Pharmacology Reasoning Case Study; Susan Jones is a 42-year-old African-American female with a past medical history of diabetes mellitus type II.ALL ANSWERS 100% CORRECT FALL-2021 SOLUTION AID GRADE A+

Medication Categories Concepts Antihypertensives Perfusion NCLEX Client Need Categories Percentage of Items from Each Category/Subcategory Covered in Case Study Safe and Effective Care Environment • Management of Care 17-23% • Safety and Infection Control 9-15% Health Promotion and Maintenance 6-12% Psychosocial Integrity 6-12% Physiological Integrity • Basic Care and Comfort 6-12% • Pharmacological and Parenteral Therapies 12-18% • Reduction of Risk Potential 9-15% • Physiological Adaptation 11-17% I. Initial Presentation: Susan Jones is a 42-year-old African-American female with a past medical history of diabetes mellitus type II. She works in a manufacturing plant in her hometown. While at work, she feels faint and has to sit down. The occupational nurse is contacted to assess her. Susan Jones is married and a mother of two elementary age children. She has been employed in her current position for two years. 1. What data from the present problem are RELEVANT and must be NOTICED as clinically significant by the nurse? (NCSBN: Step 1 Recognize cues/NCLEX Reduction of Risk Potential) RELEVANT Data from Present Problem: Clinical Significance: Past history of DM II Feels faint, dizzy, and has to sit down Might be suffering hypoglycemia The patient could be dehydrated, or could be related to her DM. Need to assess the client for further investigation of CV system. As the nurse responsible for this patient, you promptly review the medical history and note that she has NKDA. This is her PMH and current home medications documented in the employee’s medical record: 1. What is the RELATIONSHIP of the past medical history and current medications? Why is your patient receiving these medications? (Which medication treats which condition? Draw lines to connect) Medical History (PMH): Home Medications: Hypertension GERD Type II diabetes mellitus ASA 81 mg PO daily HTN Lisinopril 40 mg PO daily HTN HCTZ 25 mg PO am HTN Metformin 875 mg PO BID DM II Omeprazole 20 mg PO daily GERD Applying your knowledge of pharmacology, to provide safe patient care, answer the following essential information: 2. List each home medication from the scenario and answer the following: (NCLEX Pharmacologic and Parenteral Therapies) Home Medication: Pharm. Class: Indication(s): Mechanism of Action In OWN WORDS: Body System Impacted Common Side Effects Nursing Assessments: ASA 81mg NSAID Antipyretic salicylate Anticoagulant/bloo d thinner Decreases the chance of occlusion in blood vessels by platelet aggregation CV Bleeding, hemorrhage, nausea, bruising Watch for hypersensitivity reactions. Assess for salicylate Lisinopril 40 mg ACE inhibitor HTN Prevents conversion of angiotensin I to angiotensin II Renal Hypotension, dizziness Monitor B/P frequently, I&O, weights HCTZ 25 Thiazide diuretic HTN A loop diuretic that CV, renal Electrolyte Monitor B/P mg increases the output of urine imbalance, dehydration frequently, I&O, weights, electrolytes Metformin 875 mg Biguanide Antihyperglycemic agent Diabetes and prediabetes Inhibits glucose production and release from the liver Endocrine N/V/D-GI upset Monitor glucose, HbA1C, metabolics Omeprazole 20 mg Anti-ulcer agent Proton pump inhibitor GERD or acid reflux Binds to gastric enzymes preventing reflux of HCL and diminished accumulation GI tract GI upset/mild discomfort Assess for stomach pain, bleeding, or other complications. Advise patient not to over take as could lead to alkalosis 3. Based on this patient’s home medication list, does the nurse need to address the clinical concern of polypharmacy with the primary care provider? No, due to the patients current dx the medications are appropriate. 4. Based on this patient’s home medication list, are there any concerning medication interactions that the nurse needs to communicate to the primary care provider? No, don’t see a need to contact provider II. Present Problem: Susan had an exercise stress test six months ago and was evaluated by a cardiologist. She was referred by her primary care provider due to risk factors of stress, obesity, hypertension, smoking, diabetes mellitus and a positive family history of coronary artery disease. Susan had a negative exercise stress test, but was frightened by the experience. In the past six months, she has stopped smoking, began exercising and lost 20 pounds. She has eliminated many processed foods in her diet and has adopted a "clean eating" approach. 1. What data from the present problem are RELEVANT and must be NOTICED as clinically significant by the nurse? (NCSBN: Step 1 Recognize cues/NCLEX Reduction of Risk Potential) RELEVANT Data from Present Problem: Clinical Significance: Taking multiple antihypertensives Taking metformin Obese but losing weight-20lbs. Stress test Could lower B/P to dangerous levels, put patient at risk for falls. Patient is diabetic increasing need for individualized treatment Due to patients obesity status losing weight is healthy and can help improve patients quality of life and help symptoms of other complications