Nursing Case studies assignment

To Prepare:

· Explain the problem and discuss how you would address the problem.

· When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply), refills, etc. Also state if you would continue, discontinue or taper the patient’s current medications.

· Answer questions using, clinical practice guidelines, Medscape.com and JNC 8.

· Include at least three references to support each scenario and cite them in APA format. Please include in-text citations. You do not need an introduction or conclusion paragraph.

The ASSIGNMENTs:

SCENARIO 1

Mark Johnson is a 72 year old male recently prescribed warfarin 5 mg daily for DVT treatment. His PMH includes hypertension, hyperlipidemia and osteoarthritis. He is currently on HCTZ 25 mg po daily, celecoxib 200 mg po daily, fluvastatin 40 mg po daily, and Goody’s Powder 1 packet as needed for pain. He has no known allergies. What changes in his medications would you make? What alternatives might you prescribe (include complete medication orders)? How would a CYP2C9 polymorphism affect drug therapy? How would you monitor therapy?

SCENARIO 2

Utilizing the pill identifier tab on Medscape.com, enter the following characteristics below to identify the medication. What medication and strength is identified? What is the first-pass effect and how does it affect drug therapy with this medication? What is bioavailability and what route is considered to have 100% bioavailability? How can this medication be given to counter the first pass effect?

Characteristics: Imprint (P 80)   Shape (Round)   Color (Yellow)   Form (Tablet)   Scoring (Single)

SCENARIO 3

Alex is a 52-year-old male following up on his labs that were drawn last week. He smokes 1 pack per day. He is currently on lisinopril 20 mg po daily, semaglutide (Ozempic) 0.5 mg SC qWeek, and St. John’s Wort. Fasting lipid profile shows total cholesterol 260, LDL cholesterol 160, HDL cholesterol 35, and Triglycerides 220. What treatment plan would you implement for Alex’s lipid profile? What is the goal Total Cholesterol (TC), HDL-C, LDL-C, and Triglyceride level for Alex? How would you monitor the effectiveness of your treatment plan? How many risk factors for coronary artery disease does this patient have? Identify them specifically.

SCENARIO 4

Sandra is a 55-year-old African American female that was prescribed Toprol XL 50 mg daily for high blood pressure. Her PMH consists of depression treated with venlafaxine 225 mg daily. She states that she only occasionally takes her little white pill because she does not like the side effects of fatigue and dizziness. Her blood pressure today is 158/92. What information would you provide to the patient at her visit? What is her goal blood pressure? How would you improve Sandra’s medication therapy (include a complete medication order)?