NR603: Week 7: Case Study Discussion

Purpose

The purpose of this assignment is for students to:

1. Improve their ability to formulate diagnoses based on clinical presentation of patients
2. Design relevant treatment plan
3. Link pathophysiologic concepts to medication choices
4. Collaborate without outside providers and resources

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Describe the psychodynamic principles of alcohol, opioids, stimulants and benzodiazepines
2. Discuss harm reduction principles in SUD
3. Discuss FDA approved treatment options for SUD 
4. List the benefits of using medication assisted treatment (MAT) for SUD
5. Identify resources to complete the DATA waiver process
6. Discuss when and how to taper patients off of common addictive medications, such as benzodiazepines and psychostimulants
7. Identify treatment options for special populations

Due Date

First post due by Wednesday 11:59PM MT

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday 11:59PM MT of Week 3, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0).  

Requirements

Complete the following case studies:

1. The patient is a 58-year-old woman with chronic pain due to inflammatory arthritis. She presents for her first appointment with you in a primary care office. She states that she is aware that she is asking for an early refill of her Oxycontin however she is traveling out of state and she is concerned that she may have a flare up on her trip.

• Apply the steps in SBIRT to this scenario
• Identify additional questions for this patient
• Develop a treatment plan for this patient

2.The patient is a 24-year-old man brought to your clinic by his family for an evaluation. The patient states that he is struggling with prescription pain pills and wants help. He appears to be in opioid withdrawal; he describes anorexia and diarrhea, he is yawning and sweating upon examination. He scores 15 on the Clinical Opioid Withdrawal Scale (COWS), indicating moderate withdrawal.

• Initiate office-based buprenorphine/naloxone (Suboxone) with a plan for observation.
• Include your rationale for each treatment decision
• Develop a treatment plan for this patient that includes ongoing MAT and psychosocial treatment interventions.
• Construct a safe taper schedule for a patient taking alprazolam (Xanax) 2mg TID. Include a brief narrative explaining the evidence for tapering a patient who has been on a benzodiazepine for an extended amount of time.

Foli, K. J., Huang, W., Adams, N., Kersey, S., Good, B., Ott, C., & Duha, M. S. (2021). Nurses’ Substance Use Education Through a Massive Open Online Course (NSUE-MOOC). Purdue University, School of Nursing, West Lafayette, Indiana.