Steve is a 55 year old computer analyst who was diagnosed with widely metastatic adenocarcinoma of the prostate. He has experienced a great deal of pain throughout his disease but has fortunately been well controlled until recently. He presents now with severe back pain. He rates his pain at a level 9 on a 0-10 scale. You are the nurse practitioner on the palliative care team and have just received a consult for pain management for this patient.
Where do you start with defining a direction for managing Steve’s pain?
Discuss the various pain scales and the values of each
Define differences in nociceptive and neuropathic pain. What is pain tolerance, physical dependence versus psychological dependence? What is equianalgesia?
Discuss the six adverse side effects of opioids and the pharmacologic/non pharmacologic treatment options. What is Relistor and when is it appropriate to use?
When is it appropriate to use palliative sedation with palliative care patients?
Textbook readings as appropriate; additional reference materials as indicated
Matzo & Sherman Chapter 19Ferrell & Coyle Chapter 26, 42, 67Wrede Seaman p. 108-122; p. 179-189