Questions
CASE STUDY. You are working on an inpatient psychiatric unit and need to do an initial...

CASE STUDY.

You are working on an inpatient psychiatric unit and need to do an initial assessment of R.B., who has just been admitted. He has a diagnosis of schizophrenia, paranoid type. He is 22 years old and has been attending the local university and living at home with his parents. He has always been a good student and has been active socially. Last semester his grades began declining and he became very withdrawn. He spends most of his time alone in his room. His grooming has deteriorated; he can go days without bathing. For several weeks before admission, he insisted on keeping all of the blinds and curtains in the house closed. He refuses to join family gatherings and games. For the past 2 days he has refused to eat, saying, "They have contaminated the food." As you approach R.B., you note that he appears to be carrying on a conversation with someone, but there is no one there. When you talk to him, he looks around and answers in a whisper but gives you little information. He states, "They are watching me and told me not to cooperate.


Explain what a negative symptom of schizophrenia is, and identify at least three negative
symptoms of schizophrenia that R.B. might be experiencing.


Explain what a positive symptom of schizophrenia is, and identify at least two positive
symptoms of schizophrenia that R.B. might be experiencing


What are the most important initial interventions in treating R.B.?

In: Nursing

Betty, the chief nursing officer, had to make a decision about buying 120 new hospital beds...

Betty, the chief nursing officer, had to make a decision about buying 120 new hospital beds for patient rooms. After she interviewed nurse managers at the units where the beds were going to be placed, Betty compiled her findings and decided to contact a well-known equipment company to obtain prices and contracts. The equipment company’s executive salesperson, Jim, discussed options at length with her and invited her and her significant other to an upcoming all-expenses-paid lavish retreat at a five-star hotel in Hawaii to see demonstrations of the beds and to hear a comprehensive sales pitch. Betty thought to herself, “We badly need some relaxation and stress relief. Hawaii would be so much fun. Would it be wrong for us to go?” In your paper, address all of the following prompts: What action should Betty take in this situation? Give your rationale. Justify your answer with an ethical framework—a theory, approach, or principle. What ethical principles are at stake? What breaches? Do you consider this situation a conflict of interest? Why or why not? Give your rationale. How would Betty handle this case if she believed she needed to seek advice from someone in a higher authority? With whom would she discuss this issue? What policies should be in place regarding a scenario such as this one?

In: Nursing

The synapse is an area between two neurons that allows for chemical communication. In 3 or...

The synapse is an area between two neurons that allows for chemical communication. In 3 or 4 sentences, explain what part of the neurons are communicating with each other and in which direction does this communication occur? Be specific.

In 3–5 sentences, explain the concept of “neuroplasticity.” Be specific and provide examples.

In: Nursing

1.what is the treatment for type 2 diabetes mellitus? 2. How would you complete a focused...

1.what is the treatment for type 2 diabetes mellitus?

2. How would you complete a focused assessment on a homeless person or veteran with type 2 diabetes mellitus?

3. How do you mix NPH insulin with regualr insulin?

In: Nursing

Which of the following is a potential adverse effect when taking a tumor necrosis factor blocking...

Which of the following is a potential adverse effect when taking a tumor necrosis factor blocking agent (e.g., etanercept)?

Question 6 options:

a)

Sexual dysfunction.

b)

Headaches.

c)

Diarrhea.

d)

Infections.

Question 7 (1.25 points)

Which of the following is NOT an adverse effect of corticosteroids?

Question 7 options:

a)

Hypertension.

b)

Water retention (edema).

c)

Upset stomach.

d)

Hypotension.

Question 8 (1.25 points)

Just like prescription drugs dietary supplements have to prove safety and efficacy to the Food and Drug Administration.

Question 8 options:

True
False

Question 9 (1.25 points)

Rivastigmine (Exelon) and donepezil (Aricept) work to treat Alzheimer's Disease by increasing the levels of which of the following neurotransmitters?

Question 9 options:

a)

Acetylcholine.

b)

Dopamine.

c)

Epinephrine.

d)

Histamine.

Question 10 (1.25 points)

Which of the following best describes the mechanism of action of octreotide?

Question 10 options:

a)

Beta-2 agonist.

b)

Stimulates the release of cortisol.

c)

Inhibits insulin and growth hormone secretion.

d)

Stimulates the release of thyroxine and triiodothyronine.

Question 11 (1.25 points)

Vinca alkaloids (e.g., vincristine) should never be given intrathecally because they will lead fatal neuropathies.

Question 11 options:

True
False

Question 12 (1.25 points)

Amphetamines are controlled substances, but rarely lead to addiction or abuse.

