Sample Answer for NUR-635 Topic 3 DQ 1 Included After Question
Steve, a 19-year-old male college basketball player, fell during practice. He is now complaining of leg pain. His trainer recommends a combination of rest, acetaminophen, and ibuprofen for pain control. Use the guidelines and relevant literature in your topic Resources to discuss the following:
How does acetaminophen treat pain? Include pathophysiology and mechanism of action, and determine if it treats the perception of pain or the site of trauma.
Describe how ibuprofen treats pain. Be sure to include the pathophysiology and mechanism of action, and determine if it treats the perception of pain or the site of trauma.
Explain your rationale for combining the two medications for treatment of Steve’s pain.
Develop a plan to treating Steve’s pain, include non-pharmacologic and pharmacologic approaches, include monitoring parameters and relevant counseling points.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns to AACN Core Competencies 1.2, 2.2, 2.5. 4.2, 6.4, 9.2
A Sample Answer For the Assignment: NUR-635 Topic 3 DQ 1
Title: NUR-635 Topic 3 DQ 1
How does acetaminophen treat pain? Include pathophysiology and mechanism of action, and determine if it treats the perception of pain or the site of trauma.
Acetaminophen is processed through the liver and has analgesic and antipyretic properties that are equivalent to aspirin. It reduces signals within th nervous system. Acetaminophen is devoid of clinically clinically useful antiinflammatory and antirheumatic actions. It does not suppress platelet aggregation, does not cause gastric ulceration and does not decrease blood flow or cause impairment (Rosenthal & Burchum, 2020).
Describe how ibuprofen treats pain. Be sure to include the pathophysiology and mechanism of action, and determine if it treats the perception of pain or the site of trauma.
Ibuprofen inhibits cyclooxygenase. It blocks the body’s production of prostaglandins that cause inflammation. It has anti-inflammatory, analgesic and antipyretic actions. It is processed through the kidneys. It treats fever, mild to moderate pain, and arthritis (Rosenthal & Burchum, 2020).
Explain your rationale for combining the two medications for treatment of Steve’s pain.
Acetaminophen and ibuprofen work a little differently, the combination of targeting different pathways is beneficial for pain control and fever reduction, however, if you have kidney, digestive, bleeding or liver problems, you need to be careful with taking these over-the-counter (OTC) medications (Cleveland Clinic, 2023).
Develop a plan to treating Steve’s pain, include non-pharmacologic and pharmacologic approaches, include monitoring parameters and relevant counseling points.
Non-pharmacologic:
• Physical therapy
• Occupational therapy
• Exercise
o Tai Chi
o Yoga
o Exercise regimens
• Chiropractic
• Massage
• RICE protocol (rest, ice, compression, elevation)
• MEAT protocol (movement, exercise, analgesia, treatment)
• Heat applied to joint
Pharmacologic: Nonnarcotic pain relievers and NSAIDs are first line of treatment. Acetaminophen dose of 650-1,000 mg q 4-8 hr; max QID. For Ibuprofen, 1,200-3,200 mg/day divided into 3-4 doses.
Monitoring:
Acetaminophen:
• Side effects: headache, decreased appetite
• Allergy: rash, itching, angioedema, severe dizziness, shortness of breath
• Rare but severe: liver toxicity, Stevens-Johnson syndrome, thrombocytopenia, lymphopenia
• Caution: hepatic impairment, chronic alcohol use
Ibuprofen:
• Side effects: tinnitus, hearing loss, nervousness
• Caution:
o Women trying to conceive
o Asthma
o Fluid retention
o Dehydration
o Smoker
o Alcohol use
o May interfere with effectiveness of loop and thiazide diuretics
Follow-up:
• Within 2-4 weeks after initiating medication
• As needed for increased pain or disability
• For complaints of swelling, increased warmth, or erythema in the affected joint(s) (Care on Point, 2021).
References:
Rosenthal, L. D., & Burchum, J. R. (2020). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants – e-book (2nd ed.). Elsevier Health Sciences.
Wilbur, V. (2021). APEA terms & conditions. COP . https://app.careonpoint.com/Search.aspx
Cleveland Clinic. (2023, February 24). Is it safe to take acetaminophen with ibuprofen? https://health.clevelandclinic.org/acetaminophen-with-ibuprofen/
How does acetaminophen treat pain? Include pathophysiology and mechanism of action and determine if it treats the perception of pain or the site of trauma.
Acetaminophen has the analgesic and antipyretic properties of aspirin without the antiplatelet effects as well as a decreased risk of gastric ulceration. Acetaminophen overdose can lead to severe liver injury. Acetaminophen works by inhibition of cyclooxygenase in the CNS. By limiting prostaglandin production in the CNS, acetaminophen reduces pain and fever. Acetaminophen’s inability to reduce prostaglandin production outside of the CNS means it does not have the anti-inflammatory effects.
Describe how ibuprofen treats pain. Be sure to include the pathophysiology and mechanism of action and determine if it treats the perception of pain or the site of trauma.
Ibuprofen inhibits COX-1 and COX-2 without the suppression of platelet aggregation of aspirin. Ibuprofen has anti-inflammatory properties therefore treating not only the perception of pain but also the site of trauma.
Explain your rationale for combining the two medications for treatment of Steve’s pain.
Due to the increased risk of stroke and MI, a stepped-care approach should be used in treating pain. Non-pharmacologic methods such as rest, hot/cold therapy, and physical therapy should be first. If non-pharmacologic methods are ineffective, the initial drug used should be acetaminophen. If acetaminophen is not effective, Ibuprofen can be added. Patients should take the lowest effective dose for the shortest time possible.
Combining the analgesic properties of acetaminophen with the analgesic and anti-inflammatory properties of ibuprofen, Steve’s pain should be well controlled.
Develop a plan to treating Steve’s pain, include non-pharmacologic and pharmacologic approaches, include monitoring parameters and relevant counseling points.
Steve should utilize non-pharmacologic methods such as rest, elevation, and heat/cold therapies to treat his pain. He should also alternate ibuprofen and acetaminophen for a multi-modal approach to treat his pain. He should be counseled that to consult a provider for any severe pain not relieved by the above therapies, significant swelling/bruising, or pain that persists for longer than a few days, or for pain that limits function of his leg.
Rosenthal, L., Burchum, J. (2020). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants. (2nd ed). Elsevier.
