While working with A.D. for two days I was able to witness the effectiveness of her multi-drug therapy, that mainly consisted of medications for her preexisting heart conditions and was able to assess her progress. A.D.’s medications were able to successfully lower her blood pressure and keep her heart rate in a safe range so she was able to work with therapy. Also, her pain was mainly tolerated with her scheduled doses of Tylenol and a PRN was only requested once after completing an intense therapy session. A.D. is showing no signs of a DVT formation and is successfully sleeping well at night with the help of her PRN Robaxin.
Some suggestions I would have as to how/when A.D. would take her medication are as followed. I have also included assessments
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Avoid taking when consuming alcohol as it may increase the risk of hepatotoxicity. Nurse should assess patient for a rash periodically, as it may cause Stevens-Johnson syndrome. (Davis,2017)
• AmLODIPine- Nurse should monitor BP and pulse before therapy, during titration, and during therapy. Medication should be withheld if systolic BP is <50 medication should be withheld. Advise patient to take medication as directed at the same time every day. to avoid driving until the effects of the medication are known, and that the medication can cause sensitivity to cold. This medication may mask signs of hypoglycemia, so blood glucose levels should be closely monitored. (Davis,2017)
• Lisinopril- Nurse should monitor patient BP and pulse before and during therapy and check for signs of angioedema, if present discontinue therapy. Weight should be monitored and assessed for fluid overload. Patient should take medication at the same time every day and avoid food containing high levels of potassium or sodium due to the risk of hyperkalemia. Nurse should teach about the risk of orthostatic hypotension and dizziness, when changing positions or driving. Blood glucose levels should also be monitored for risk of hypoglycemia.
What is the purpose of each of the medications the patient is on? Why is this patient receiving them?
...estions if not 100% sure of something or use a double checking system. When a nurse is administrating medication, they should use the ten rights of medication administration (right patient, right drug, right route, right time, right dose, right documentation, right action, right form, right response, and right to refuse). Nurses should always keep good hand hygiene and always wear appropriate clothing to prevent from the spread of disease. Good communication with patients and healthcare team members is also key to success. Keeping on the eye on the patient within an appropriate time is important. If the patient ever seems to be looking different than their usual self vitals should be taken immediately. Encouraging patients to ask questions if they are unaware of something can prevent errors as well. Nurses should make sure the patient is on the same page as they are.
Per nursing report, patient in 6west rm 6626 (MR 331609) was combative, received 2 mg Ativan IVP per nursing, slumped over, was not responding to stimuli, respirations less than 8 and was desating on room air. RRT was activated. Alison Teel, RRT RN right away responded to RRT. Alison Teel is currently on the Stroke/RRT unit orientation.
Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.
As patients grow older, and develop conditions that require prescription and over the counter medications, opportunities for dangerous alcohol/drug interactions increase.
When working in healthcare we are taught first and foremost that patient confidentiality is always extremely important. You should talk to one other than the patient about their medication condition,
A large aspect that may have helped this case is if we had asked her what has previously worked to get her pain to her desired goal. This would have helped us create a better plan of care to help achieve her goal. We acknowledged the fact that the pain she was experiencing after administration may be the least amount she could have felt with her condition. Because the syndrome has so many unanswered questions, it is impossible to know whether the relief of all pain is even possible, or a goal of a 2 on a 0-10 scale is
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Patients who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. There is a great need for nursing interventions in conducting a patient medication review also known as “brown bag”. As nurses obtain history data from patients at a provider visit, the nurse should ask “what medications are you taking?” and the answer needs to include over-the-counter medications as well. If the response does not include any medications other than prescribed meds, it is incumbent upon the nursing professionals to question the patient further to ensure that no over-the-counter medications or supplements are being consumed. This is also an opportunity for the nurse to question about any adverse reactions the patient may be experiencing resulting from medications. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients continuing to take medications that have been discontinued by the physician. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Elderly who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. Elderly who take over-the-counter medications, herbs, and supplements without consulting their physician are at risk for adverse reactions associated with polypharmacy. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients who continue to take medications which have been discontinued by the physician. There is a great need for nursing interventions regarding polypharmacy, including medication reviews also known as “brown bag”. As nurses obtain history data and conduct a patient assessment, it is essential to review the patients’ medications and ask open-ended questions regarding all types of medications in which the patient is taking. In addition, the patient assessment is also an opportunity for the nurse to inquire about any adverse reactions the patient may be experiencing resulting from medications. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Business risk management has been a widely crucial tool for firms to include in their operations and its importance cannot be overlooked. In the case of British Petroleum (BP) Gulf of Mexico Oil Spill in 2010, there was negligence and lack in the contingency plan and response of the company to the risks that arose. It became evident in this analysis that BP’s manner of handling the incident had a massive financial implication that ensued negative public perception and company reputation and value.
Due to my uncertainty, I asked the pharmacist for some tips on how to proceed. He said to use simple language and tell the patient the medication’s dose and frequency, as well as how long to take it for. He also said to mention the cautions and side effects, and which side effects would require coming back to see the pharmacist or the patient’s GP. I was also told to mention any interactions (i.e. if alcohol interacts with the drug to cause drowsiness then avoid driving). These points are in accordance with the NHS’s Patient Counselling and Consultation Skills (2014). Having a mental checklist of what to do improved my confidence when it came to talking to the patient, therefore making me feel less
Client Profile: Lane Bronson is a 55 year old male with a history of angina, hypertension, Type 2 diabetes, COPD, and sleep apnea. He comes to the physican’s office complaining of worsening shortness of breath. His skin tone is grey, and his angina is worsening. Previously stable, he now does not get relief from rest or nitroglycerin. The physician called 911 and had Mr. Bronson directly admitted to the hospital.
Nearly 70 percent of Americans are taking at least one prescribed medication. At least half take more than one. With one of the most frequent line of treatment for many diseases being prescribed medication, nonadherence is a very real issue for many professional nurses. There may be many reasons for patients to not adhere to their medication regime, and as part of the healthcare team, nurses need to examine these and find ways to correct it. Nonadherence can easily lead to negative outcomes for many patients (Streed, 2013).
1. What external environment (general, industry and competitive) segments do you think BP considered or did not consider prior to their drilling off the Gulf coast. What should the wedding business owners now consider in their external environment?
Firstly, nurses are expected to practice evidence-based health care hence a mastery of information about the essential and safe dose of drugs for a patient is very important for a nurse. Consequently, it could be the determinant between the life and the death of the patient. Pharmacology is a discipline which is mandatory for the nurse to excel in to be efficient in discharging his/her duties. Understanding which drug to use, the right dosage, the expected side effects which may occur and the contra-indications of the various drugs are key in the preservation of