Patient rounds involve various disciplines coming together to discuss the patient’s condition and coordinate care. They are used as an educational tool and also help keep everyone on the same page when it comes to the treatment plan. The following case is found in the textbook (Pharmacotherapy: Principles and Practices. Chisholm-Burns et al, eds. 5th edition. McGraw-Hill. New York 2019. ISBN-978-1-260-01944-5; Chapter 34. “Patient encounter”).
After reading the assigned chapters in the textbook, resources identified in Dynamed and Evidence based practice guidelines, please present the case to your peers in the form of a discussion. This will be your initial post. Please be sure to address all parts of the case and ensure your responses are well researched [including supporting, evidence based guidelines such those of the WHO, CDC, APS, etc.].
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 of 0 to 10.
- Based on the type of injury, what type of pain is this patient likely to experience?
- What type of pain management regimen would you suggest in operative period? Explain your answer
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.
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 daily until discharged home. He will be discharged to a skilled nursing facility for rehabilitation therapy.
You would like to convert him to a combination preparation of hydrocodone and APAP for as-needed pain relief.
- What dosing regimen would you suggest?
- What would your monitoring plan include for this patient?
- How would you assess pain response?
- The patient is concerned about the redness and itching that he developed while on morphine. Would you document this as an allergic reaction?
- What other interventions or education may be necessary at this time?
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 the patient is unable to complete therapy goals due to complaints of pain.
- Based on this information, what would you recommend to optimize pain control?
- Prescribers play a critical role in prescription drug misuse and abuse prevention. What steps can be taken to identify signs of dependence and abuse and what education can you provide to the patient regarding the negative effects of medication misuse?
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; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily, heparin 5000 units twice daily until discharged home,
- What additional recommendations would you have at this time regarding pain management?
- Are there any other therapeutic issues that should be addressed?
QUALITY: 100% ORIGINAL - NO PLAGIARISM
(USA, AUS, UK & CA PhD. Writers)
About Our Service
We are an online academic writing company that connects talented freelance writers with students in need of their services. Unlike other writing companies, our team is made up of native English speakers from countries such as the USA, UK, Canada, Australia, Ireland, and New Zealand.
- At ClassicWritersBay.com, most of our writers are degree-holding native speakers of English who are familiar with various writing styles. Our writers are proficient in many fields, including Economics, Business, Accounting, Finance, Medicine, Chemistry, Literature, Mathematics, Statistics, and many others.
- Making our customers happy is an important part of our service. So do not be surprised if you get your paper well before the deadline!
- We pay a lot of attention to ensuring that you get excellent customer service. You can contact our Customer Support Representatives 24/7. When you order from us, you can even track the progress of your paper as it is being written!
- We are attentive to the needs of our customers. Therefore, we follow all your instructions carefully so that you can get the best paper possible.
- It matters to us who writes for you, and we are serious about selecting the best candidates.
- Our writers are always learning something new, so they are familiar with the latest developments in the scientific world and can write papers with updated information and the latest findings.
- Quality original papers that follow your instructions carefully.
- On time delivery – you get the paper before the specified deadline.
- Attentive Customer Support Representatives available 24/7.
- Complete confidentiality – we do not share you details or papers with anybody else.