Pharm Case Study

Case Essay Instructions Review the case overview, major case decisions, learning objectives and case introduction. Proceed to the questions. Provide your answer to the questions in short essay format. Provide a rationale for each question. This assignment will be graded using the Written Assignment Rubric. Cite your resources in text in APA format. Citations must be appropriate, meaning you need to paraphrase. when using the author’s ideas while putting them in your own words. Provide your References at the end of the case in APA format. Please apply the nursing literature and other scholarly resources in text and in references at the end of the assignment. Organization and structural components of this assignment are considered your short essay reply and rationale. Your essay should be double-spaced with 12 pt font, and 1 margins per APA guidelines. Case Introduction You work as a nurse in an emergency department. You are the nurse assigned for four patients. Case #1 Which of the following patients would require a priority teaching intervention? The parents of a 10-year-old child that has been given acetaminophen (Tylenol) for a fever and flu-like symptoms (chewable tablets (160mg/tab) and the appropriate dose of 2.5 tablets every 4-6 hours. A 50-year-old patient that is taking acetaminophen (Tylenol) 300mg every four hours to reduce ankle swelling after a fall. A 40-year-old patient that is worried about a gastric ulcer and is planning to use acetaminophen (Tylenol) instead of ibuprofen (Advil) for headache pain. A 70-year-old patient that drinks one glass of wine a night. The patient states that wine is avoided when taking acetaminophen (Tylenol) as needed for discomfort. Case #2 You are continuing your shift in the emergency department and assigned to patients as they attend the emergency department for care. Mrs. Johnson is a 32-year-old patient who arrives at the emergency department after removing a tick three days ago. Today, the patient presents with a concern about the bullseye-shaped rash that has developed at the site of the tick removal. Past History: Asthma since childhood managed with an inhaler as needed. The patient reports a positive childbirth event six months ago. Breast feeding is continuing. Vaginal candidiasis was treated effectively one month ago. Medication History Albuterol metered-dose inhaler (Proventil HFA), two inhalations/puffs every 4-6 hours as needed, max 12 inhalations/day Albuterol (Proventil) inhaler prior to exercise, two inhalations (180mcg) orally 15-30 minutes before exercise. Lo loestrin Fe (Ethinyl estradiol and Norethindrone acetate) as directed Prenatal vitamins are continued and B12 supplements are prescribed Personal-Social History The patient denies smoking or alcohol use. Mrs. Johnson is trying to adhere to a vegan diet, but does consume eggs, dairy, and some other animal products. Caffeine is limited to one cup of coffee/day. Please answer the following questions in essay format. You must provide a rationale for all your recommendations. What additional assessment information is appropriate to gather during the assessment phase? Provide two. The nurse knows that the patient may be infected with the Borrelia burgdorferi bacteria. What is the body’s immune response against this organism? The healthcare provider meets with the patient. The patient is prescribed doxycycline (Vibramycin) 100mg bid for 14 days and instructos the nurse to administer the first dose of doxycycline to Mrs. Johnson orally before she is discharged. What is the classification and expected action of doxycycline (Vibramycin)? Would the nurse question the healthcare provider’s medication order prior to administering the first dose of doxycyline (Vibramycin)? What patient teaching is appropriate to provide to Mrs. Johnson prior to this patient’s discharge? Include two teaching interventions. Mrs. Johnson returns to the emergency department following five days of doxycycline (Vibramycin) 100mg bid previously ordered for 14 days. The patient complains of vaginal soreness, itching, a burning sensation and white discharge. The patient states this occurred once in the past and a medication fixed the problem. Mrs. Johnson denies any additional complaints or problems since her last emergency department visit. The patient denies any symptoms related to the previous Lyme disease prevention plan and states, “I think I will stop the doxycyline now so this new problem will go away. I don’t have any symptoms of Lyme disease.” What is probable cause of Mrs. Johnson’s vaginal symptoms? What teaching is a priority for Mrs. Johnson?