• Readings: Woo, T. M., & Robinson, M. V. (2020). Pharmacotherapeutics for advanced practice nurse prescribers (5th ed.). Philadelphia, PA: F.A. Davis Company.
  • Chapter 12: Drugs Affecting the Central Nervous System
  • Chapter 21: Drugs Affecting the Bones and Joints
  • Chapter 25: Drugs Used to Treat Inflammatory Processes
  • Chapter 44: Pain Management: Acute and Chronic Pain
  •  
  • Recommended for drug dosing desk reference of adult populations based practitioners: Lexicomp. (2017). Drug information handbook for advanced practice nursing (17th ed.). Hudson, OH: Wolters Kluwer Clinical Drug Information.
  • Recommended for drug dosing desk reference of pediatric and family medicine populations based practitioners: Taketamo, C. K. (2017). Pediatric and neonatal dosage handbook (24th ed.). Hudson, OH: Lexicomp Incorporated

Answer the following questions for A and B in three well-developed paragraphs (450–500 words) using APA formatting, integrating two evidence-based resources to include clinical practice guidelines as well as the course textbook.

As an Advanced Nurse Practitioner (ANP), you are working in an acute care setting.

Jason Tyler is a 65-year-old male admitted to the hospital with history of chronic cancer pain using Morphine SR 60 mg PO q8h. On admission, morphine 2 mg IV q4h was ordered. The patient reports his pain only went from a 9 to an 8 after the morphine dose and is asking for more pain medication. The staff begins to question the motivation of the patient and if addiction is present. The resident decides to start a PCA for his pain. In a few hours, the patient is comfortable, resting in bed.

A: Answer the following questions and provide your rationales for your choices.

1. J.T.’s behavior is best described as: (Please provide the definition for your choice and your rationales)
   1. Tolerance
   2. Addiction
   3. Pseudo addiction
   4. Dependence
2. During his hospital stay, J.T. went into acute renal failure. He is increasingly lethargic and is experiencing confusion and some hallucinations. The physician believes the morphine metabolites may be responsible and would like to convert to an alternative regimen. What would be your recommendation?
   1. Change opioid to fentanyl patch 50 mcg q72h.
   2. Decrease morphine SR dose to 60 mg PO q8h.
   3. Switch to hydromorphone 8 mg orally q4h as needed.
   4. Add haloperidol 1 mg PO q6h.
3. Tolerance will not develop to which adverse opioid effect?
   1. Respiratory depression
   2. Sedation
   3. Constipation
   4. Nausea

B: What pieces of the holistic assessment are missing from this scenario: (Answer the following questions and provide your rationales)

1. As a healthcare provider, what else do you need to understand about this patient related to pain management?
2. In your response please provide the teaching you would provide to JT.
3. What is meant by the DEA Drug Classification Schedule? Explain each category/classification.

Please use scholarly articles from 2017 and up

APA 7th ed

As an Advanced Nurse Practitioner (ANP), you are working in an urgent care setting. TC comes to the clinic with a work-related injury to the right shoulder. The patient rates the pain 8 on a scale of 0–10. The patient is unable to perform any ROM to the shoulder. There is no neck pain.

What pieces of the holistic assessment are missing from this scenario?

1. 1- As a healthcare provider, what else do you need to understand about this patient related to pain management?
2.  
3. 2- Describe the process of rational drug choice for this case study. In your process, discuss your thought processing of anti-inflammatory agents, topical agents, and narcotics.
4.  
5. 3- Include in your response the teaching you would provide to TC.
6.  
7. 4- What is meant by the DEA Drug Classification Schedule? Explain each category/classification.