Controlled Substance Management

Select a chronic or acute pain patient treated during your preceptorship whose condition or compliance with the treatment plan was particularly challenging and involved the prescription of Schedule II controlled substances.

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40 yr old male with PMH of bi polar disorder, DM, ETOH abuse, and drug abuse( cocaine). While drinking patient crashed a motorized bicycle with bike petal impaling left lower leg. Presents with pain 9/10 large laceration 5inx2inx2in smells of alcohol and blood shot eyes.

Analyze the patient’s overall social and medical history, clinical symptoms, and clinical assessment in the context of the disease state based on relevant literature.

Develop a 20- to 30-minute Microsoft® PowerPoint® presentation, with detailed speaker notes, on the clinical management of the selected patient.

Identify the relationship of the natural history of illness, disease or injury, pathophysiology, and symptomatology to pharmacotherapeutic agents commonly used to treat patients with conditions requiring the use of Schedule II controlled substances.

Assess the risk of addiction associated with the use of Schedule II controlled substances utilizing 1 of the risk assessment tools.

• Evaluate the diagnostic work-up and clinical findings, including a rationale for each diagnostic test and expected findings, and recommend a diagnosis based on clinical and diagnostic findings.
• Develop the plan of care, including modifications of proposed therapy and dosages based on history of substance abuse or end-of-life considerations.
• Include a Schedule II controlled medication; provide a written prescription that contains all relevant components appropriate for the Schedule II controlled substance. (For California, the prescription writing for Schedule II through V must be consistent with Health and Safety Code and Pharmacy law.)
• Include any assistive therapies and specific limitations of activities.
• Address any age-appropriate modifications of proposed therapy or dosage modifications.
• Analyze the potential complications of care, drug interactions, and potential side effects of medication.
• Describe ethical and legal standards and ramifications of prescribing controlled substances. Consider the following in your discussion:
• Pharmacy monitoring programs
• Treatment addiction centers
• NP scope of practice in addiction rehab
• Medication-assisted therapies
• Create a patient education plan that shows understanding of the patient’s developmental age, health literacy, socioeconomic status, cultural sensitivity, and health belief models.
• Include underlying health issues, the proposed plan of care, and possible side effects or complications.

Demonstrate how patient/family engagement in the plan of care will be observed.

Provide examples of how the principles of Watson’s Theory of Human Caring are integrated into the plan of care and patient education.

• Analyze the challenges that this patient presented to you and how this impacted your growth as a professional nurse practitioner