Converting 90 mg of daily oxycodone to morphine step by step, with cross-tolerance, rescue dosing and reassessment timing shown, is what this NU435 Unit 3 pain case study models. Searches like "nu 435 unit 3 assignment example", "nu435 unit 3 sample" and "nu435 unit 3 example" land here.
Arithmetic Before Recommendation: Converting 90 mg of Oxycodone for a Man With Spinal Bone Metastases
[Student Name]
Purdue University Global
NU435: Hospice and Palliative Nursing Care
Unit 3 Assignment
[Instructor Name]
[Date]
Composite patient written as a model document. All doses are bracketed composites for teaching; conversions must be checked by the prescriber and pharmacist.
Case Summary
Current regimen: [oxycodone extended-release 20 mg every 12 hours] plus [oxycodone immediate-release 10 mg], taken five times a day for breakthrough pain. Pain 7 of 10 in the low back and left hip, worse on standing. Kidney function normal.
Assessment: Total Pain
Cicely Saunders described total pain as physical, emotional, social and spiritual suffering together (Clark, 1999). His bone pain sits beside a fear he named on admission: "I don't want my wife lifting me."
Why Change
Five breakthrough doses a day signal that the scheduled dose is too low. The hospice formulary favors morphine, and his normal kidney function allows it.
The Conversion
1. 24-hour oxycodone total: 20 mg × 2 = 40 mg scheduled; 10 mg × 5 = 50 mg breakthrough; total 90 mg.
2. Oral oxycodone to oral morphine ratio: 1 to 1.5 (McPherson, 2018).
3. Oral morphine equivalent: 90 × 1.5 = 135 mg a day.
4. Reduction for incomplete cross-tolerance: 25 percent; 135 × 0.75 = about 101 mg a day.
5. Scheduled dose: about 101 mg a day, rounded to available tablet strengths as [morphine extended-release 45 mg every 12 hours], 90 mg a day.
6. Breakthrough dose: 10 to 15 percent of the daily total, about 10 to 15 mg; [morphine immediate-release 15 mg every 2 hours as needed].
Each line is labeled so a pharmacist checking the work can find an error without redoing it.
The Rest of the Plan
Bowel regimen: [a scheduled stimulant laxative], since constipation does not improve with time on opioids.
Bone-directed adjuvant: [a composite adjuvant] per the prescriber.
Referral for palliative radiation to the painful spinal and hip lesions.
Nonpharmacologic measures: a hospital bed, heat to the hip for 20 minutes several times a day, and a walker for the trip to the bathroom.
Evaluation
Pain rated at 1, 4 and 24 hours after the first scheduled dose, then daily. Number of breakthrough doses counted each day; more than three a day means the scheduled dose needs review. Success in his words: sitting through his granddaughter's piano recital next Saturday. His wife will record breakthrough doses on a sheet by the bed, and the hospice nurse will review it at each visit. If he becomes drowsy or confused after the change, the scheduled dose is held and the prescriber is called, since sedation usually comes before any effect on breathing.
References
Clark, D. (1999). "Total pain," disciplinary power and the body in the work of Cicely Saunders, 1958-1967. Social Science & Medicine, 49(6), 727-736. https://doi.org/10.1016/S0277-9536(99)00098-2
McPherson, M. L. (2018). Demystifying opioid conversion calculations: A guide for effective dosing (2nd ed.). American Society of Health-System Pharmacists.
How this NU435 Unit 3 example is structured
Everything turns on one table. Before it, the case establishes why a change is needed at all: breakthrough doses five times a day signal that the scheduled dose is too low, and the hospice formulary favors morphine, which his normal kidney function allows. The table follows the arithmetic in the order a pharmacist would check it, each line labeled, so a reader can find an error without redoing the work. Only after the table does a dose appear, rounded to available tablet strengths and set against the calculated figure. Nonpharmacologic measures get their own paragraph rather than a closing line: a hospital bed, heat to the hip, and a walker for the trip to the bathroom. Evaluation defines success in his words, sitting through his granddaughter's recital, alongside the pain score and the number of rescue doses used each day.
Get an NU435 Unit 3 example written to your instructions
Conversion ratios differ between the tables sections assign, so the ratio your course uses matters more than any on this page. With the case as posted, the reference your instructor names and your rubric in hand, a writer works the arithmetic on that ratio; turnaround is 24-48h and the first sample is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU435 Unit 3 questions, answered
Which equianalgesic table should the conversion use?
The one your course assigns, named in the paper. Published tables disagree at the margins, especially for methadone and transdermal fentanyl, which is why a conversion paper cites its source line by line. The oxycodone to morphine ratio of 1 to 1.5 in the sample is common in palliative references, but a different assigned ratio should replace it, with the arithmetic redone and bracketed.
Is a dose reduction always applied when switching opioids?
Most references recommend reducing the calculated equivalent by roughly a quarter to a half for incomplete cross-tolerance, and the sample explains why it chose the smaller reduction for a man in uncontrolled pain. Some protocols handle that differently, so state the rule your source gives. Showing the reasoning matters more to markers than which end of the range a paper chooses.
Can the case recommend a specific dose?
It can recommend, as nursing analysis supporting a prescriber, and many prompts expect exactly that. Frame it that way in your paper and keep every figure tied to the composite patient in your case. The sample brackets each amount because it belongs to an invented man, not to anyone reading it, and it is never guidance for a real patient's medication.