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I’m Struggling with understanding this case study. Could really use some help? Thanks in advance

CASE STUDY Assignment: Pain Management

 

Mrs. Chang is an 80-year-old Asian female with terminal small-cell carcinoma of the right lung with brain metastases. The patient is on your palliative care unit and frequently reports intense breakthrough pain.

Data Obtained From Nursing Assessment

ï‚· Vital signs: afebrile; pulse, 92; blood pressure, 112/86; respiration, 28

ï‚· Dyspneic

ï‚· Weight: 96 pounds

ï‚· Height: 5 feet, 2 inches

ï‚· Lung sounds: bilateral rales and gurgling; improved after nebulization therapy

ï‚· Confused, restless, and agitated

ï‚· Bowel sounds diminished in all four quadrants

ï‚· Last bowel movement 2 days ago

ï‚· Speaks few words in English; family members at the bedside can translate

ï‚· Points to “4” pain rating on FACES pain scale

ï‚· Has used 6 rescue doses for pain in last 24 hours

 

Lab Data

ï‚· CBC shows anemia: Hgb 9

ï‚· Pulse oximetry: 92% on 02 2L/NC

 

Current Drug Therapy

ï‚· Fentanyl 75 transdermal patch, change q72h

ï‚· Morphine, 1-3 mg IM qh prn for breakthrough pain

ï‚· Amitriptyline, 150 mg PO bid

ï‚· Albuterol solution for inhalation, 2.5 mg, diluted to 3 mL with normal saline via nebulizer, three to four times daily

 

Case Study Questions:

1.     How do each of these drugs work together to address Mrs. Chang’s underlying pathologic conditions?

 

 

 

2.      Are there any contraindications or precautions that would eliminate the use of these drugs for Mrs. Chang?

 

 

3.     What patient variables are most important to consider for Mrs. Chang when assessing her drug therapy?

 

 

 

 

4.     Which of the findings from the nursing assessment demonstrate effectiveness of drug therapy?

 

 

 

 

 

 

5.     What type of medication treatment is the above treatment regimen considered?

 

 

 

 

6.     Which of the findings from the nursing assessment demonstrate possible adverse effects from drug therapy?

 

 

 

7.     What are some non-pharmacologic interventions that can be used to help pain control other than medications?

 

 

 

8.     What teaching is required for Mrs. Chang and her family regarding the drug therapy? Include list of any additional data needed to determine appropriate teaching

SCIENCE
HEALTH SCIENCE
NURSING
PHARM NR 293

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