[Expert Solution]: The case study below will be used to…

The case study below will be used to develop the concept map. Case StudyMS is a 47yo patient with chronic pain related to metastatic breast cancer who is admitted to the hospital at 1 AM because of severe lumbar pain that radiates down both legs. She was diagnosed with cancer two years ago. She underwent successful cancer treatment, including chemotherapy, and was considered in remission 1 year ago. She is now unable to move her legs due to the pain which has gradually worsened over the last two weeks. She has a prescription for Norco to treat her cancer pain throughout the day. She has been taking an increasing amount of Norco with little effect, most recently two Norco 5/500mg every 4 hours. MS also complains of sharp pain sensations to her feet. Her skin is warm, dry, intact, pedal pulses are 3 and no bruises or discoloration are present. Vital signs are BP=142/90, HR=90, Temperature=99.0 F, RR= 20. Pt has lost her appetite and hasn’t had a bowel movement for the past 4 days. Pt’s CBC is within the normal limit. Pt has a history of smoking a pack of cigarettes a day for the past 25 years. Pt quit smoking after diagnosed with breast cancer. MS is assessed by the on-call physician and the following medication orders are written: Morphine 5mg IVP( IV push) every hour prn moderate pain, morphine 10mg IVP every hour prn severe pain, Percocet 5/325mg 1 tablet PO mild pain, and Percocet 5/235mg 2 tablets PO moderate pain, Zofran 4mg PRN (every 12 hours) for nausea/vomiting. A PET scan was completed during the assessment and metastasis was found to the bones. An X-ray was completed during the assessment and revealed spinal cord compression. The next morning (8 hours after admission) the patient is still in severe pain in spite of receiving morphine and Percocet. Currently, the patient reports 8/10 pain, describes the pain as electrical pain that radiates down both legs but is much worse on the right side, worsens upon movement, and the medication is not effective. Radiation therapy is discussed as an option to minimize the compression and relieve the pain.