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Case 01: Focused Exam: Pain Management Results | Turned In
Pharmacotherapeutics for Advanced Nursing Practice - Spring 2020, NGR 6172
Return to Assignment (/assignments/283572/)
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Experience Overview
Transcript
Started: Jan 21, 2020 | Total Time: 149 min
Your Results Lab Pass (/assignment_atteOverview
Transcript
Subjective Data Collection
Objective Data Collection
Education & Empathy
Documentation
Debrief
Medication Selection
Patient Teaching
Prescription Writing
Patient: Tanner Bailey
Digital Clinical Experience Score
100%
This score measures your performance on the Student Performance
Index in relation to other students in comparable academic programs.
Your instructor has chosen to scale your Student Performance Index
score so that the average score on the index is a 80.0%. This score
may not be your final grade if your instructor chooses to include
additional components, such as documentation or time spent.
Student Performance Index
56.5 out of 58
Proficiency LeveStudents rated as “proficient” demonadvanced practice competencies acomparable programs, the top 25% of a proficient practitioner.
Beginning Developing PSubjective Data Collection
25 out of 25
Me9 Education and Empathy
6 out of 7
Pa6.Prescription Writing
10 out of 10
Time
149 minutes total spent in assignInteraction with patient
149 minutes
Interview Questions (105) Statements (22) Exam ActionsHello Tanner, my name is Tori. I am a nurse practitioner and will be taking care if you today.
Hey.
What brings you in today?
I picked up this heavy box at work--with like, sound equipment and stuff in it--and ever since
then, the pain in my lower back has been killing me. I think I need to be on opioids or something
oh, Im sorry to hear that you had to deal with that.
Hey, thanks.
You're welcome. I hope that through our discussion and today's exam that we can find a
solution to help you and reduce your pain. (No matching questions found.)
You're welcome. I hope that through our discussion and today's exam that we can find a
solution to help you and reduce your pain.
I appreciate your saying that.
Approximately how heavy was the box you lifted at work when you initially hurt your back? (No
matching questions found.)
How heavy was the box you lifted at work when you initially hurt your back? (No matching
questions found.)
How heavy was the box you lifted at work when you initially hurt your back?? (No matching
questions found.)
How heavy was the box you lifted at work?
Surprisingly heavy. I could tell immediately it was sound equipment and not scarves like I was
expecting.
How did you lift the box?
I'm pretty sure I lifted it from my back. I wasn't really cognizant of proper lifting technique; I was
expecting it to be like two pounds of costumes, but no. I feel pretty stupid.
All Lines (127)
Its not something to feel stupid about, its an easy mistake.
Thanks for getting it.
Its important to always practice proper lifting technique by lifting with your knees, not your back.
I hadn't thought of that.
Just something good to get in the habit of to help avoid accidents.
OK. Got it.
How would you describe the pain?
The pain is sharp and burning, and it tingles sometimes. It's always in my lower back. Never
really thought about being hurt at work, and now I've been laid up forever.
So the pain is only in your lower back?
Well, my lower back feels terrible. I just hurt it so bad picking up that box at work. I really need to
be on opioids for the pain.
Did you report the accident that occurred at work? (No matching questions found.)
Did you report the accident at work?
Yeah, I injured myself at work. Thirteen weeks ago, I picked up this box that was way heavier
than I thought.
Is the pain radiating anywhere?
No, I'd more call it hot and burning. Sharp. It tingles, too.
Does the pain spread anywhere, like to your legs? (Clarified to Does the pain radiate from your
back?.)
It only hurts in my lower back. (Clarified to if the pain radiates from my back.)
You havent been able to work since the injury?
I haven't been able to go to work since I got hurt. Doing anything physical just makes the pain
worse. Directing plays is a pretty active job. Besides, even walking hurts right now.
Im sorry to hear that, I imagine its been hard.
Thanks. I think I really needed to hear that.
So what makes your pain worse?
Physical activity like walking or lifting things hurts really bad. The physical therapy exercises I
tried at home hurt so much I haven't bothered with a therapist, even though they said to at the
hospital.
Does anything make your pain better?
Sometimes just shifting around--changing the way I'm sitting or lying--can help a little. Rest
helps a little bit, too. Drinking kind of worked, but I did have to go up to three drinks a day.
Ibuprofen didn't work at all, but these opioids I tried--hydrocodone and acetaminophen--they
actually stopped the pain.
How often do you drink alcohol?
Normally, I don't drink all that much, but I started drinking three times a day just to take the edge
off of this back pain. Before this all started, I only drank once or twice a month.
How many drinks do you have per sitting? (Clarified to How many drinks do you have in a day?.)
When I was using alcohol for my back pain, I'd drink a tumbler of whiskey three times a day.
Spread it evenly throughout the day. Sip it slowly. Tried to make it last. (Clarified to how many
alcoholic drinks I have each day.)
How big is the tumbler? (Clarified to What size are the drinks?.)
I would drink three tumblers of whiskey a day. I'm not sure how many ounces that is. I don't
think I ever got dependent on it, though. [AUDIO COMING SOON] (Clarified to what size the
drinks are.)
And when did you first start drinking alcohol?
For my back pain, I started drinking around 11 weeks ago -- stopped the ibuprofen and started
drinking, so as not to mix. But first time drinking ever? The normal story -- sip of wine when I
was a kid; my early twenties, I had drink or two a month.
Thats good you know not to mix substances,
Thank you.
Its important to realize that mixing opioids and alcohol is just as dangerous, if not more.
Thank you. One more thing to think about, huh?
When did you start taking opioids?
So, the timeline's complicated. It goes, injury, thirteen weeks ago; took ibuprofen for two weeks,
which did nothing, so I stopped; started drinking to help the pain a little; stopped drinking a
week ago to try the opioids.
So you havent been combining any substances for the pain? (No matching questions found.)
So you havent been taking substances simultaneously? (No matching questions found.)
Why did you resort to opioids? (No matching questions found.)
Why did you start taking opioids?
It was kind of perfect how it worked out -- my friend says he has some hydrocodone leftover
from a surgery and didn't need them, knowing I did. I was desperate to get some relief.
How much hydrocodone are you taking?
I take a pill morning and night; the pill has I believe 5 milligrams of hydrocodone in it and 325 of
acetaminophen.
That combination is called Percocet and is very strong.
Yeah, I guess that makes sense.
It can be very dangerous to take someone elses prescription medication.
Good to know.
Do you smoke tobacco?
Ooh, yuck. A lot of my theatre crew smokes, but I never touch the stuff.
Use any nicotine products?
Ooh, yuck. A lot of my theatre crew smokes, but I never touch the stuff.
Do you use any other illicit drugs?
I've never used any recreational drugs. [AUDIO COMING SOON]
How do you rate your pain on a scale of 1 to 10, with 10 being the worse pain youve ever
experienced?
At its worst, I'm probably at a 7 out of 10. It can get d
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