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Expert answer:How do you assess and Treat Clients With Pain ? - colle writers

Expert answer:How do you assess and Treat Clients With Pain ?

Solved by verified expert: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. State the rational for picking one medication over the other two. Include all three medication options available at each decision level .
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Assessing and Treating Clients with Pain
Complex Regional Pain Disorder: Male patient With Hip pain
BACKGROUND
This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is
assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client
reports that his family doctor sent him for psychiatric assessment because the doctor felt that the
pain was “all in his head.” He further reports that his physician believes he is just making stuff up to
get “narcotics to get high.”
SUBJECTIVE
The client reports that his pain began about 7 years ago when he sustained a fall at work. He states
that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays,
CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage
surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports
that none of the surgeons he saw would operate because they felt him too young for a total hip
replacement and believed that the tissue would repair with the passage of time. Since then, he
reported development of a strange constellation of symptoms including cooling of the extremity
(measured by electromyogram). He also reports that he experiences severe cramping of the
extremity. He reports that one of the neurologists diagnosed him with complex regional pain
syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist
referred him back to his family doctor for treatment of this condition. He reports that his family doctor
said “there is no such thing as RSD, it comes from depression” and this was what prompted the
referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a
wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!”
The client reports that he used to be a machinist where he made “pretty good money.” He was
engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she
thought I was just turning into a junkie.”
He reports that he does get “down in the dumps” from time to time when he sees how his life has
turned out, but emphatically denies depression. He states “you can’t let yourself get depressed…
you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat
it.”
During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him
to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right
leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes
are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two,
then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and
the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can
do to help me with this pain, I would really appreciate it.” He does report that his family doctor has
been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the
side effects of feeling “sleepy” and constipation. He also reports that the medication makes him
“loopy” and doesn’t really do anything for the pain.
MENTAL STATUS EXAM
The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the
weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and
spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood and
content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid
thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies
suicidal/homicidal ideation, and is future oriented.
Diagnosis: Complex regional pain disorder (reflex sympathetic dystrophy)
In summary: What needs to be in the essay.
-Introduction regarding disease
state
-High-level summary of patient case
-Purpose of the essay statement
1, Decision 1
-What options were listed
-What option did you choose?
-Why did you select that option?
-Why didn’t you select the other two
options?
-What was your goal of treatment
-Was the outcome what you
expected? Why?
2, Decision 2
-What options were listed
-What option did you choose?
-Why did you select that option?
-Why didn’t you select the other two
options?
-What was your goal of treatment
-Was the outcome what you
expected? Why?
3, Decision 3
-What options were listed
-What option did you choose?
-Why did you select that option?
-Why didn’t you select the other two
options?
What was your goal of treatment
-Was the outcome what you
expected? Why?
-Conclusion with Ethical
considerations
Resourse : Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical
applications (4th ed.). New York, NY: Cambridge University Press

The Assignment
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.
At each decision point stop to complete the following:



Decision #1
o Which decision did you select?
o Why did you select this decision? Support your response with evidence and
references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response
with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #1
and the results of the decision. Why were they different?
Decision #2
o Why did you select this decision? Support your response with evidence and
references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response
with evidence and references to the Learning Resources.
o Explain any difference between what you expected to achieve with Decision #2
and the results of the decision. Why were they different?
Decision #3
o Why did you select this decision? Support your response with evidence and
references to the Learning Resources.
o What were you hoping to achieve by making this decision? Support your response
with evidence and references to the Learning Resources.
o 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.

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