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Woman with cystic fibrosis hospitalized for exacerbation


Question: A 28-year-old woman with advanced cystic fibrosis is hospitalized for a pulmonary exacerbation. She has chronic chest wall pain from coughing and pleurisy, and she recently broke 2 ribs from coughing. She is on IV glucocorticoids, IV ketorolac, IV ketamine before vest treatments, and lorazepam. At home, she was taking oxycodone ED 30 mg q12h. Currently, she is on a hydromorphone patient-controlled analgesia (PCA) pump at 2 mg/hour, with 2 mg q30 minute boluses as needed. She is becoming drowsy and reports that her pain is minimally improved and still severe for most of the day (7-8/10) and "nearly intolerable" during vest therapy. Which of the following is the best step in management? Looking for Assignment Help? A. Increase her PCA basal and "bolus" doses by 50% B. Add a second opioid C. Discontinue hydromorphone and switch to another opioid D. Stop the vest therapies

 

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Other Subject: Woman with cystic fibrosis hospitalized for exacerbation
Reference No:- TGS03451266

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