Step 1: Review your assigned client scenario below. Your assigned client is based on the first letter of your last name in the chart below. The scenarios below depict inappropriate or excessive opioid use.
| Last Name | Client from Week 3 Lesson |
| A – E | David Ball, a 45-year-old male, is currently taking hydromorphone (Dilaudid) 4mg PO QID for chronic pain from fibromyalgia. |
| F – J | Terrence Brown, a 71-year-old male, is currently taking oxycodone 10mg/acetaminophen 325mg (Percocet) QID for neuropathic pain from diabetic peripheral neuropathy. |
| K – N | Geraldine Marzec, a 60-year-old female, is currently taking oxycodone ER (OxyContin) 20mg PO BID for chronic low back pain from an old injury. |
| O – R | Bola Ogunwande, a 31-year-old female, is currently taking oxymorphone ER (Opana) 5mg PO QID for migraines. |
| S – V | Le Chin, a 54-year-old male, is currently taking morphine sulfate (MS Contin) 30mg PO TID for dental pain. |
| W – Z | Marianne Rubenstein, an 80-year-old female, is currently taking hydrocodone 10mg/acetaminophen 325mg (Norco) PO QID for osteoarthritis. |
Step 2: Review the client’s case and CDC’s (2022) CPG related to opioid prescribing. You can use the Ctrl F function on your keyboard to assist in your review of the CPG to help find keywords.
Step 3: Analyze and critique your assigned case and answer the prompts below with explanation and detail, providing complete references for all citations.
Step 4: Reply to peers with different assigned clients.
Include the following sections:
- Application of Course Knowledge: Answer all questions/criteria with explanations and detail.
- Introduce your client, their situation, and their medication regimen. Calculate and describe your client’s daily morphine milligram equivalents (MME). Provide your calculations and a rationale for your answer. Refer to this linkLinks to an external site. for reference.
- Discuss how your client’s daily MME falls above or below the threshold for additional consideration. How do you know?
- Consider the need for additional considerations given the total MME, the limited information available in the case, and the risks for overdose. What other consultations, prescriptions, and education may be required given their current individual circumstances and medications?
- Consider the appropriateness of your client’s medication regimen. According to the CPG, what other prescriptions may be more appropriate for their individual circumstances? If no change is needed or warranted according to the CPG, state that with support from the CPG.
Answer
Hello Class,
1. Due to a prior accident, my client, Ms. Geraldine, a 60-year-old woman, is currently prescribed 20 mg of oxycodone ER (OxyContin) to be taken orally twice a day for chronic low back pain. Clinicians can compare the potency of various opioids to morphine using the MME, a standardized measure. It is beneficial to establish a standardized reference for narcotic dosing to assess the risk of overdose and other opioid-related complications. The CDC offers a conversion factor for oxycodone to morphine. Oxycodone possesses an MME conversion factor of 1.5, indicating that 1 milligram (mg) of oxycodone equates to 1.5 mg of morphine. In Ms. Geraldine’s case she takes 20mg of oxycodone ER twice a day, which is a total daily dose of 40mg. The calculation for converting the total daily oxycodone dose to MME is as follows:
40 mg/day of oxycodone×1.5=60 MME/day
Therefore, Geraldine’s total daily morphine milligram equivalent (MME) is 60 mg/day……………Kindly click the purchase icon to access the full solution for $10 OR WHATSAPP +254712575747.