Week 5: Case Study: Pharmacology

Scenario

You are the nurse working in an anticoagulation clinic. One of your patients is K.N., who has a long-standing history of an irregular heartbeat, known as atrial fibrillation or A-fib, for which he takes the oral anticoagulant warfarin. Recently K.N. had his mitral heart valve replaced with a mechanical valve.

1. How does atrial fibrillation differ from a normal heart rhythm?

2. What is the purpose of the warfarin in K.N.'s case?

CASE STUDY PROGRESS K.N. calls your anticoagulation clinic to report a nosebleed that is hard to stop. You ask him to come into the office to check his coagulation levels. The laboratory technician draws a PT/INR test.

3. What is a PT/INR test, and what are the expected levels for K.N.? What is the purpose of?

the INR?

4. When you get the results, his international normalized ratio (INR) is critical at 7.2.

What is the danger of this INR level?

The health care provider does a brief focused history and physical examination, orders additional laboratory tests, and determines that there are no signs of bleeding other than the nosebleed, which has stopped. The provider discovers that K.N. recently started to take daily doses of an over-the-counter pro ton pump inhibitor (PPI), omeprazole (Prilosec OTC), for heartburn.

5. What happened when K.N. began taking the PPI?

.

6. What should K.N. have done to prevent this problem?

The provider gives K.N. a low dose of vitamin K orally, asks him to hold his warfarin dose that evening, and asks him to come back tomorrow for another prothrombin time (PT) and INR blood draw. Why is K.N. instructed to take the vitamin K?

You want to make certain K.N. knows what "hold the next dose" means. What should you tell him?

K.N. grumbles about all the laboratory tests but agrees to follow through.

What is potential S/S of bleeding that should be taught to K.N.? (Select all that apply.)

a. Black, tarry stool

b. Stool that is pale in color

c. Paresthesia lower extremities

d. Bruising

CASE STUDY PROGRESS You know that sometimes the only needed action is to stop the warfarin several days before the surgery. Other times, the provider initiates "bridging therapy," or stops the warfarin and provides anti coagulation protection by initiating low-molecular-weight heparin. After reviewing all his anticoagulation information, the provider decides that K.N. will need to stop the warfarin 1 week before the surgery and in its place be started on enoxaparin therapy.

Which nursing interventions are appropriate when administering enoxaparin? Select all that apply.

a. Monitor activated partial thromboplastin time (aPTT) levels.

b. Administer via intramuscular (IM) injection into the deltoid muscle.

c. The preferred site of injection is the lateral abdominal fatty tissue.

d. Massage the area after the injection has been given.

e. Inject two inches from belly button.

Test I.
•Immune system causes tissue damage as it fights off a perceived threat also known as allergies.
A. hypersensitivity
B. autoimmune diseases
C. immunodeficiency
D. antibodies

•The following are immune-deficiencies EXCEPT?
A. AIDS
B. SCID Syndrome
C Type I Diabetes
D. none of the above

•Types of hypersensitivities are determined by their time course and whether ______ cell are the principal element involved.
A. B
B. A
C. T
D. all of the above

•The following are all autoimmune disease except:
A. myasthenia gravis
B. multiple sclerosis
C. anaphylaxis
D. rheumatoid arthritis

•An inflammation-causing signal released by mast cell at the site of an infection is:
A. an interferon
B. lymphatic fluid
C. histamine
D. mucus

Test II.

a. A client's immunization is up-to-date. What type of immunity does this provide to the client?
b. Do not search, differentiate the types of immunity
c. What your thoughts about the "concept of Immunity and Inflammation" (10 sentences)

this is a reflection on the process and new learning from clinical reasoning cycle (critically discuss the role of the nurse in facilitating self-efficacy and self-management for patients (and their families) living with a chronic condition in order to achieve improved health outcomes and quality of life. Use the best available scholarly evidence to support your discussion).

hello, I am writing an article why pharmacists need to be utilized as precribers in the U.S in effort to help accessibility for women to obtain birth control?

any thoughts based on evidence?
please provide reference of articles.

Write a letter scheduling a debriefing session with a person named John who has experienced an accident in the workplace.

Q1: Define the role of health information management department in a health care facility and explain five responsibilities of health information management. (2 marks + 5 marks)

2- Responsibilities of Health Information Management:

3- Describe the role of the Health Information Management Department in a health care facility, and discuss the development of the HIM profession in the UAE (6 lines only) (3 + 5 marks)

4- Name and compare the credentials offered at preprofessional level of health information management.

5- What is the e-HIM initiative?   

Assess the community and/or state sponsored services that are available to veterans with co-morbid chronic mental illness. For example, what services are available to a veteran who suffers from post-traumatic stress disorder and alcohol abuse? In a 10-12 slide informative PowerPoint presentation (title slide and reference slides are in addition to the 10-12 slide requirement), answer the following:

1. Using nursing evidence, Clearly and thoroughly describe factors outside of military service that influence the veteran’s need for mental health services.

2. Clearly identify how veterans are evaluated to determine eligibility for services and examine the cost of services to those receiving it.

3. Using nursing evidence, Describe adequacy of available services for the population served.

4. Clearly identify how services can be improved to better serve veterans. provide two specific recommendations.

Strategies for improving diabetes care: A patient-centered communication style that incorporates patient prefer- ences, assesses literacy and numeracy and addresses cultural barriers.

Welcome to the Body Company. You are applying for a job with us as a vitamin or mineral. Please describe 3 functions you can play for The Body Company and which other nutrients you work best with. Include in your interview what will happen when there is too much of you (toxicity) or not enough (deficiency) as well as the 3 best places to get you (food sources). Please find your name on the table below. Supplements Use Google or some other search engine, or look in the supplement aisle in the store, or even (maybe) on your medicine shelf at home to locate a real supplement that contains at least 3 vitamins or minerals and promises to help your body respond to stress. List those 3 ingredients and describe how these vitamins might combat stress in the body. For each of the 3 ingredients, identify a food source you are willing to eat instead of taking a supplement. "Please focus on Calcium foods" This is important all you can use is Calcium rich foods.

Create/formulate a clear research questions about this topic: Medicinal herbs or plants vs. Pharmaceutical medicine

PHC 181

“Social class stratification system can have a great long-term impact on individuals’ health and can result in health disparities in all life resources”.

Based on this statement, answer the following: -

• Discuss the influences of social class on health
• Mention the theoretical explanations that highlight the relationship between social class and health

Written in a Word document (ONE PAGE) divided as introduction, body conclusion