You are a new FNP in a restricted state and you have your DEA license and state furnishing for schedule II-V controlled substances. You are working at a busy family practice group and you have a patient, ML, that is establishing care for the first time with your practice, and comes to you with the following scenario:
ML is a 54 y.o. Hispanic female with hx of chronic shoulder and back pain that began 10 years ago when she was in a boating accident
She lives in both US and Mexico, making regular visits across the border; lately, she has stayed in US due to Covid border crossing constraints, living with her daughter’s family
She had rotator cuff surgery in 2011 and reports to you that due to a long operation and poor positioning, she has suffered from not only pain, but also chronic numbness and tingling in her R shoulder
As “la abuela” (grandma) she is the primary caregiver of the children and homemaker for her family and her pain is exacerbated with housework, and especially with the prolonged carrying of her grandchildren; one of which is 10 m.o.
Currently, her med list is as follows
Losartan 50 mg BID for HTN
Gabapentin 300 mg po BID for pain
Atorvastatin 40 mg daily for cholesterol
Diazepam 5 mg po up to TID prn pain
Norco 5/325 mg – takes up to two, sometimes up to 4-5x a day, prn pain
She is a smoker, only smokes outside the house, and drinks 2-3 cans of beer on the weekends, but more on family celebrations
Denies recreational drugs and denies past overdoses
Recently moved to CA more permanently to stay to take care of children during Covid/school closures
She asks you to refill all her meds for 6 months like her doctor in Mexico did so she doesn’t have to make another co-pay and come back and see you so often; it’s hard for her to get an appointment, and with Covid her daughter has to take off of work to watch the kids just so she can come to you by bus since there is only one family car
Here VS are 135/75, 80, 97.5, 20 and PE unremarkable other than R shoulder exam with pain with ROM, but full ROM, no tenderness, otherwise normal, back exam including SLR are normal/neg
In 600 or fewer words, but a minimum of 250, please describe your approach with this patient. In your paragraphs, include the following:
What concerns do you have about her current regimen, and what alternatives will you discuss and offer? What other screenings might you apply? What are your own ethical standards on this case that you might consider in addition to legal standards?
Provide a sample of an appropriate pain contract that would suit this patient and address her specific safety concerns (cite it and attach the actual contract you found – you do not have to make your own – there are plenty online)
Include your steps to ensure safe prescribing. Include the registry you will search prior to any prescribing; name the CA registry and if you are in a different state, you should name that registry also.
If you were to keep her current list, what are the laws surrounding refills and the amounts you are allowed to dispense with the schedule II and III medications in the state of CA? In your own state?
Which medications on her list may you call into the pharmacy and which would you need a written script or electronic order? What are some elements required to include on the prescription form (paper or electronic signature) for the scheduled medications?
After you prescribe, how, when, and where would you (or your staff) go about making a report of your scheduled prescription in the state registry so that other prescribers and pharmacies could be aware?
Length: A minimum of 250 words, max of 600 not including references or attachments
Citations: At least two high-level scholarly references in APA from within the last 5 years
We are a professional custom writing website. If you have searched a question and bumped into our website just know you are in the right place to get help in your coursework.
Yes. We have posted over our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill our Order Form. Filling the order form correctly will assist our team in referencing, specifications and future communication.
2. Fill in your paper’s requirements in the "PAPER INFORMATION" section and click “PRICE CALCULATION” at the bottom to calculate your order price.
3. Fill in your paper’s academic level, deadline and the required number of pages from the drop-down menus.
4. Click “FINAL STEP” to enter your registration details and get an account with us for record keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.
Need this assignment or any other paper?
Click here and claim 25% off
Discount code SAVE25