As an MSN professional nurse, you need to be aware of the legal and ethical implications of using controlled substances in the treatment and management of chronic diseases. You should be able to identify diseases and situations where controlled substances are the best treatment option when compared to noncontrolled medications. Being able to recognize the risk factors for substance abuse is also an essential skill, especially when it comes to chronic pain management.
Scenario
You are a nurse working at a free community health clinic and have been asked to collaborate with an interdisciplinary team to help study and manage a case. You have been asked to analyze and present a case study to your supervisor about pathophysiology and possible treatment options for the individual in this case.
Case: The case concerns a homeless gentleman who appears intoxicated and in pain. He is a 68-year-old Caucasian, who is known to the clinic and often presents weekly complaints of generalized pain to his feet and knees bilaterally. He is usually given fluids and over-the-counter ibuprofen stocked by the clinic. He is then sent to the local homeless shelter after an hour or so. Today, he is refusing the ibuprofen, while complaining of more pain than usual. He wants stronger pain medication. The team suspects either chronic gout, rheumatoid arthritis (RA), or osteoporosis. They have ordered several diagnostic tests to confirm the diagnosis.
Directions
Topic: chronic gout. Then write a case study analysis explaining the pathophysiology of the selected disease and potential treatment options for the individual in this scenario. In your analysis, explain whether you would recommend using controlled substances to manage pain in this situation. Provide specific evidence from at least two scholarly sources, including one clinical practice guideline, to support your paper. You may use your textbook as a source, but it will not count as one of your scholarly sources.
Specifically, you must address the following rubric criteria:
Pathophysiology: Explain the pathophysiology of your selected disease. Include the following in your response:
What are the specific causes and risk factors for the disease?
What are the common types of pain experienced by an individual with this disease?
Is the pain likely to be acute or chronic?
Pharmacotherapeutics: Analyze potential pharmacotherapeutic options, including a first-line drug therapy option and at least one second-line or third-line option, for the individual in the case. Include the following in your response:
Would you recommend a controlled substance for pain management in this situation? Please explain.
What are some alternative and complementary treatment options you would recommend in this situation?
Legal and Ethical Implications: Describe the legal and ethical implications surrounding the use of controlled substances in this situation. Consider the following in your response:
The age of the individual in the case
Specific risks for substance abuse, including tolerance, ethnicity, and socioeconomic considerations, for the individual in the case