solved

Jenna is a 27-year-old woman with a history of recent intravenous (IV) drug use is
admitted to the observation unit for IV antibiotics after the incision and drainage of an
antecubital abscess. She has a history of heroin dependence, she indicates that she followed a
boyfriend to Florida for treatment and that they left the treatment center together and have been
“treatment hopping.” She says her boyfriend was arrested two weeks ago and she has been
exchanging sex acts for money and or heroin during this time.
She receives IV morphine followed by IV hydromorphone for acute pain, as she had a
significant debridement performed. After the procedure, she is demanding increasingly higher
doses of IV opioids, and the observation unit team is becoming uneasy regarding the dose and
frequency of opioid medications that she is receiving. The nursing staff raises concerns that she
has tampered with her IV tubing and may be using her IV to “inject something.”
1. How do you Approach This Patient with Respect to her Pain and her Behavior?

2. What lab work should be evaluated in Jenna’s case?

3. Knowing Jenna’s recent history what other assessments/screening should be
implemented?

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