 mg every 6 hours as needed for pain. Pain Assessment: Patient reports pain of 7 out of 10; worse with movement....
The patient has been at the skilled nursing facility for 4 weeks and is making progress toward rehabilitation goals; however, he complains that his leg is throbbing and feels like pins and needles. As a result, he requests to rest several times during her therapy sessions. During unit rounds, his therapist inquires whether her previous pain medication should be reordered. Pain Assessment: 4 out of 10 Current Meds: Aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily;...
Following surgery he was placed on morphine patient-controlled analgesia (PCA). He has been using 55 mg of morphine/24 hours with adequate pain control; however, he developed redness and itching on his neck that is believed to be due to the morphine. Diagnosis of Phantom Limb Pain. Current Meds: Morphine PCA; aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily; heparin 5000 units twice...
Part 1: HPI: A 78-year-old man who is to undergo a left above the knee amputation due to a limb abscess PMH: Peripheral artery disease for 18 years; cardiomyopathy, benign prostatic hypertrophy for 13 years FH: Mother had osteoporosis; father had diabetes SH: Lives with wife; has two grown children Meds: Aspirin 81mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; pantoprazole 40 mg daily; tamsulosin 0.4 mg daily Pain Assessment: Patient rates pain as 8 on a scale...
A client who has cancer is being discharged to home with hospice services. The client has a prescription for oxycodone for pain control. Which of the following medications should the nurse remind the client to take regularly to prevent a common adverse effect of this pain mediation? Ranitidine Gabapentin Docusate sodium Lorazepam A nurse is caring for an adolescent client who has been hospitalized for several weeks. Which of the following actions should the nurse take relative to the client’s...