Pharmacology Case Studies

This discussion question is based on a case study. As in all case studies, review the facts of the case and consider the various steps of the nursing process in order to address the critical thinking questions.

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

The patient tells me he started noticing symptoms on Sunday, August 16th. He said he started noticing some blisters along the left side of his face as well as his left ear started hurting and as he would scratch at it, he would see blood and discharge coming from it. He says that he typically does use Q-tips after the shower, but he does not think that he traumatized his ear. He has never had anything like this happen before. He has not really noticed any itching, but there is some discomfort. He describes it more of a discomfort, than a true pain. He has not had any fevers, chills, or body aches. There have been no

Mr. P, a 27-year-old African American man, was brought to the emergency department (ED) by his wife. The patient reported polyuria for the past three days, few episodes of vomiting prior to arrival and polydipsia. On assessment, the patient appears flushed, and his lips and mucous membranes are dry and cracked. His skin turgor is very poor. He has deep, rapid respirations and there is an acetone smell to his breath. He is alert and oriented X 2 and is having trouble focusing on the questions.

At CTPA study performed at the time excluded any pulmonary emboli and the report made comment of a moderate sized right-sided pleural effusion with compressive atelectasis. There was no comment on the report of any parenchymal infiltrate and I have not cited the images myself. CRP was 113. He was given a presumptive diagnosis of pneumonia with parapneumonic effusion and commenced an Augmentin Duo Forte and doxycycline. In

PHYSICAL EXAMINATION: HEENT: Tympanic membranes and external auditory canals are within normal limits. Throat is clear with no gingival lesions. He is ______________. No obvious proliferate retinopoathy. NECK: No carotid bruit. No thyroid enlargement. LUNGS: Clear to auscultation. HEART: No S3, S4 or murmurs. ABDOMEN: Soft with no organomegaly. Normal bowel sounds. FEET: Good dorsalis and posterior tibial pulses bilaterally. Left foot has no abrasions, lesions, sores or ulcers. Right foot shows obvious deformity from previous break. He has an area located between his second and third metatarsal head that has clearly been an abscess that has broken through. He also has an obvious foot ulcer located over the instep of his right foot, full thickness. There is tracking to the broken foot, to which the ulcer area is connected and there is a question of osteomyelitis in this area.

Following consultation, blood studies were ordered which showed an ongoing elevated white cell count. Blood cultures showed no growth. Influenza antigens were negative and sputum gram-stain showed many white blood cells with normal upper respiratory tract flora. Chest x-ray showed previous coronary artery

First, the medical assistant should convert the doctor’s prescription into layman’s terms for Doris. Medication A is two teaspoons by mouth every four hours. Medication B is 2.5 milliliters by mouth three times daily (Fulcher, Fulcher, & Soto, 2012, p. 1b). Doris should be cautious of confusing her medication dosages as that could lead to possible overdose. If Doris is afraid of mixing her medications, the medical assistant should convert to the unit that Doris is more comfortable with. For example, if Doris prefers milliliters, she should take around 9.8 milliliters of medication A. Alternatively, medication B could be taken at .5 teaspoons (Fulcher, Fulcher, & Soto, 2012, p. 131). Patients taking multiple medications should have a medication

his chronic pain in his back. Nurse J. never questioned the orders for medications or the

Patient 1 : A 3-week-old baby is brought into the urgent care clinic with a fever of 101.4 degrees F. Without hesitating or assessing the infant, the physician orders a complete blood count (CBC), a urinalysis, blood cultures, and a lumbar puncture.

is not employed, as she attends priority preschool four days per week. Her primary sources of income include family and public assistance. Jade currently receives $722/month for SSI for cystic fibrosis. No recent changes were reported in Jade’s ability to manage her household chores. She relies on family for transportation, as she does not have a driver license. Jade has no history of arrests.

The patient was given acetaminophen, and fever and general discomfort logically diminished throughout the following 5 days. He was released 11 days after the fact, on May 17, in great general condition regardless of steadiness of

contracted the flu, but in past few days his symptoms have significantly increased. Recently, he

Case Description: A 25 year old healthy male who is a very active running back in the sport of football came to the emergency room. The patient has a history of previous

patient was not having any pain or significant discomfort in the area. The throat was