Case Study Assignment-PharmClinical Dilemma Case Study

Clinical Dilemma Case Study Erin McLaughlin Pain Control or Drug Seeking Behavior? I. Scenario History of Present Problem: Angela Stevens is a 28-year-old woman who is post-operative day (POD) #2 after a small bowel resection and lysis of adhesions. She has chronic abdominal pain due to severe Crohn's Disease and has developed narcotic tolerance and dependence as a result. She has been clinically stable post-op, but has been c/o increasing incisional pain despite the Fentanyl/Ropivicaine epidural drip being increased from 8 mL/hr· to 12 mL/hr· earlier today. She has hydromorphone (Dilaudid) 1mg IV push prn every 3 hours for abdominal pain that remains persistently greater than 6/10 on a 0-10 pain scale. Her pain goal is to be 4 or less. Personal/Social History: Angela is a single mother of two children ages three and one. She lives in her own apartment. She has struggled with chemical dependency in the past and denies any current problems. A routine urine drug screen before surgery was positive for benzodiazepines, even though she has no scheduled medications in this pharmacologic classification. She is estranged from her mother and has little support at home. What data from the histories is important and RELEVANT? Why is this significant to the RN? (Each data point must include a corresponding signif