WK8Assgnbowlingh6521.docx - 1 Complex Regional Pain...

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1Complex Regional Pain DisorderHolly BowlingWalden UniversityAdvanced PharmacologyNURS-6521NDr. Janet GunterJanuary 16, 2020
2Complex Regional Pain DisorderAs advanced practitioners, it is important to understand different disorders of the nervous system as well as factors that affect them to properly diagnose and treat each patient specifically. Complex Regional Pain Disorder/Syndrome (CRPD/S) is a chronic condition that can affect the peripheral and central nervous system and is characterized by pain lasting longer than six monthsto an affected limb, usually after injury (National Institute of Neurological Disorders and Stroke (NINDS), 2019). CRPS is divided into two different categories, where CRPS-I indicates an individual without a confirmed nerve injury, and CRPS-II indicated an individual with an associated, or confirmed nerve injury in the affected area. Manifestations of the chronic pain disorder may include changes in skin color and temperature, swelling, nerve pain that may feel like burning or squeezing, changes in skin texture, hair and nail growth pattern changes, coordination issues, and abnormal movements of the affected limb (NINDS, 2019). Although CRPD is more common in middle-aged women, the disorder can affect anyone of any age. (NINDS, 2019). The purpose of this paper is to get a better understanding of how CRPD can be treated. The following will discuss a patient scenario and three decision trees that will be addressed in guiding the appropriate treatment for the patient.Patient ScenarioA forty-three-year-old white male presents to the office with crutches and complaints of pain to his right hip and leg after sustaining an injury to his right hip from a fall approximately seven years ago. The patient has been referred because previous physicians seem to think that thepain is “in his head” and that he is just trying to get “narcotics to get high.” After multiple diagnostics over the years, he was finally fount to have 75% of his cartilage around his hip joint torn. At this point, no surgeon will repair as they feel he is too young for hip replacement. He has
3developed multiple manifestations such as cramping, cooling of the extremity, and discoloration. Although the patient has had a run of bad luck with losing his job and fiancé, he denies being depressed but does get “down in the dumps” at times. He has been prescribed hydrocodone from his family physician but does not always take it because of the side effects of constipation and drowsiness. The patient's mental status exam is relatively normal, with a euthymic mood and

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