Current Meds: Metoprolol succinate ER 50 mg daily; rivaroxaban 20 mg daily; levothyroxine 150 mcg daily; polyethylene glycol 3350 17 g daily; lisinopril 2.5 mg daily; amiodarone 200 mg daily; sertraline 50 mg daily, hydrocodone/acetaminophen 10/325 mg every 6 hours as needed for pain. Pain Assessment: Patient reports pain of 7 out of 10; worse with movement. She complains of pain "everywhere, but my shoulder is really bothering me.". Physical therapy notes indicate patient is unable to complete therapy goals due to complaints of pain in her shoulder. • Based on this information, what would you recommend to optimize pain control? • Prescribers play a critical role in prescription drug misuse and abuse prevention. What steps can be taken to identify signs of dependence and abuse and what education can you provide to the patient regarding the negative effects of medication misuse?

Part 3 This patient is complaining of shoulder pain after surgery. This would indicate to me that she had a laparoscopic procedure. The most common issues with laparoscopic surgeries are referred pain to the shoulder due to the CO2 gas that is utilized. “Not all of the CO2 introduced into the abdominal cavity is removed through the incisions during surgery. Gas tends to rise, and when a pocket of CO2 rises in the abdomen, it pushes against the diaphragm (the muscle that separates the abdominal from the thoracic cavities and facilitates breathing) and can exert pressure on the phrenic nerve. This produces a sensation of pain that may extend to the patient's shoulders in about 80% of women for example. In all cases, the pain is transient, as the body tissues will absorb the CO2 and eliminate it through respiration” (Kaloo et al., 2019). To help with her pain control at this time I would first seek other non-pharmacologic interventions such as a TENS unit to her shoulder and alternate with ice and heat. If there is no relief then adding a topical lidocaine patch might bring her some relief

Order this paper