Question

Case Study

Scenario: Your patient Gladys that was admitted for an unwitnessed fall has returned to the emergency department complaining of shortness of breath, confusion and anasarca. Upon diagnostic results, Gladys was found to have bilateral pneumonia and myxedema. The healthcare provider has ordered the following medications to manage her care.

Drugs Dose   

solu-medrol 50 mg. IV B.I.D

Levothyroxine sodium 64 mcg. IV every morning

Furosemide (Lasix) 20 mg. IV once daily

Ceftriaxone (Rocephin) 1 gm. IV every 24 hours

Labs/Diagnostics Value

WBCs 15.9

Sodium 130

Blood Glucose 220

Potassium 3

Temperature 99.3 F

Question: Check the medications the patient is currently taking to assess for any interactions. Please also take into consideration Gladys lab and diagnostic results. Write the interactions you found, concerns with the concurrent medication list, and provide a minimum of 3 recommendations to prevent any adverse events with Gladys.

Answer 1

Doctor ordered for solu- medrol 50mg IV B.I.D. This medicine should be slowly administered by IV into the vein, before giving this injection a skin test is necessary to assess for any allergic reaction. Do not stop this medicine in between until the dose completes. Patient is having bilateral pneumonia that's why this medicine is started to decrease the level of infection in the blood.

Levothyroxine sodium 64 mcg is recommended because Gladys is having myexedema. Myexedema is a disease in which there is low secretion of thyroid hormone, so to treat severe hypothyrodism this medicine should be given regularly.

Furosemide 20mg IV once a day. it is advised to reduce anasarca. lasix reduces swelling in the body by excreting excessive fluid through urine.

Inj. Ceftriaxone treats several types of infection. It is an antibiotic.

WBC is 15.9 . WBCs are increased due to increased level of infection in the blood or any part of the body. Normal WBC is 10.5.

Sodium level is 130mgdl which indicates low level of sodium in the blood which is also known as hyponatremia. Increasing salt intake in the diet as per dietician's order.

Blood glucose is 220 which is very high value. Treating high blood sugar is very necessary otherwise infection spread in the body very fast so diabetic diet and insulin infusion or medication should be started to control it.

Potassium is 3. Low level of potassium may lead to may serious health issues. So potassium rich diet should be given and potassium level should be checked regularly.

Temp 99.3 There is increase in the body temperature which means infection is there and ther body is trying to destroy the infection. So to reduce infection paracetamol should be  given.

TO PREVENT ADVERSE EVENTS WITH GLADYS WE HAVE TO DO FOLLOWING THINGS;

1. Provide side railed bed so that patient may not fall of the bed.

2. Keep the floor dry that the patient may not slip.

3.Constant monitoring should be done.

4.Patient came with the complaint of breathing difficulty so provide oxygen , Keep the oxygen cylinder near the patient.