Case Study:
The patient is a 31-year-old male. He states that his insomnia has gotten progressively worse over the past 6 months. Per the patient, he has never been a “great sleeper” but he is now having difficulty falling asleep and staying asleep at night. The problem began approximately 6 months ago after the sudden death of his fiance. The patient states this is affecting his ability to perform his job, which is a forklift operator at a chemical company. The patient states he has used diphenhydramine in the past to sleep but does not like the way it makes him feel the morning after. He said he has fallen asleep on the job due to a lack of sleep the night before. The patient medical record from the previous physician state that he has opiate abuse, which began after he broke his ankle from a skiing accident and was prescribed hydrocodone/APAP(acetaminophen) for acute pain management. The patient has not received a prescription for an opiate analgesic in 4 years. The patient states recently he has been using alcohol to help him fall asleep, appropriately 4 beers prior to bed. The patient is alert and oriented to place, person, time, and events. He makes good eye contact and is dressed appropriately for the time of the year. He denied auditory/homicidal ideation and is future-oriented.
(a) Which Medication decision did you select.
(b)Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
(c) Why did you not select the other two medication options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
(d) What were you hoping to achieve by making this decision? Support your response with evidence and references to the learning resources( including the primary literature).
(e) Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.