Case 3 (use this case to answer the 5 questions that follow)…
Case 3 (use this case to answer the 5 questions that follow) Name: Brooks K. Age: 57 Gender: Male Medical History: Sickle cell disease, first vascular occlusive event (VOE) at age 10. Asplenic due to infarcts. Moderate renal impairment. Chief Complaint: Pain in lower left leg at fracture point. Needs outpatient medications for pain. Presenting Concerns: Brought to the emergency room following a motor vehicle accident (MVA). He is found to have minor cuts and contusions on his head, as well as a broken left tibia. His cuts are sutured, and other injuries dressed and casted. He is complaining of a new dull but severe pain in casted left leg. Other injuries from his MVA are less noticeable and not bothersome. Patient describes chronic pain in both knees and shoulder from previous VOE. Multiple past VOE in knees, elbows, and right shoulder leading to chronic pain for which he takes extended-release morphine (stable dose since Oct 2016) with good effect. Current Medications: Morphine sulfate extended-release tablets 30 mg Q12H PO Acetaminophen 1000 mg 4x daily PO Vitamin D 2000 IU Daily PO Calcium 1200 mg Daily PO Social History: Employed as an attorney. Reports drinking 4-5 cups of coffee per day and 1 alcoholic beverage per evening on average.
Read Details