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AdvPharm

Advanced Pharmacology nurs 6521

Provide 3 CITATIONS AND 3 MATCHING REFERENCES 1 to 2 pages. Answer all parts of the bullet points.

 

CASE STUDY: HH is a 68 year old Male who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.

Ht: 5’8”  Wt: 89 kg

Allergies: Penicillin (rash)

 

 

Lab Results.

THE ASSIGNMENT: Critical Decision making

· Write a brief description of your patient’s health needs from the patient case study you assigned. Be specific.

· Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response.

· Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

READINGS

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advacned practice providers. St. Louis, MO: Elsevier.

· Chapter 44, “Anticoagulant and Antiplatelet Drugs” (pp. 451–472)

· Chapter 45, “Drugs for Deficiency Anemias” (pp. 473–483)

· Chapter 48, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 521–533)

· Chapter 49, “Birth Control” (pp. 535–547)

· Chapter 50, “Androgens” (pp. 549–556)

· Chapter 51, “Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia” (pp. 557–569)

· Chapter 68, “Basic Principles of Antimicrobial Therapy” (pp. 769–781)

· Chapter 69, “Drugs That Weaken the Bacterial Cell Wall I: Penicillins” (pp. 783–790)

· Chapter 73, “Sulfonamides and Trimethoprim” (pp. 619–826)

· Chapter 74, “Drug Therapy of Urinary Tract Infections” (pp. 827–831)

· Chapter 75, “Antimycobacterial Agents” (pp. 833–847)

· Chapter 76, “Miscellaneous Antibacterial Drugs” (pp. 849–853)

· Chapter 77, “Antifungal Agents” (pp. 855–866)

· Chapter 78, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 867–886)

· Chapter 80, “Drug Therapy of Sexually Transmitted Diseases” (pp. 905–911)

 

Lunenfeld, B., Mskhalaya, G., Zitzmann, M., Arver, S., Kalinchenko, S., Tishova, Y., & Morgentaler, A. (2015). Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male, 18(1), 5–15. doi:10.3109/13685538.2015.1004049

 

This article presents recommendations on the diagnosis, treatment, and monitoring of hypogonadism in men. Reflect on the concepts presented and consider how this might impact your role as an advanced practice nurse in treating men’s health disorders.

 

Montaner, J. S. G., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., … Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS ONE, 9(2)e87872. Retrieved from https://doi.org/10.1371/journal.pone.0087872

 

This study examines HAART therapy and its sustainability and profound population-level decrease in morbidity, mortality, and HIV transmission.

 

 

Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53–58. .https://doi.org/10.1016/j.maturitas.2016.01.007

 

This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition.

 

Agency for Healthcare Research and Quality. (2014). Guide to clinical preventive services, 2014: Section 2. Recommendations for adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

 

This website lists various preventive services available for men and women and provides information about avail

 

Results

On admission Day 3 Urine Legionella antigen: Non-reactive

Urine Pneumococcal antigen: Non-reactive

 

CXR: Right lower lobe infiltrate

 

Blood cultures (2 sets): No growth to date x 3

days

Vitals

Temp (F) 102.7 100.9

BP 138/72 136/70

HR 124 88

RR 34 20

O2 Saturation 90% (4L O2) 92% (room air)

Na (mEq/L) 144 140

K (mEq/L) 4.6 4.3 Bronchial alveolar lavage (BAL) culture:

Gram-positive cocci in pairs, 34 WBCs, 3

epithelial cell

Heavy growth Streptococcus pneumoniae

Antibiotic MIC Interpretation

Penicillin 1 Susceptible

Ceftriaxone 0.25 Susceptible

Vancomycin 0.125 Susceptible

Erythromycin >16 Resistant

Levofloxacin ≤ 0.5 Susceptible

Tetracycline >16 Resistant

 

Cl (mEq/L) 103 105

HCO

3

(mEq/L) 34 30

BUN (mg/dL) 30 18

Cr (mg/dL) 1.2 1.1

Glucose (mg/dL) 180 143

WBC (x 10

3

 

cells/mm

3

)

18.2 14.6

Neut 86% 83%

Bands 10% 8%

Lymph 4% 6%

Mono 0% 1%

Eos 0% 1%

Baso 0% 1%

 
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