The Initial Orders to Help Control the Acute Pain
The initial step in controlling the pain should entail exploring the cause of the patient’s acute pain, implying that there is a need to get a detailed history. In addition, the plan for pain control, in this case, should be flexible since the extent of pain and the additional opioid requirement can be unpredictable among individuals chronically using opioids; thus, the level of pain may depend on the activity. Maximization of the non-opioid treatment approaches should be explored before additional opioid therapy. Methadone can be offered to the patient to manage acute pain (10-15 mg) and not exceed 20 mg per day (Jin et al.,2020). In case the patient presents with substantial opioid withdrawal symptoms within three hours, then the additional dosage should be offered, while if sedation occurs, then the next dosage has to be reduced
The Diagnosis For GI symptoms
The patient has not used medication for the last two days, and combined with the symptoms. The patient could be experiencing opioid withdrawal. Initial withdrawal symptoms may include insomnia, runny nose, anxiety, restlessness, and muscle aches (Kosten & Baxter, 2019). Other symptoms that can appear later include diaphoresis, high blood pressure, fast heart rate, vomiting/nausea, abdominal cramping, and diarrhea.
Response for Methadone and Whether I can Prescribe Methadone As an AGACNP
In our state, ARNPs operate and restrictive authority but can prescribe schedule II, III, and IV medication. Therefore, I can prescribe methadone but maintain a written collaborative agreement for prescriptive authority. In case the patient needs the medication, I can prescribe it; only that, I will have to monitor the patient’s overall condition, mental status, and vitals since the patient has a history of opioid use.
Concerns For The Patient and ACNP Practice, Resources Available, and Anticipated Referrals
Various concerns exist. From the professional and ethical perspective, the main concern is that the patient has polysubstance abuse, which can put the license at risk. The patient’s wellness is also at risk due to the influence of several medications. Indeed, it has been shown that RNs have fifty percent higher rates of substance abuse in comparison to the general public since they have drug access (Fradkin, 2022). Various resources can be used. For instance, a prescription drug monitoring program can be used to electronically track the prescription of controlled substances. They can be vital in helping practitioners to identify individuals who misuse opioids and other prescribed medication. Referrals are also anticipated in this case. For example, I anticipate r
eferring the patient to orthopedics for the assessment of pain and chronic back pain for better management. Another referral is to the psychiatric unit for mental health assessment.
Populations At Risk of Addiction, Pain Medication Diversion, and Psychological Conditions That May Cause Hyperalgesia or Adverse Reactions to Pain Regimens
Individuals from any belief or background can be at risk of addiction. However, age, medical history, environment, and genetics all have a critical role to play. Certain medications and how patients use them can also lead to addiction. Heredity also plays a big role in addiction. For example, the risk of nicotine and alcohol addiction has been shown to be based on genetics. Living in an environment where drugs are available can increase the risk of addiction. One of the conditions that may cause adverse reactions to pain regimens is opioid-induced hyperalgesia (Higgins et al.,2019).
Resources Available to A Provider of Medical Care Who Suffers From Addiction
Various resources exist in every state. One of the resources is a Physician Health Program which can be used as an intervention (DuPont, 2018). They are confidential resources used by physicians and other professionals who could be experiencing behavioral, medical, psychiatric, or addictive conditions. Depending on what is impacting a healthcare professional, the individual chooses what to use as appropriate.
References
DuPont, R. L. (2018). The opioid epidemic is an historic opportunity to improve both prevention and treatment. Brain Research Bulletin, 138, 112-114. https://doi.org/10.1016/j.brainresbull.2017.06.008
Fradkin, D. (2022). Psilocybin: A brief overview for psychiatric mental health nurse practitioners. Perspectives in Psychiatric Care, 58(3), 1200-1203. https://doi.org/10.1111/ppc.12888
Higgins, C., Smith, B. H., & Matthews, K. (2019). Evidence of opioid-induced hyperalgesia in clinical populations after chronic opioid exposure: a systematic review and meta-analysis. British Journal of Anaesthesia, 122(6), e114-e126. https://doi.org/10.1016/j.bja.2018.09.019
Jin, H., Marshall, B. D., Degenhardt, L., Strang, J., Hickman, M., Fiellin, D. A., … & Larney, S. (2020). Global opioid agonist treatment: a review of clinical practices by country. Addiction, 115(12), 2243-2254. https://doi.org/10.1111/add.15087
Kosten, T. R., & Baxter, L. E. (2019). Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment. The American Journal on Addictions, 28(2), 55-62. https://doi.org/10.1111/ajad.12862
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Lopes Write Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
- Your response needs to be a minimum of 150 words (not including your list of references)
- There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
- Include in-text citations in your response
- Do not include quotes—instead summarize and paraphrase the information
- Follow APA-7th edition
- Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
- A minimum of 6 responses per week, on at least 3 days of the week.
- Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
- Each response needs to be at least 75 words in length (does not include your list of references)
- Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
- Follow APA 7th edition
- Points will be deducted if the above is not followed
- Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
- Here are some helpful links
- Student paper example
- Citing Sources
- The Writing Center is a great resource