Oral and Parenteral Your text here 1
Medication Administration
Skills & Reasoning
Jerry Williams, 62 years old
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
• Gas Exchange
• Clinical Judgment
• Patient Education
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory 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
1
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, ✓ Basic Care and Comfort 6-12% ✓
✓ Pharmacological and Parenteral Therapies 12-18% ✓
✓ Reduction of Risk Potential 9-15% ✓
✓ Physiological Adaptation 11-17% ✓
History of Present Problem:
Jerry Williams is a 62-year old obese (BMI 35.2) Caucasian male with a history of diastolic heart failure and type II
diabetes. Last evening, he began having difficulty breathing with activity. He thought he might be getting a cold because
he had a runny nose. He reports more swelling in his lower legs the past couple days. He woke up this morning with
increased difficulty breathing when he woke up and his wife called 911.
Paramedics report that his initial VS: HR:92 RR: 28 BP: 172/88 O2 sat: 80% on room air with scattered expiratory
wheezing bilat. He was placed on oxygen by facemask and albuterol nebulizer administered with some improvement in
his breathing. His RR is now 24 upon arrival to the emergency department ED). His initial labs have resulted; creatinine of
2.5 (last adm. 1.8), K+ 3.5 (last adm. 3.7) and BNP 944 (last adm. 322). Jerry is given furosemide 40 mg IV in the ED and
had 800 mL urine output in the last hour. He is admitted to cardiac telemetry, and you are the nurse responsible for his
care.
What data from the present problem do you NOTICE as RELEVANT and why is it clinically significant? (Reduction
of Risk Potential/Health Promotion and Maintenance)
RELEVANT Data: Clinical Significance:
(BMI 35.2) Pt is obese according to the BMI scale. This pt. is at increased
history of diastolic heart failure and risk for HTN, stroke, Type 2 diabetes and other cardiovascular
type II diabetes problems.
Swelling in lower legs With diastolic failure the body is not pumped correctly out of
Difficulty breathing, RR28, O2 Sat your vents. Blood will build up in them. Could also cause lung
80% issues too.
BP 172/88 Diabetes damage the vessels overtime and put you at increased
Respiratory Wheezing bilat.
risk for heart disease
Creatine of 2.5 (last Adm. 1.8)
Edema is sign of Heart failure and deep vein thrombosis.
BNP 944 (last Adm. 322)
If the patient is not breathing good the 02 will be lower and
cause your body to work harder thus increasing your RR.
With wheezes there is fluid on lungs, or constriction of
bronchioles.
Creatine indicates problem with kidneys. We all know
cardiovascular issue will cause kidney issues
High BNP indicates some form of heart failure. His was super
high!
What is the RELATIONSHIP of his past medical history and current medications? Why is your patient receiving these
medications? (Which medication treats which condition? Draw lines to connect)
Past Medical History (PMH): Home Medications:
Hyperlipidemia Furosemide 20 mg PO every morning
Hypothyroidism Atorvastatin 40 mg PO at bedtime
Type II diabetes Metoprolol 50 mg PO BID
Diastolic heart failure Levothyroxine 112 mcg PO daily
Chronic kidney disease stage III Exenatide microspheres 2 mg subq. weekly
2
This study source was downloaded by 100000842722785 from CourseHero.com on 06-03-2022 01:54:46 GMT -05:00
https://www.coursehero.com/file/68216370/STUDENT-Medication-Admin-Skills-Reasoningdocx/
Medication Administration
Skills & Reasoning
Jerry Williams, 62 years old
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
• Gas Exchange
• Clinical Judgment
• Patient Education
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory 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
1
This study source was downloaded by 100000842722785 from CourseHero.com on 06-03-2022 01:54:46 GMT -05:00
https://www.coursehero.com/file/68216370/STUDENT-Medication-Admin-Skills-Reasoningdocx/
, ✓ Basic Care and Comfort 6-12% ✓
✓ Pharmacological and Parenteral Therapies 12-18% ✓
✓ Reduction of Risk Potential 9-15% ✓
✓ Physiological Adaptation 11-17% ✓
History of Present Problem:
Jerry Williams is a 62-year old obese (BMI 35.2) Caucasian male with a history of diastolic heart failure and type II
diabetes. Last evening, he began having difficulty breathing with activity. He thought he might be getting a cold because
he had a runny nose. He reports more swelling in his lower legs the past couple days. He woke up this morning with
increased difficulty breathing when he woke up and his wife called 911.
Paramedics report that his initial VS: HR:92 RR: 28 BP: 172/88 O2 sat: 80% on room air with scattered expiratory
wheezing bilat. He was placed on oxygen by facemask and albuterol nebulizer administered with some improvement in
his breathing. His RR is now 24 upon arrival to the emergency department ED). His initial labs have resulted; creatinine of
2.5 (last adm. 1.8), K+ 3.5 (last adm. 3.7) and BNP 944 (last adm. 322). Jerry is given furosemide 40 mg IV in the ED and
had 800 mL urine output in the last hour. He is admitted to cardiac telemetry, and you are the nurse responsible for his
care.
What data from the present problem do you NOTICE as RELEVANT and why is it clinically significant? (Reduction
of Risk Potential/Health Promotion and Maintenance)
RELEVANT Data: Clinical Significance:
(BMI 35.2) Pt is obese according to the BMI scale. This pt. is at increased
history of diastolic heart failure and risk for HTN, stroke, Type 2 diabetes and other cardiovascular
type II diabetes problems.
Swelling in lower legs With diastolic failure the body is not pumped correctly out of
Difficulty breathing, RR28, O2 Sat your vents. Blood will build up in them. Could also cause lung
80% issues too.
BP 172/88 Diabetes damage the vessels overtime and put you at increased
Respiratory Wheezing bilat.
risk for heart disease
Creatine of 2.5 (last Adm. 1.8)
Edema is sign of Heart failure and deep vein thrombosis.
BNP 944 (last Adm. 322)
If the patient is not breathing good the 02 will be lower and
cause your body to work harder thus increasing your RR.
With wheezes there is fluid on lungs, or constriction of
bronchioles.
Creatine indicates problem with kidneys. We all know
cardiovascular issue will cause kidney issues
High BNP indicates some form of heart failure. His was super
high!
What is the RELATIONSHIP of his past medical history and current medications? Why is your patient receiving these
medications? (Which medication treats which condition? Draw lines to connect)
Past Medical History (PMH): Home Medications:
Hyperlipidemia Furosemide 20 mg PO every morning
Hypothyroidism Atorvastatin 40 mg PO at bedtime
Type II diabetes Metoprolol 50 mg PO BID
Diastolic heart failure Levothyroxine 112 mcg PO daily
Chronic kidney disease stage III Exenatide microspheres 2 mg subq. weekly
2
This study source was downloaded by 100000842722785 from CourseHero.com on 06-03-2022 01:54:46 GMT -05:00
https://www.coursehero.com/file/68216370/STUDENT-Medication-Admin-Skills-Reasoningdocx/
