NRNP 6550 Week 9 i-Human Case Study Betty Burns

Course : Course

Contributed : Amelia

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Primary Diagnosis: L4 compression fracture secondary to metastatic bone cancer

Status/Condition (Critical, Guarded, Stable, etc.): Stable

Code Status: Full Code

Allergies: NKDA

Admit to Unit: med/surg tele

Activity Level: Bedrest, then as ordered by specialty

Diet: Cardiac

IV Fluids: NS @ 100cc/hr- ( to assist with hypercalcemia and clearance)

Critical Drips (If ordered, include type and rate. Do not defer to ICU protocol.): None

Respiratory: Oxygen (If ordered, include type and rate.), pulmonary

toilet needs, ventilator settings: Oxygen PRN via NC to maintain saturation of ≥ 94%, titrate up to 6 lpm

Medications (include ALL, tx of primary condition, underlying conditions, pain, comfort needs, etc., dose and route):

Lidocaine patch to lumbar spine every 12 hours
Gabapentin 300 mg orally daily (Tanna & Ong, 2022)
Fluticasone/salmeterol Inhalation daily (consult with primary pharmacy for dose)
Hydrochlorothiazide orally daily (consult with primary pharmacy for dose)
Albuterol MDI 2 puffs PRN every 4 hours as needed for wheezing
Morphine 4 mg IVP now and then 2mg IVP every 4 hours PRN breakthrough pain
Norco 5/325mg 1 tab orally every 4 hours PRN pain 1-5/10
Norco 10/325mg 1 tab orally every 6 hours PRN pain ≥ 6/10
Acetaminophen 650 mg orally every 6 hours PRN temp > 100.4 F
Zofran 4 mg IVP every 4 hours PRN nausea
Maalox 30 cc orally every 4 hours PRN indigestion…….. Continue