I’m studying for my Health & Medical class and don’t understand how to answer this. Can you help me study?
Write a paper that addresses the following:
? Explain your diagnosis for the patient, including your rationale for the
diagnosis.
? Describe an appropriate drug therapy plan based on the patient’s history,
diagnosis, and drugs currently prescribed.
? Justify why you would recommend this drug therapy plan for this patient. Be
specific and provide examples.
Patient:
DC is a 46-year-old female who presents with a 24-hour history of RUQ pain. She states
the pain started about 1 hour after a large dinner she had with her family. She has had
nausea and on instance of vomiting before presentation.
PMH: Vitals:
HTN Temp: 98.8 o F
Type II DM Wt: 202 lbs
Gout Ht: 5’8”
DVT – Caused by oral BCPs BP: 136/82
HR: 82 bpm
Current Medications: Notable Labs:
Lisinopril 10 mg daily WBC: 13,000/mm 3
HCTZ 25 mg daily Total bilirubin: 0.8 mg/dL
Allopurinol 100 mg daily Direct bilirubin: 0.6 mg/dL
Multivitamin daily Alk Phos: 100 U/L
AST: 45 U/L
ALT: 30 U/L
Allergies:
Latex
Codeine
Amoxicillin
PE:
o Eyes: EOMI
o HENT: Normal
o GI:bNondistended, minimal tenderness
o Skin:bWarm and dry
o Neuro: Alert and Oriented
o Psych:bAppropriate mood
How to solve
DU Nursing Drug Therapy Plan Based on The Patients History Discussion
Introduction:
Based on the patient’s symptoms and medical history, it will be important to perform a thorough analysis in order to arrive at an accurate diagnosis. Additionally, we will consider various factors such as the patient’s current medications and any relevant allergies, as well as conduct a physical examination to gather more information. This will allow us to formulate an appropriate drug therapy plan and provide justification for its recommendation.
Answer:
Diagnosis:
Based on the patient’s presenting symptoms of RUQ pain, onset after a large meal, and associated symptoms of nausea and vomiting, along with the absence of any significant findings on the physical examination, the most likely diagnosis for this patient is acute cholecystitis.
Rationale:
Acute cholecystitis is characterized by inflammation of the gall bladder, often caused by gallstones. The typical symptoms include RUQ pain, which may be exacerbated by fatty meals, and can radiate to the right shoulder. Nausea and vomiting are commonly present as well. The patient’s history of a large dinner and the temporal relationship between the meal and the onset of symptoms align with this diagnosis. Additionally, the physical examination findings, such as non-distended abdomen and minimal tenderness, are consistent with acute cholecystitis.
Drug Therapy Plan:
To manage the patient’s acute cholecystitis, the following drug therapy plan is recommended:
1. Pain Management:
– Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or ketorolac can be prescribed to relieve pain and inflammation associated with acute cholecystitis.
– Avoid the use of opioids (e.g., codeine) due to the patient’s allergy.
2. Antibiotics:
– Antibiotic therapy should be initiated to cover likely pathogens in acute cholecystitis, such as Escherichia coli or Klebsiella species.
– Preferred agents include third-generation cephalosporins (e.g., ceftriaxone) or fluoroquinolones (e.g., levofloxacin).
– Given the patient’s history of allergy to amoxicillin, it should be avoided.
3. Symptomatic relief of nausea:
– Antiemetic medications, such as ondansetron or prochlorperazine, may be prescribed to alleviate the patient’s nausea symptoms.
Justification:
The recommended drug therapy plan for this patient is based on the understanding of the underlying pathophysiology of acute cholecystitis and the aim to effectively manage the associated symptoms and prevent complications. NSAIDs are known to provide analgesic and anti-inflammatory effects, reducing pain and inflammation associated with cholecystitis. Appropriate antibiotic therapy is essential to target the likely pathogens involved in the infection, thereby reducing the risk of complications. Lastly, antiemetic medications can help alleviate the patient’s symptoms of nausea, improving comfort and overall well-being.
It is important to tailor the drug therapy plan to the specific patient, taking into consideration factors such as allergies and concurrent medications. Regular monitoring of the patient’s response to therapy, as well as any adverse effects or changes in clinical status, is crucial to ensure the chosen drug therapy plan remains appropriate and effective.
