2. Matt is a 15-year-old male who presents with complaints of ankle

2. Matt is a 15-year-old male who presents with complaints of ankle pain x 4 hours after “twisting” his foot while playing soccer. His x-ray is negative and examination is consistent with a moderate ankle sprain. He rates his pain 8/10 (1-10 pain scale). What pain medication options can you offer Matt? What side effects of your prescribed regimen does he need to be educated on? Should his parents be involved in your discussion?
Matt is presenting to me as a moderate ankle sprain as confirmed by a negative x-ray and examination. He is a 15 year-old male who has an 8/10 pain on his ankle due to twisting his foot playing soccer. For any acute ankle sprain appropriate treatment can reduce or resolve the long term impact an ankle sprain may cause in the future (Melanson & Shuman, 2021). Ankle sprains are the most frequent injury sustained in sports and over 2 million ankle sprains are treated in the emergency department in the United States and United Kingdom (Melanson & Shuman, 2021). Any immediate treatment for a sprained ankle follows PRICE protocol (protection, rest, ice, compression, and elevation) (Melanson & Shuman, 2021). After 72 hours of rest of the ankle followed by gradual and lighter resumption of activity as tolerated can help (Melanson & Shuman, 2021). If immediate pain is not relieved by ice and compression via elastic bandage or ankle support, nonsteroidal anti-inflammatory drugs or acetaminophen can be used for analgesia (Melanson & Shuman, 2021).
NSAIDs are useful to reduce mild to moderate pain and inflammation, and are often the first-line drugs of choice for analgesia (Woo & Robinson, 2020). Nonsteroidal anti-inflammatory drugs (NSAIDs) are a drug class for use as antipyretic, anti-inflammatory, and analgesic agents (Ghlichloo & Gerriets, 2021). Since Matt is 15 years-old, I would suggest the use of taking 400 mg of Ibuprofen every 4 to 6 hours as needed for pain (Mayo Clinic, 2021). Side effects of NSAIDs that Matt and his family should be educated on is any stomach irritation, diarrhea, itching skin, nausea, decrease in urine output, and heartburn or indigestion (Mayo Clinic, 2021). Matt’s family should be involved in taking him to the hospital if he has any serious adverse reactions such as a hypersensitivity, excess bleeding or bruising, vomiting blood, or extreme fatigue (Ghlichloo & Gerriets, 2021).
As with any teenager encounter it is best to involve Matt’s family in the discussion as well. First I would explain the importance of PRICE protocol and taking medication for breakthrough pain. Next, I would want to educate not only Matt, but also his family on how to take the medication, when to take the medication, and when to seek medical help. Finally, I would educate and emphasize to Matt on the importance of stretching and conditioning to minimize the severity of ankle sprain (Melanson & Shuman, 2021) to prevent future reoccurrences. 
Ghlichloo, I., Gerriets, V. (2021). Nonsteroidal Anti-inflammatory Drugs (NSAIDs). StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK547742/ (Links to an external site.)
Mayo Clinic. (2021). Ibuprofen. Drugs and Supplements. https://www.mayoclinic.org/drugs-supplements/ibuprofen-oral-route/proper-use/drg-20070602
Melanson, S. W, Shuman, V. L. (2021). Acute Ankle Sprain. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK459212/
Woo, T., M. & Robinson, M. V. (2020). Pharmacotherapeutics for Advanced Practice Nurse Prescribers: Fifth Edition. F. A. Davis Company