Pharmacology and the Nursing Process, 8e
Pharmacology and the Nursing Process, 8e
8th Edition
ISBN: 9780323358286
Author: Linda Lane Lilley PhD RN, Shelly Rainforth Collins PharmD, Julie S. Snyder MSN RN-BC
Publisher: Elsevier Science
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Chapter 7, Problem 1CS

(1)

Summary Introduction

To determine:

How should the nurse answer J.V.? On the form, J.V. lists the following items:

  1. 1. Baby aspirin each day to prevent blood clots. Sleep-Well herbal product with valerian at night if needed. Benadryl as needed for allergies, especially at night
    Stress-Away herbal product with ginseng as needed. Generic ibuprofen, 3 or 4 tablets three times a day for muscle aches from working out. Memory Boost herbal product with ginkgo every morning.

Case summary:

J.V., a 28-year-old graduate student, is at the student health clinic for a physical examination that is required before he goes on a research trip out of the country. As he completes the paperwork, he asks the nurse, "The form is asking about my medications. I don't have any prescribed medicines, but I take several herbal products and over-the-counter medicines. Do you need to know about these?"

(2)

Summary Introduction

To determine:

J.V. tells you that he has been wondering why he bruises so easily and shows you some bruises on his arms and his knees. Examine the products on J.V.'s list, and state whether there are any concerns with interactions or adverse effects. You may need to refer to descriptions of the individual herbal products (see the inside back cover for a complete listing of Safety: Herbal Therapies and Dietary Supplements boxes located throughout the textbook) or to the appropriate drug chapters for more information. What do you think has happened?

Case summary:

J.V., a 28-year-old graduate student, is at the student health clinic for a physical examination that is required before he goes on a research trip out of the country. As he completes the paperwork, he asks the nurse, "The form is asking about my medications. I don't have any prescribed medicines, but I take several herbal products and over-the-counter medicines. Do you need to know about these?"

(3)

Summary Introduction

To determine:

Upon further questioning, J.V. remembers that he has had problems with "acid stomach" for about a year and takes Prilosec-OTC for that as needed. What concerns, if any, are there about this?

Case summary:

J.V., a 28-year-old graduate student, is at the student health clinic for a physical examination that is required before he goes on a research trip out of the country. As he completes the paperwork, he asks the nurse, "The form is asking about my medications. I don't have any prescribed medicines, but I take several herbal products and over-the-counter medicines. Do you need to know about these?"

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Considering the kcals the patient is receiving from propofol and D51⁄2NS, what should be the rate (ml/hr) of the tube feeding you selected? 30 ml/hr 45 ml/hr 55 ml/hr 65 ml/hr
You are seeing a 68 year-old male patient admitted to the ICU. He is sedated on the ventilator with propofol at 20ml/hr, D51⁄2NS running at 75ml/hr. and a past medical history of DM2, obesity, CAD, HTN, and Pneumonia. Ht 172cm, Wt 72kg, Alb 2.3, VE=7.9 L/min, Tmax =38.4 C 4.1 What is the total kcal this patient is receiving before the initiation of TF (Hint: include propofol and D51⁄2 NS in calculation)? 306 kcal 528 kcal 678 kcal 834 kcal   What is the estimated kcal goal for this patient? 1787 kcal 1847 kcal 1927 kcal 2317 kcal What is the estimated protein need for this patient? 45 – 50 g/day 86 – 108g/day 108 – 180g/day 144 – 188 g/day What type of tube feeding formula would you recommend for this patient? Standard 1.5 kcal/ml formula Glycemic control product, 1.0 kcal/ml Low residue, high protein, nutritionally balanced,1.2 kcal/ml High protein, calorie control product, 2.0 kcal/ml
You are seeing a 68 year-old male patient admitted to the ICU. He is sedated on the ventilator with propofol at 20ml/hr, D51⁄2NS running at 75ml/hr. and a past medical history of DM2, obesity, CAD, HTN, and Pneumonia. Ht 172cm, Wt 72kg, Alb 2.3, VE=7.9 L/min, Tmax =38.4 C 4.1 What is the total kcal this patient is receiving before the initiation of TF (Hint: include propofol and D51⁄2 NS in calculation)? 306 kcal 528 kcal 678 kcal 834 kcal Which estimated prediction equation will you recommend to calculate the kcal need for this patient? Penn State Equation (2003b): Mifflin(0.96)+ VE (31) + Tmax (167)-6212 MifflinStJeor =(10xW)+(6.25xHt)–(5xAge)+5 Harris-Benedict equation: kcal/day (male) = 66 +13.8 (W) + 5.0(H) – (6.8 x A) Ireton-Jones equations (1992)(ventilator-dependent): 1925 – 10 (A) + 5 (W) + 281 (S) + 292 (T) + 851 (B) What is the estimated kcal goal for this patient? 1787 kcal 1847 kcal 1927 kcal 2317 kcal What is the…
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