A 57-year-old female is undergoing recovery from sepsis. She has dysphagia and is on a continuous PEG-tube feeding. She has been suffering from sharp pain secondary to multiple stage III-IV decubitus ulcers. The patient also describes a burning and throbbing pain from her toes up to her knees. Currently, she is very uncomfortable and states that her pain is at least 8 to 9 on the scale of 10.
Past medical history (PMH) Motor vehicle accident one year ago which left her quadriplegic, diabetes type 2, end-stage renal disease on hemodialysis on Tuesday/Thursday/Saturday. Pain medications Fentanyl Transdermal 75mcg/hr patch Q 3 d, and hydromorphone 2 mg IV Q 3 hr PRN breakthrough pain. What should be done to manage the pain?
