Lillymed

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Lillian has been on her medication for pneumonia for 24 hours. The physician says the pneumonia is improving, but she also is having an acute exacerbation of her COPD and a chronic irregular heart rate. Her vital signs are T 37C, B/P 140/87, P 82 and irregular, R 12, and pulse oximetry 92% on 2L O2 per nasal cannula. The physician is concerned about her blood pressure and wants to continue to watch it. She feels that Lillian will benefit from regular medication for her COPD while in the hospital and when she goes home. Lillian also is complaining of cigarette cravings and constipation. The physician is urging her to quit smoking.

The physician leaves the following orders.

  • Albuterol MDI two puffs every 6 hours
  • Ipratropium MDI two puffs every 6 hours
  • Nicoderm 7 mg/24 hr transdermal patch daily
  • Bisacodyl 10 mg suppository now x1 then 10 mg po daily
  • Bathroom privileges
  • Respiratory therapist to determine the need for O2 at home
  • Cardiologist, Dr. B, to consult for irregular heart rate

For your first post, answer all of the following questions about the unfolding case study. Remember that you must also respond to at least one peer in this thread.
1. How does albuterol MDI work? Make sure to include the drug category, mechanism of action, onset and duration of action, and safety considerations.
2. How does ipratropium MDI work? Make sure to include the drug category, mechanism of action, onset and duration of action, and safety considerations.
3. How would the nurse properly administer the two MDIs when both have been scheduled at the same time of day?
4. Lillian asks the nurse why she is on two inhalers for her COPD when she used to use just one. What points would the nurse want to cover to answer her question, considering her history of noncompliance?

 

For your second post, answer all of the following questions about the unfolding case study. Remember that you must also respond to at least one peer in this thread.
The following morning, the cardiologist came to consult on Lillian’s case and left orders for anticoagulation because of Lillian’s chronic irregular heartbeat from atrial fibrillation. Dr. B left the following orders for anticoagulation.

  • Heparin 5,000 units SQ every 12 hours
  • Warfarin 2.5 mg po daily for a target INR of 2.5
  • aPTT, PT, and INR now and then every morning
  • Digoxin 0.25 mg po daily

1. What is the rationale for the cardiologist ordering heparin and warfarin at the same time?
2. What are some nursing implications when administering digoxin?

Microbial And Non-Microbial Presentation

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For this assignment you will complete research using scholarly sources to locate and discuss two different diseases. One disease example must be of microbial origin and the second disease example must be of non-microbial origin.

As a reminder, microbes that cause disease are called pathogens. A pathogen is a micro-organism that has the potential to cause disease. The most common microbial causes of diseases and infections are bacteria, fungi, parasites, and viruses. Examples of non-microbial causes of disease include immune or nervous system disorders, psychological stress, traumatic injury, chemicals, etc.

You will create a PowerPoint presentation. For each disease, discuss the following:

pathophysiology

prevalence

etiology

clinical manifestations

diagnosis

treatment – when discussing treatment, it will be imperative that you discuss medication administration and dosage.

Presentation

Use PowerPoint

Include a title slide

Make sure that each slide is clearly labeled

Use the notes area of the slide to use as speaker notes (script) as if you were presenting the slide to an audience/class

Minimum of 13 slides

Include slide transitions

Make sure the design is professional and the text is readable.

Make sure to spell check.

Note: You can use the template as a starting point or create your own.

Microbial and Non-microbial Diseases

Your name

Date

Diseases

Microbial

Name of disease discussed

Non-microbial

Name of disease discussed

This is where you will add the speaker notes. A script of what would be said as if you were presenting this in class.

 

For instance:

 

This presentation will be discussing two diseases. The first, microbial, disease is… The second, non-microbial disease is… In the following slides, I will discuss the pathophysiology, prevalence, etiology, clinical manifestations, diagnosis, and treatment of these two diseases.

2

Disease name

Microbial

Pathophysiology disease name

 

Prevalence disease name

 

Etiology disease name

 

Clinical Manifestations disease name

 

Diagnosis disease name

 

Treatment disease name

 

Disease name

Non-Microbial

Pathophysiology disease name

 

Prevalence disease name

 

Etiology disease name

 

Clinical Manifestations disease name

 

Diagnosis disease name

 

Treatment disease name

Ethical Dilemmas In Medication Administration

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Choose a medication type from the following list, note why the medication is used, and consider adverse effects. Invent a scenario where giving this medication could result in an ethical or legally charged situation. Try not to choose a category that has been well addressed by your peers.

  1. Bethanaechol / cholinergics: Consider risks of inducing urgency or bradycardia in a clients with dementia issues
  2. Benztropine /anticholinergics: Consider harms that can occur with comorbidities like glaucoma or BPH
  3. Albuterol /adrenergics: Consider harms that can occur is asthmatic children are in charge of their own inhalers
  4. Atenolol/ beta blockers: Consider harms that could occur if heart rate was low or patient was asthmatic
  5. Lorazepam /benzodiazepines: Consider vulnerability issues related to sedation and induction of memory loss
  6. Oxycodone / opiates: Consider addiction, drug seeking and patient vulnerability in impaired nurses
  7. Amitriptylline /tricyclics: Consider vulnerability issues with risk of suicidal overdose given anticholinergic effects
  8. Phenelzine /MAOIs: Consider consequences of nonadherence to dietary restrictions on these medications
  9. Haloperidol / neuroleptics: Consider risks of chemical sedation, especially long term risks
  10. Lithium: Consider risks of mismanagement by clients whose behaviors are unpredictable
  11. Phenytoin / antiepileptics: Consider risks of Class D in young women vs risks of going without anti-epileptics
  12. Secobarbital / barbituates: Consider risks related to availability of barbituates to teens via the internet
  13. Kava or Valerian: Consider risks of availability of compounding poorly controlled over the counter sedatives
  14. Sumatriptan / triptans: Consider risks of cerebral ischemia when giving vasoconstrictors for migraine control
  15. Cyclobenzaprine for back spasms: Consider risks of impaired function when nurses take muscle relaxants
  16. Prednisone / steroids: Consider long term effects, when other immune suppressors are too expensive to access.
  17. Aspirin / NSAIDs: Consider vulnerability of elders due to over the counter, affordable nature of this analgesic

ALA- Anti-Infective Medication And Associated System Disorder

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ACTIVE LEARNING TEMPLATES TherapeuTic procedure A11

System Disorder STUDENT NAME _____________________________________

DISORDER/DISEASE PROCESS __________________________________________________________ REVIEW MODULE CHAPTER ___________

ACTIVE LEARNING TEMPLATE:

ASSESSMENT SAFETY CONSIDERATIONS

PATIENT-CENTERED CARE

Alterations in Health (Diagnosis)

Pathophysiology Related to Client Problem

Health Promotion and Disease Prevention

Risk Factors Expected Findings

Laboratory Tests Diagnostic Procedures

Complications

Therapeutic Procedures Interprofessional Care

Nursing Care Client EducationMedications

 

  1. STUDENT NAME:
  2. DISORDERDISEASE PROCESS:
  3. REVIEW MODULE CHAPTER:
  4. Pathophysiology Related to Client Problem:
  5. Health Promotion and Disease Prevention:
  6. Risk Factors:
  7. Expected Findings:
  8. Laboratory Tests:
  9. Diagnostic Procedures:
  10. Nursing Care:
  11. Therapeutic Procedures:
  12. Medications:
  13. Client Education:
  14. Interprofessional Care:
  15. Alterations in Health:
  16. Safety Considerations:
  17. Complications: