White Man with Hip Pain Essay.

Posted: November 8th, 2022

White Man with Hip Pain Essay.

Examine Case Study: A Caucasian Man With Hip Pain. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

ORDER A PLAGIARISM-FREE PAPER HERE

At each decision point stop to complete the following:

Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn+last name+first initial.(extension)” as the name.
Click the Week 7 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 7 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:

Week 7 Assignment Rubric

Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:

White Man with Hip Pain
Introduction
Complex regional pain disorder refers to a chronic condition where, in most cases, one limb is affected, particularly after an injury. The condition is also accompanied by depression, anxiety, parenthesis, sleep disturbances, and deterioration of physical function (Zanotti et al., 2017). The client in the case study presented with complains of a hip pain that began 7 years ago after sustaining a fall. The client also reported a euthymic mood. He was diagnosed with complex regional pain disorder. The purpose of this assignment is therefore to discuss three decisions about the appropriate treatment choices for the client.
Decision Point One
The first decision is for the client to start Savella 12.5 mg and have the dose increased appropriately. Savella was chosen because the efficacy of the medication in the treatment of fibromyalgia has been demonstrated in various studies. Fibromyalgia is a condition that affects cartilages, muscles, as well as other supporting tissues. Savella is an SNRI and possesses NMDA antagonist activity and hence increases the level of neurotransmitters (serotonin and norepinephrine) in the brain; this produces analgesic effects and hence treatment the pain (Abida et al., 2016). In addition, Savella has minimal side effects and hence the client will tolerate the medication (Masuda et al., 2014).
The selection of this decision hoped that the pain score would reduce. This is because Savella produces analgesic effects leading to pain reduction (Abida et al., 2016). It was also hoped that the client would tolerate the medication and hence experience no or minimal side effects.
As per the expectation, the client reported significant pain reduction and this was attributable to the analgesic effects of Savella (Abida et al, 2016). However, the client reported nausea, sweating bouts, butterflies within his chest, and increased heart rate and blood pressure. These are the side effects of Savella(Abida et al, 2016).
Decision Point Two
The second decision is to have the client continue with Savella but at a reduced dose of 25mg twice daily. This decision was selected because the client is responding well to Savella as indicated by reduced pain score due to the analgesic effects of the medication (Abida et al, 2016). The client reported side effects and hence this is the reason a lower dose was selected.
Selecting a lower dose of Savella hoped that the pain score would continue reducing and that the client would not experience major side effects. This is due to the efficacy of Savella as an analgesic (Abida et al, 2016).
However, the outcome of the decision was that the client experienced increased pain score, which was negatively affecting his mood as indicated by the sad look. However, the client did not report significant side effects. The increase in pain score is attributable to the reduced efficacy of the lowered dose. The recommended dose of Savella is 2.5 mg/day on the initial day, which should be increased systematically up to 100 mg/day after the 7th day (Mease et al, 2014). This hence explains the decreased efficacy of Savella 25 mg in reducing the pain.
Decision Point Three
The third decision is changing Savella to 25 mg orally in the MORNING and 50 mg orally at BEDTIME. The rationale for selecting this decision is due to the increased efficacy of higher doses of Savella. According to Hayashi et al., (2017), if the efficacy of the standard dose of Savella is poor, the dose can be elevated, while closely monitoring the response or any side effect. The rationale of increasing the dose at bedtime is to lower the side effects when the client is active and awake.
The selection of the decision hoped to increase the efficacy of the medication and hence reduce the pain score to acceptable levels for the client. This is due to the increased efficacy of Savella with higher doses (Hayashi et al., 2017).It was also hoped the client would tolerate the dose and report no or minimal side effects.
Ethical Considerations
The main ethical issue associated with the treatment of this client is informed consent. The PMHNP should explain to the client all the information regarding the available treatment choices, and this includes the associated side effects. This will help the client to make an informed treatment choice.
Conclusion
The first decision was to have the client start Savella 12.5 mg and have the dose increased appropriately. This is because Savella has been shown to be effective in relieving pain and treating fibromyalgia. The client reported significant pain reduction but also reported serious side effects. The second decision was hence to continue with the same mediation but at a reduced dose. However, even though the client reported reduced side effects, the pain score increased. Therefore, the last decision was changing Savella to 25 mg orally in the MORNING and 50 mg orally at BEDTIME. This decision was selected to increase the efficacy of the medication and lower the pain score while ensuring that the client did not experience side effects because a higher dose was administered at bedtime.