Discussion Post
You are working in the critical care unit as an ACNP, in your first year, on nights, and you are the only one in the department. You have a critical care MD, pharmacist, and hospitalist on call and available to you by phone. Describe your assessment and appropriate interventions and referrals for the following patient.
• He is a 90-year-old male with mild dementia who underwent a total right hip replacement and a right-sided thoracotomy/chest tube placement earlier in the day due to trauma: He fell down 13 stairs and remained on the floor for 13 hours prior to discovery and rescue.
• His head CT noncontrast is negative, but closed head injury is highly suspect. He is confused, combative, yet understandably complaining of 10/10 pain in his hip and chest tube site.
• The surgeon has ordered morphine 1 mg q. 4 hours prn pain and Tylenol 650 q. 4 hours prn. The patient's family is very concerned and wants the patient's pain addressed.
• He is a full code blue; his VS are as follows: BP 160/75, HR 98 Afib RVR, RR 24 spontaneous, 02 sat 90% on 3 liters NC. This patient has COPD with 2 liters of 02 at home, hypertension, dementia-early, Afib on ASA and metoprolol, and takes oxycodone 10 mg q. 3 hours at home prn due to debilitating rheumatoid arthritis.
The response should include a reference list. Using double-space, Times New Roman 12 pnt font, one-inch margins, and APA style of writing and citations.