Question 12 options:

True
False

Question 13 (1.25 points)

Please match the correct mechanism of action to the correct drug.

Question 13 options:

1234

Atomoxetine (Strattera).

1234

Guanfacine Extended Release (Intuniv).

1234

Amphetamine /Dextroamphetamine Mixture (Adderall).

1234

Modafinil (Provigil).

1.

Decreases the effects of GABA.

2.

Selective norepinephrine reuptake inhibitor.

3.

Alpha-2 Agonist.

4.

Releases norepinephrine and dopamine and blocks the reuptake of norepinephrine and dopamine.

Question 14 (1.25 points)

Which of the following medications can be used to treat extrapyramidal symptoms (drug-induced parkinsonism)?

Question 14 options:

a)

Entacapone (Comtan).

b)

Benztropine (Cogentin).

c)

Amantadine (Symmetrel).

d)

Levodopa-carbidopa (Sinemet).

Question 15 (1.25 points)

Tricyclic Antidepressants are rarely used for the treatment of depression and are more commonly used for insomnia or neuropathic pain.

Question 15 options:

True
False

Question 16 (1.25 points)

Which of the following is NOT an adverse effect of iron?

Question 16 options:

a)

Constipation.

b)

Diarrhea.

c)

Nausea and vomiting.

d)

Dark stools.

Question 17 (1.25 points)

Atropine is given prior to the administration of irinotecan to prevent this adverse effect.

Question 17 options:

a)

Constipation.

b)

Diarrhea.

c)

Bradycardia.

d)

Seizures.

Question 18 (1.25 points)

All corticosteroids have the same degree of potency.

Question 18 options:

True
False

Question 19 (1.25 points)

Which of the following is the preferred treatment for status epilepticus?

Question 19 options:

a)

Lacosamide (Vimpat).

b)

Lorazepam (Ativan).

c)

Lamotrigine (Lamictal).

d)

Ethosuximide (Zarontin).

Question 20 (1.25 points)

Which of the following lab values should be monitored while taking lithium?

Question 20 options:

a)

Lithium levels and serum creatinine.

b)

Lithium levels and liver enzymes.

c)

Serum creatinine and liver enzymes.

d)

No monitoring of lab values is required.

Question 21 (1.25 points)

Pembrolizumab (Keytruda) is an anti-CD-20 Monoclonal antibody.

Question 21 options:

True
False

Question 22 (1.25 points)

Antidepressants will take ______________ to achieve their full therapeutic effect.

Question 22 options:

a)

3-4 months.

b)

3-4 days.

c)

4-6 weeks.

d)

4-6 days.

In: Nursing

methotrexate 4 mg PO daily for a child with leukemia Child weighs 70 lb and is...

methotrexate 4 mg PO daily for a child with leukemia

Child weighs 70 lb and is 67 inches tall

The safe dosage range is 3 – 3.5 mg per square meter per day

A. Calculate the BSA for this child.

B. Is the BSA needed to calculate the safe dosage range, in mg per day, for this child? Why or why not?

C. Calculate the safe dosage range, in mg per day, for this child.

D. Is the order safe? Why or why not? Explain.

In: Nursing

Case study (3)Myocardial Infarction (MI) Scenario Mr FG is a 69-year-old retired school teacher who was...

