Discussion 1
The present case involves a 26-year-old runner that experienced persistent pain after an ankle sprain. The pain-relieving medication to be prescribed would be Celecoxib (Celebrex), Hydrocodone and Acetaminophen. The reason for these medications is that Acetaminophen would not provide adequate pain relief for the ankle by itself and the patient may also not be able to tolerate NSAIDs (Marcus, 2017).
The dosage for the medications would be Celecoxib 100 mg which would provide sufficient analgesia throughout the day. Additionally, Hydrocodone 5 mg and acetaminophen 500 mg in two tablets would be able to treat the severe pain. Thirty tablets will be provided to the patient. The patient should also be informed of the possible risks and side effects of the medication. One of the most common side effects of the medication is gastrointestinal distress.
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The age of the patient influences the medication prescribed. He is a healthy 26-year old individual. At this age, he is not at a high-risk for chemical dependency. He lives an active lifestyle, is health-conscious, and highly motivated to return to normal activities.
The patient care plan would have the goal of treating the ankle sprain in order to decrease the swelling and pain. The PRICE therapy would be one of the best treatment plans. Protection will be done by wrapping and supporting the ankle. Rest would be recommended with minimal activities and no exercising. Ice would be used to relieve the swelling. Compression would be done by compressing the ankle sprint to control the swelling. Elevation will be done by raising the ankle above the level of the heart (Ploumis & Gkiatas, 2019). A follow-up visit will also be included in the treatment plan where the patient’s progress will be observed. It is expected that the swelling will have reduced and that he should be able to bear the weight of the ankle. In the case of intestinal problems due to the treatment, he will be advised to increase his fiber intake.
Discussion 2
The organ that is mostly affected by taking NSAIDs is the stomach and gastrointestinal disturbances are the most common side effect. These side effects could be apparent through diarrhea, constipation, vomiting, and nausea. Intestinal bleeding and ulcers could also be caused. Patient education to be provided will involve informing them to take foods along with the medications in order to decrease the discomfort. NSAIDs can also be harmful to the kidneys and patients with pre-existing conditions are at high risk (Woo & Robinson, 2015).
Aspirin is a salicylate which has anti-inflammatory, anti-platelet, and antipyretic actions. The anti-inflammatory actions of Aspirin are higher than NSAIDs. Just like the NSAIDs, aspirin can damage the gastrointestinal system and can result in severe irritation and even bleeding. Taking aspirin in large amounts can lead to ototoxicity. Patient education when taking aspirin will involve taking aspirin with a balanced diet in order to lessen the gastrointestinal upset. Individuals taking aspirin for the long-term should be especially keen with their diet. Additionally, patients should avoid foods that contain salicylates such as licorice, paprika, and curry (Woo & Robinson, 2015). In case the patient is already taking an anticoagulant, they should not take aspirin as this could increase the possibility of gastrointestinal bleeding.
The diagnoses for which NSAID would be administered include rheumatoid arthritis, gout, and bursitis. The diagnoses for which Aspirin would be administered include juvenile rheumatoid arthritis, acute rheumatic fever, and transient ischemic attacks. Aspirin is normally prescribed to arthritis patients and NSAIDs are prescribed when an individual cannot tolerate Aspirin ().
There are a series of diagnostic tests that would be performed for a patient that has had a large intake of NSAIDs and Aspirin. One of the tests that can be carried out would be the alteration of urine pH to indicate salicylate poisoning. Salicylic acid is usually eliminated by the body through renal secretion and the amount secreted usually exceeds the normal urine pH. Laboratory Studies through the use of a momogram has been developed to test for ibuprofen. Additional tests may also include may include analysis of liver function tests, a complete blood count, and coagulation studies (Hardy et al., 2017).
References
Hardy, E., Toro, C., Dorrian, S., & Salanke, U. (2017). 37 Routine testing of salicylate levels in overdose patients: still needed?. Emerg Med J , 34 (12), A886-A886.
Marcus, C. (2017). Sprains, Strains, and Fractures. Journal of Consumer Health on the Internet , 21 (2), 177-187.
Ploumis, A., & Gkiatas, I. (2019). Musculoskeletal Pain Management. In General Orthopaedics and Basic Science (pp. 105-110). Springer, Cham.
Woo, T. M., & Robinson, M. V. (2015). Pharmacotherapeutics for advanced practice nurse prescribers . FA Davis.
