Reflection On Drug Abuse

When a patient is

In the case of “Whose Pain is it Anyway?” Mr. T is admitted to the orthopedic unit after an open reduction of a fractured ankle. After receiving acetaminophen, he continues to complain of severe pain. Nurse V notifies his surgeon, who had not ordered narcotics because of Mr. T’s prior history of addiction, that the pain was not controlled. Despite the patient

Considerable cautions have been obtained throughout the United States to decrease the misuse of prescription opioids and helps to minimize opioid overdoses and related complications. Even though the pain medications have a significant part in the treatment of acute and chronic pain situations, it sometimes happen that the high dose prescription or the prescribed medications, without having enough monitoring, can create bad outcomes. It is always a dilemma for the providers to find who is really in need of pain medications and to identify those who are questionably misusing opioids.

The healthcare team honored the patients’ wishes as best as possible; the only time we bothered the patient was when we changed the dressings on the pressure ulcers located on the anterior portion of the left foot and right buttocks and when we provided the patient with PRN pain medications. Since this is a Medical Surgical floor, we were required to do one assessment, and that occurred during the time the health care team went in as a group to clump all of the care up and do it at one time. The only negative experience that had occurred was when the patient was expressing non-verbal signs of pain – and from that point, we worked quickly to give him his PRN pain medications to manage it.

Providers have left some of the discretion in the hands of the nurse in regards to how much medication the patient receives. This can cause issues if all staff do not communicate or are not trained in how to assess pain. For example, the day shift nurse provides the patient with two tablets of Percocet after their procedure. Once the night shift nurse comes in they decide the patient should not be getting two tablets and one should be sufficient. The patient may develop feeling of resentment or feel that the second nurse is judging them or not providing proper care. Having a variable dose can be a positive thing if the nurse starts with the lowest dose and if that is insufficient they can administer a second dose. Also, the plan of care must be discussed openly with the patient. The nurse who is attempting to transition a patient from intravenous pain medication to something that can be taken by mouth must communicate this with the patient and explain why this is important. If the patient is not provided with the information they may not understand and communication may break

S first, because of the worsening back pain, which can be indicative of a potential rupture and therefore be life threatening. The RN would have the UAP take vitals and report within specific parameters to maintain a close watch over Mr. S. This is the only thing the UAP would be able to do within their scope of practice but she would be alleviating the workload. Next, the RN would assess Mr. R who is reporting severe pain due to an arterial ulcer. She would use the universal pain scale and would ask what his pain level is from a 0-10. Depending on his response, the RN would then proceed by administering pain medication depending on the rating of the pain and the physicians order. The RN would then ask the LPN/LVN to administer the pain meds but only if they are PO. If it were an IV pain medication, the RN would have to administer due to the scope of practice. In 2009, Chornick found that the scope of practice for each staff member needs to be clear and delegation needs to be administered to the competent individuals who are able to perform each task according to the current situation. After administering the pain medication, the RN would need to return to Mr. R within 30 minutes to reassess the pain level and make sure the pain had subside. After treating Mr. R, the RN would assist Ms. A by providing teaching of the Doppler study that would be performed and answer any questions she may have prior to the

Two patient verifier completed. Per PA Wu , the patient was informed that she has added an additional bp med to his current regimen. Asked the patient that he has any swelling in legs. The pt says no. Informed the patient that only a 30 day supply was ordered on his Lisinipril. Please record bp readings for the next seven days at the same time then email reading via Micare. If bp in not controlled then a f/u with his provider is needed. The patient agrees and verbalized

The staff assesses Jt and then asks his mother about his allergies and medical history. They then ask what medication he takes. She states he has environmental allergies so he always takes Equate Allergy and Sinus Headache. She says he takes two tablets every 4 hrs. She then proceeds to tell the staff that the dentist who removed his wisdom teeth prescribed him Percocet 5/325mg 1 tab every 4 hrs for his pain, which he has been taking routinely. The

If the NP suspects the patient is abusing opiates and sedatives, which class of medication poses the greatest medical threat to the patient and why?

In the emergency room, Rudd was connected to the cardiac monitor, labs were drawn and a 20-guage peripheral IV was started in the right arm. An IV infusion of nitroprusside was started and vital signs were recorded periodically. The Pain was assessed using a PQRST pain assessment method and Rudd rates throbbing pain bilaterally in the head with a pain score of 8 that aggravates with moving and does not radiate to elsewhere other than the head. The orthostatic BP shows no changes. The E.D physician decides to admit Rudd in CCU to further monitor his blood pressure and watch for any signs of organ damage. The E.D physician writes an order for pain management and transfer to CCU. The ER nurse

his chronic pain in his back. Nurse J. never questioned the orders for medications or the

If a patient makes an enquiry and you are unsure of it is better to seek the correct information from a colleague than to give the wrong information.

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to

My reflection paper is on the subject of substance abuse. As the structure of society changes, the acceptability of one drug or another changes. I have dealt with my own experiences of substance abuse personally and through family and friends throughout my community. I believe there are many underlying problems Native people face today that lead to substance abuse. So, drug use and alcoholism is not the problem in my town, those are more like side effects of something deeper. I would have to agree most with the symbolic interactionist perspective as far as the labeling theory goes. There are also many images in the media that depict the use of drugs and alcohol to make it seem like even though it is bad, it is sometimes okay. These images sparked my own curiosity to experience a fun high or a night out with friends and hopefully getting lucky. I had so many questions about drug use and alcohol. My older siblings and cousins were involved in those circles so it was only natural that me and my cousins and peers who I grew up with got into smoking marijuana and buying drinks on the weekends. I did not know at the time about the dangers of underage drinking. I also had very little knowledge of the condition of my mental health at my young age. Eventually I found out that I had an addictive personality and I got myself into a downward spiral of substance abuse.

A drug is a chemical substance applied into treating, diagnosing and preventing one from disease infections or a substance that is used by a person to enhance his or her physical and mental state in the perceived effect. Drugs used for different purposes and their effect depend on which cause for usage. It causes both positive and negative consequences directly to the user and in the long-run it affects the whole society or community. Drug addiction is the activity of uncontrollable dependence on a substance by the user no matter the harm caused by its usage. It is a habit that has been in many years hard to curb especially among the youths. “We must recognize that substance abuse and addiction is a disease, not a moral failing or easily abandoned self-indulgence,” (Califano, 2008).The cases of drug abuse have been on the rise over the recent years and resulted in crimes. The cases have a great effect affected the society in general since the reliable energetic youths have turned to drug abuse. However, some measures have been initiated to mitigate, curb and treat drug addiction in the society as outlined in the essay.