Answer to Question 1
Elevate, ice, immobilize, and assess the ankle and foot.
Raise the side rails, instruct him not to climb out of bed, and provide a call light.
Obtain VS and assess neurologic status (assess his level of alcohol-related impairment).
Ask D.M. how much beer he has ingested, how long ago, how many pain pills he took, and when he
took them.
Inform the physician of D.M.'s recent visit to the ED, prescribed medication, and current problem.
An alcohol intake history should be obtained and a blood alcohol level drawn.
Answer to Question 2
Take this medication with food (at mealtimes or with crackers and a glass of milk).
Do not combine this drug with other medications or over-the-counter (OTC) drugs without first
checking with a pharmacist. Lortab should never be taken with alcohol. He should not drive or
operate heavy machinery after taking the medication.
Patients with a history of heavy alcohol consumption should be warned against using medications
containing acetaminophen.
Lortab contains hydrocodone, which is constipating. The patient needs to increase fiber and liquid
intake. If this is not effective, he might need to take a stool softener, such as docusate (Colace), or
laxatives, such as milk of magnesia or senna laxatives (Senokot). In addition, he should increase his
fluid intake to six to eight glasses a day.
Lortab contains acetaminophen 500 mg. Patients should be cautioned not to take more than 3 g in
24 hours of acetaminophen (maximum of six Lortab 2.5/500 per day).
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