Nursing Process Paper
Mr. Black is a 67-year-old African-American man who is married with three children. His wife died about 15 years ago from a car accident, and he has been living alone since then with occasional checks from his daughter. Being a truck driver is in the middle-class income range; his highest qualification is a high school diploma. He has been his usual self until a month ago when he was admitted on February 15, 2020, to the emergency room when he noticed some swelling on his feet, shortness of breath, and fatigue. With his preexisting conditions on Hypertension, CVA, diabetes, asthma, and Hyperlipidemia, he was admitted, and a student was assigned on February 17, 2020.
Medications
Mr. Black had been given medication to deal with his preexisting conditions. For Hypertension, he was given losartan; for diabetes, he was prescribed metformin; he has prescribed albuterol for asthma. For Hyperlipidemia, his prescription was Simvastatin.
Optech LPN- ADN Flex Program Clinical Drug Information NUR 201X - 2020
Student Name: Khadijah Green, ADSN Pt. s Initials: M.B. Date of Care: 2/17/2020
Drug:
Trade name/Generic Name:
Losartan
Metformin
Albuterol
Simvastatin
Nexium
Classification:
Angiotensin II Receptor Blockers.
Biguanides
Bronchodilators
HMG-CoA Reductase inhibitors
Proton pump inhibitors
Frequency & Time/s Due:
one pill per day
One pill twice a day
Two puffs
One pill a day
One pill a day
Dose and Form: (pill capsule, ml, units, etc.)
100mg
500mg
180mg
10mg
20mg
Route:
Oral
Oral
Inhaled drug
Oral
Oral
Pt. diagnosis for this drug:
Hypertension
Diabetes
Asthma
Hyperlipidemia
Gastro-esophageal
reflux
disease
Indication Uses:
Once a week for five days
Once a week for five days
4-6 hours with
12inhalations/
24hrs
Used once a day for five days
Used twice a day for
Four weeks.
Common side effects:
Diarrhea
Stomach pain
Dizziness
Headache
Tiredness
Diarrhea ,nausea ,flatulence,
Indigestion
and abdominal pain.
Wheezing
Leg cramps
Extreme thirst
Blurred vision
Diarrhea
Abdominal bloating
Muscle cramping
Flatulence
constipation
Headache
Nausea
Flatulence
Adverse life-threatening effects :
Vasodilation
It decreased Blood pressure.
Allergic reaction
Kidney damage
Lactic acidosis
Nausea
Chest pains
Convulsions
Tremors
Cause muscle myopathies
Decrease liver function
Inhibits the gastric
Proton pump and
Prevent the formation of
Hydrochloric acid.
Action:
Block the binding of angiotensin II to receptor cells.
Lower blood glucose levels by decreasing liver glucose production
Prevent bronchospasm
Lowering LDL-C levels
It controls acidic reflux and its symptoms.
Nursing Implications:
Assessment:
What do you need to assess before giving?
Monitor the blood pressure
Do not give drugs without checking with the health care provider if systolic Blood pressure is below 100.
The patient does not receive the drug after the procedure requiring IV contrast material.
To teach patient to monitor heart rate
The patient should not have active liver disease or pregnant.
Nexium should not be
given with other IV
drugs
Implementation:
What do you need to know about this medication regarding food, other medications, crushing, route, etc.?
Avoid foods high in potassium because they can cause hyperkalemia.
Patients should not take alcoholic beverages when taking this drug
To use the drug five minutes before the other inhaled drugs.
To avoid grapefruit and grape juice in their diet.
To reduce alcohol or
caffeine consumption
Smoking and fasting.
Toxicity and Overdose:
If applicable:
Therapeutic Serum Level and Antidote:
It can lead to death due to the blocking of adrenaline
Visit the nearest hospital
Lactic acidosis.
Treatment include; sodium bicarbonate infusion and hemodialysis
Chest pain, irregular heartbeat to control the use of a ventilator.
If inactivated, it remains in patients bloodstream leading to kidney failure, heart failure, G.I. bleeding. Visit the nearest hospital
Dizziness, fast heartbeat, and increased fractures of the hip, wrist.
Visit the nearest hospital for treatment
Source/Page:
(Ignatavicus et al., 2018),
(Ignatavicus et al., 2018),
(Ignatavicus et al., 2018),
(Ignatavicus et al., 2018),
(Ignatavicus et al., 2018),
Laboratory Studies
Laboratory tests were done to determine the cause of his shortness of breath, fatigue, and swelling of his feet. Tests were done to determine his blood sugar level, his sodium and potassium concentration levels. Arterial blood gas tests, estimated glomerular filtrate rate, NT-proBNP test, creatinine are also done. Hematology tests are done as hemoglobin transports oxygen to tissues. Red blood cell count provides data about oxygen transport. A deficiency of hemoglobin leads to hpoxemia. The normal male has a 6.11012/L(Ignatavicus et al., 2018). Mr. Black has a red blood count of 4.51012/ L, which is lower due to the production of excessive...
Mr. Black has been suffering from Hypertension, which he was diagnosed in 2020, year 2009 he was diagnosed with asthma and Hyperlipidemia, and in 2011 he was diagnosed with type 2 diabetes. His preexisting Hypertension from causes such as atherosclerosis leads to pressure damages to the glomerular capillaries (Shimamoto et al., 2014). Hypertension damages kidney arterioles reducing the circulation of blood through tissues.
Fluid overload or blood vessel injury leads to pulmonary edema. The heart cannot remove blood from the left ventricle leading to increased pressure in the right atrium and blood vessels, leading to fluid crossing from the capillaries into the pulmonary tissue leading to edema. The patient had shortness of breath and crackles that had begun from the base of the lung. As the fluid level increases, the lungs level of fluid increases (Assaad et al., 2017). Heart failure is likely to occur because of the increased load due to fluid overload and Hypertension. The accumulation of uremia may lead to a uremic toxic effect on the myocardium. Patients with chronic kidney disease, pulmonary edema, and other cardiac and gastric diseases are less likely to respond to treatment.
Nursing Care Plan
Nursing of patients…
References
Assaad, S., Kratzert, W. B., Shelley, B., Friedman, M. B., & Perrino Jr, A. (2018). Assessment of pulmonary edema: principles and practice. Journal of cardiothoracic and vascular anesthesia, 32(2), 901-914.
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-Surgical Nursing-E-Book: Concepts for Interprofessional Collaborative Care. Elsevier Health Sciences.
Shimamoto, K., Ando, K., Fujita, T., & Hasebe, N. (2014). The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2014). Hypertension Research, 37(4), 253-253. https://doi.org/10.1038/hr.2014.20
APPENDIX AOCtech LPN- ADN Flex Program Clinical Drug Information NUR 201X - 2020Student Name: Khadijah Green, ADSN Pt.’s Initials: M.B. Date of Care: 2/17/2020Drug:Trade name/Generic Name:Classification:