NR292 Pharmacology II: Case study 1
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NR292 Pharmacology II: Case study 1
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NR292 Pharmacology II: Case study 1
Mrs. Chang is an 80-year-old Asian female with terminal small-cell carcinoma of the right lung with brain metastases. The patient is on your palliative care unit and frequently reports intense breakthrough pain
Data Obtained From Nursing Assessment
•Vital signs: afebrile; pulse, 92; blood pressure, 112/86; respiration, 28
•Dyspneic
•Weight: 96 pounds
•Height: 5 feet, 2 inches
•Lung sounds: bilateral rales and gurgling; improved after nebulization therapy
•Confused, restless, and agitated
•Bowel sounds diminished in all four quadrants
•Last bowel movement 2 days ago
•Speaks few words in English; family members at the bedside can translate
•Points to “4” pain rating on FACES pain scale
•Has used 6 rescue doses for pain in last 24 hours
NR292 Pharmacology II: Case study 1
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Lab Data
•CBC shows anemia: Hb 9
•Pulse oximetry: 92% on 02 2L/NC
Current Drug Therapy
•Fentanyl 75 transdermal patch, change q72h
•Morphine, 1–3 mg IM qh prn for breakthrough pain
•Amitriptyline, 150 mg PO bid
•Albuterol solution for inhalation, 2.5 mg, diluted to 3 mL with normal saline via nebulizer,three to four times daily
Case Study Questions:
1. How do these drugs work together to address Mrs. Chang’s underlying pathologicconditions? (15 pts)
2. Are there any contraindications or precautions that would eliminate the use of these drugs for Mrs. Chang? (10 pts)
NR292 Pharmacology II: Case study 1
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