Bob arrived on the ward last evening at 9pm following an admission from the emergency department with increasing abdominal pain and diarrhoea for the past week. (See NSG2HPB for full examination). Bob presses his call bell and asks for pain relief. He describes his pain using COLDSPA as:
| Character | It feels like a ‘dull ache’ all the time but increases to a ‘strong pressure’ on the body |
| Onset | Pain has been ongoing over the past week however it has got worse in the last 2 days |
| Location | LLQ abdominal pain |
| Duration | On and off for the past week but worse in the past 2 days |
| Severity | At rest abdominal pain is 6/10 but can increase to 9/10 |
| Pattern | When at rest and not exerting myself it makes the pain manageable |
| Associated factors | Occasionally I have diarrhoea and after I pass stools the pain is a ‘little’ better |
Question 1. According to Bob’s medication chart the options you have for pain relief are:
- Paracetamol 1gm PO QID (Bob last had 1gm dose at 0800am)
- Endone 5-10mg PO PRN (3-4 hourly) (Bob last had 5mg dose at 1130am)
- Celebrex 200mg PO PRN (BD) (Bob last had one 200mg dose before he came to hospital he has not had a dose since his hospital admission)
Which medication (select only one) would you administer to Bob now based on the above information you have been given? And Why? Provide a detailed rationale for your answer (use an array of literature to support your choice)
- 400 words
Question 2. Working as a nurse requires a multidisciplinary team approach. Select one member of the multidisciplinary team (NOT a doctor) that you would engage in Bob’s care throughout his hospital admission. Provide a detailed rationale for your answer (use an array of literature to support your choice)
- 400 words
