Question

You are the home health nurse assigned to care for a patient who is in the terminal phase of cancer. Mrs. Downs is 48-years-of-age and underwent a bilateral mastectomy last year with lymph node involvement. Recently she has been diagnosed with metastasis to the bone. She has been taking oxycodone - one 5 mg tablet every 6 hours - and not being able to sleep well through the night and now has increasing pain to the point that her quality of life has decreased significantly. She wants to stay at home through her terminal phase of her illness but also must have adequate and safe pain control. Her husband of 18 years is very supportive. They have no children and both are college graduates. Mrs. Downs's recent increase in pain has been attributed to bone metastasis to the area of the lumbar spine. At this time the oxycodone is not beneficial and you as her nurse must novw advocate for the patient to her physician to receive adequate pain relief. 1. When discussing her pain medication with her physician, what type of medication would you expect to be ordered to relive the bone pain and what is the rationale for this medication? Mrs. Downs visits her physician and receives a different opioid medication that is to be given around the clock, plus an immediate-release opioid to help with any breakthrough pain. After one week Mr. Downs finds Mrs. Downs awake but lethargic and speaks with slurring her words. What do you think has happened? 2. What should Mr. Downs do? 3. Mrs. Downs is taken to the local emergency room and is treated for overdose. Her physician is contacted and her medication dosages are adjusted to a lower dose How can this problem be prevented in the future? 4. Reviewed 9/18

Answer 1

1. The type of medication that would be expected to be prescribed for this patient is NSAIDS . Nonsteroidal anti-inflammatory drugs (NSAIDs) block the COX enzymes and reduce prostaglandins throughout the body.

2. Due to overdose of NSAIDS , slurring of speech occured

3. Mr. Down should immediately take her wife to hospital

4. By taking proper dose of medication ,and maintaining compliance will prevent such situations in future .