Brunner & Suddarth's Textbook of Medical-Surgical Nursing 13th Edition by Kerry Cheever, Janice Hinkle

Exercise 1

A 32-year-old woman has been admitted to your nursing unit after havingorthopedic surgery, specifically an open reduction with internal fixation to stabilize aright ankle fracture.Your nursing intervention includes a pain assessment.Thepatient is already asking questions about when her parenteral opioids for pain will bechanged to oral agents.She reports having had poor pain control with oral opioidsafter a prior fracture; in particular, she describes having to ask more frequently forpain medication than was recommended.During that recovery period, she felt verydiscouraged because she was accused of "drug-seeking behavior." Whatpharmacogenomic evidence-based information would you give this patient about herpast experience with pain medications? What evidence related to pain medicationssupports your discussion? How would you determine the strength of that evidence?What pharmacologic measures would you discuss with the surgical team to plan foreffective pain control?