Complex regional pain disorder http://cdnmedia.waldenu.edu/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_07/index.html

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Working Through Decision Trees
Posted on: Sunday, July 3, 2022 12:00:00 AM EDT
As you start your decision tree assignment in Week 6 and complete by Day 7 for Week 8, please keep in mind on how to clinically justify your choices for treatment options for patients.
• Always think through the patient’s current medications and their past medical history to evaluate new therapies. Complex Regional Pain Disorder Essay Paper
• When evaluating new therapies, think about whether the patient has any contraindications to treatment, potential drug interactions, and the safety profile of the drug. Are there any medical conditions that may prevent the patient from taking the new medication?
• Finally, consider counseling points for the patient. What are the things you would inform the patient to monitor for while on therapy? As a clinician, are there specific labs or assessments you would need to complete at baseline, during, or after therapy?
To Prepare
• Review the interactive media piece assigned by your Instructor.
• Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
• Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
• You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.
Write a 1- to 2-page summary paper that addresses the following:
• Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.Complex Regional Pain Disorder Essay Paper
• Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
• What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
• Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.
You will have to evaluate those treatment options and determine if you would make any changes to the regimen in terms of the medication, dosage, and evaluation of adverse effects and or contraindications that could complicate treatment.
The full description of the case is under “Week 6”, then go to ”Resources”, then go to “Interactive Media” where you will find the case and the different Decision Trees. http://cdnmedia.waldenu.edu/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_07/index.html
Decision Point 1: Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and day 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter

Complex regional pain disorder

Case Summary

The client is a Caucasian male who is 43 years old and complains mostly of pain when he comes in for treatment. The patient has to use crutches to go about since he is unable to walk on his own. The patient has been diagnosed with a complex regional pain disorder following an examination by a medical professional. This is a disease that is a persistent condition of the nervous system and is brought on as a consequence of impairment to the sensory, trophic, autonomic, and motor processes in the lower extremities.

Decisions

A 12.5 mg dose of Savella, to be taken orally and only once per day, was the first course of action that was decided upon. After this, the patient should proceed to take the drug twice daily on the second and third days after the first dose. After that, the dosage is raised to 25 milligrams, which will be given out twice a day beginning on day eight forward. Decision two is to continue with the current treatment plan, but with the dosage of a more manageable 25 milligrams each dose, to be taken twice daily. The third decision involves a modification in the dosage, which will result in the drug being taken orally at a dosage of 25 milligrams in the morning and 50 milligrams before going to bed. Complex Regional Pain Disorder Essay Paper

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Basis of the Decisions

In light of the diagnosis that was reached, the primary goal of treatment was to aid the patient in attaining physical and mental well-being, with a particular emphasis on pain management. According to evidence-based medicine, both pharmacologic and nonpharmacologic therapies are necessary for the control of pain brought on by complex regional pain conditions (Shim et al., 2019). At the beginning of the therapeutic process, it is recommended that the client use a medicine that has NMDA antagonist effects. The purpose of this medication is to exercise control over the mechanism of causing neurological pain (Taylor, 2021). After a period of four weeks, the client visits the doctor again and reports that the level of pain has significantly decreased, scoring a four out of ten. At this point, he is walking unassisted, meaning that he is not using crutches. In addition, he notes that the pain is at its height first thing in the morning and gradually subsides over the day. There is a slew of adverse effects that the client is reporting as well. As a result of the adverse effects, it is agreed that the medication dosage should be lowered in order to limit the number of adverse effects that would result from this treatment.

The patient comes back after a few weeks, exhibiting an even more painful state than before. Taking the medication at half the starting dose has been shown to be effective in alleviating acute morning pain. Non-pharmacological approaches to pain treatment, like mild physical activity and chiropractic therapy, are also recommended to the client, which improves their mental health (Birklein & Dimova 2017).

The care of the client was focused on reducing the patient’s degree of discomfort to an acceptable level so that the patient would be able to effectively engage in typical everyday tasks, such as walking with only little assistance. Based on the fact that the client reported a decrease in discomfort to a level of four out of ten, I am able to draw the conclusion that this aim was successfully accomplished. Moreover, the client no longer needs the assistance of crutches while walking.

References

Birklein, F., & Dimova, V. (2017). Complex regional pain syndrome–up-to-date. PAIN Reports, 2(6), e624. https://doi.org/10.1097/pr9.0000000000000624

Shim, H., Rose, J., Halle, S., & Shekane, P. (2019). Complex regional pain syndrome: A narrative review for the practising clinician. British Journal of Anaesthesia, 123(2), e424-e433. https://doi.org/10.1016/j.bja.2019.03.030

Taylor, S., Noor, N., Urits, I., Paladini, A., Sadhu, M. S., Gibb, C., Carlson, T., Myrcik, D., Varrassi, G., & Viswanath, O. (2021). Complex regional pain syndrome: A comprehensive review. Pain and Therapy, 10(2), 875-892. https://doi.org/10.1007/s40122-021-00279-4

Complex Regional Pain Disorder Essay Paper