Care home nurse asks about a new opioid
PEBC OSCE practice station
Telephone consultation · 2 min to read · 7 min to perform
Answer her questions, advise on what she should do and monitor, and agree on any next steps.
Amanda RoyHi, it's Amanda, a nurse at Pine Grove. I have a resident who just started a regular opioid and I have a couple of questions. Do you have a minute?
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You are a pharmacist in a community pharmacy that supplies a long-term care home. Nurse Amanda Roy, who works at the home, is calling you about a resident, Mr Walter Chan, aged 82, who started a regular opioid for cancer-related bone pain two days ago. The nurse has questions about his care. Answer her questions, advise on what she should do and monitor, and agree on any next steps. The assessor will not take part in the conversation.
What this station tests
- Start a bowel regimen when starting a regular opioid, as constipation does not settle.
- Monitor sedation, breathing, pain and bowels on a schedule.
- Look for added sedatives and reduced kidney function when opioids are started.
- Know when to call 911 and keep naloxone available.
- Order changes go through the prescriber; offer to call and to send references.
Sources for the clinical content
- Canadian Virtual Hospice: Bowel care in palliative care
- Alberta Health Services: Constipation caused by your medications
- Health Canada: Naloxone, Save a Life fact sheet
An original practice scenario with invented patients. Not an exam question.