Case study (3)Myocardial Infarction (MI)
Scenario
Mr FG is a 69-year-old retired school teacher who was admitted to the emergencydepartment complaining of severe chest pain after climbing stairs at hisdaughter’s house. In the ambulance he is administered aspirin 300 mg. Onarrival at hospital and subsequent examination and review by the admittingdoctor the following information is obtained.
Previous medical history
Hypertension (10 years). Type 2 diabetes mellitus (recently diagnosed, currentlydiet controlled). The patient is a regular cigarette smoker (>40 per day) anddrinks approximately 10 units of alcohol per week. He has osteoarthritis of theknee.
Family history
Father died following a myocardial infarction at 60 years of age. No maternal
history of cardiovascular disease.
Drug history
Allergies: Trimethoprim. Mr FG has been taking diclofenac MR tablets 75 mg
(twice daily) and nifedipine (Adalat Retard) MR tablets 20 mg (twice daily). Both
were stopped on admission.
Signs and symptoms on examination
▪ Temperature 36.4°C
▪ Blood pressure 160/80 mmHg
▪ Heart rate 75 b/m, regular
▪ Respiratory rate 15 breaths per minute
▪ No basal crackles in the lungs.
▪ An ECG taken immediately on arrival reveals ST elevation of 3 mm in the inferior
▪ leads.
Diagnosis
A preliminary diagnosis of myocardial infarction is made.
Relevant test results
Full blood counts, liver function tests, electrolytes and renal function, CXR,total cholesterol, full blood count and blood glucose were taken at admission.
The following tests taken at admission are reported:
Na+ 134 mmol/L (135–145 mmol/L)
K+ 4.3 mmol/L (3.5–4.0 mmol/L)
Urea 5.2 mmol/L (0–7.5 mmol/L)
Creatinine 81 micromol/L (35–125 micromol/L)
Total cholesterol 5.9 mmol/L (<4 mmol/L)
Blood glucose 4.4 mmol/L (4–10 mmol/L)
Initial treatment
About 45 minutes after the onset of chest pain the patient received the following
treatment in the emergency department:
▪ Heparin 5000 units stat
▪ Reteplase 10 units i.v. bolus followed by a further 10 unit i.v. bolus after 30minutes
▪ Diamorphine 2.5 mg IV stat
▪ Metoclopramide 10 mg stat.
▪ A sliding scale insulin infusion of Actrapid 50 units made up to 50 mL with
sodium chloride 0.9% was initiated and titrated against blood glucose.
The patient is subsequently transferred 2 hours later to the coronary care unit as he is pain-free. As the ward cli
nical pharmacist, you are responsible for dailyreview of drug charts and advice to medical and nursing staff on all aspects ofdrug treatment for patients on the ward.

1.What further diagnostic and biochemical tests should be ordered to help confirm the diagnosis?

2. What is myocardial infarction and what are the classic symptoms?

3. Explain the mechanism of action of thrombolytics such as reteplase in acute MI?

4. The physician order Beta-blockers, Statins, ACE inhibitors, Antiplatelet therapy as standard secondary prevention treatment following acute myocardial infarction in this patient?For each of the classifications give an example of drug name, indication, action, adverse effect, and how can you minimize the adverse effect?

5. Mr FG experiences a chest infection 4 days post admission and is prescribedamoxicillin 500 mg three times daily and erythromycin 500 mg four times daily.What problems may this cause with this patient’s statin therapy and what advicewould you give in order to avoid this problem occurring? (Drug interaction)

6. What effect may occur if this client has decreased renal function and the physician order to give him digoxin? What actions could be taken to minimize this effect?

7. What advice should be given to the patient at discharge with regard to lifestyle
issues?

In: Nursing

Search for Digoxin  information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications,...

Search for Digoxin  information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications, Contraindications,. Dose / Adult and Pediatric, Adverse effects, Interactions, Nursing considerations in implementation and Patient Education

In: Nursing

1} List the benefits of providing good customer service to both internal and external customers in...

1} List the benefits of providing good customer service to both internal and external customers in relation to health care.

2} Discuss how each interaction and response may differ when providing customer service to internal and external customers in relation to health care.

Include your personal experience.

Task: Write 3 paragraphs (5 to 7 sentences each)

NOTE: Please could answer be in 3 paragraphs AND answering both 1 & 2 questions.

If done this way, I will give a thumbs up & positive comment. Thanks *smile*

In: Nursing

Search for Gentamycin information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, ....

Search for Gentamycin information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications, Contraindications,. Dose / Adult and Pediatric, Adverse effects, Interactions, Nursing considerations in implementation and Patient Education


In: Nursing

Search for Labetalol information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, ....

Search for Labetalol information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications, Contraindications,. Dose / Adult and Pediatric, Adverse effects, Interactions, Nursing considerations in implementation and Patient Education

In: Nursing

Search for Nitroprusside Sodium information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action,...

Search for Nitroprusside Sodium information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications, Contraindications,. Dose / Adult and Pediatric, Adverse effects, Interactions, Nursing considerations in implementation and Patient Education


In: Nursing

Search for Furosemide information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, ....

Search for Furosemide information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications, Contraindications,. Dose / Adult and Pediatric, Adverse effects, Interactions, Nursing considerations in implementation and Patient Education


In: Nursing

Search for Metoprolol information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, ....

Search for Metoprolol information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications, Contraindications,. Dose / Adult and Pediatric, Adverse effects, Interactions, Nursing considerations in implementation and Patient Education

In: Nursing

In the discussion preparation, you were asked to analyze the major connections between liability of professionals,...

In the discussion preparation, you were asked to analyze the major connections between liability of professionals, insurance policy coverage, and settlement of claims due to health care liability issues. Consider the concept of insurance coverage denial. Ascertain the manner in which such denial is built on the limitation clauses and conditions set forth by the insurance provider.

In: Nursing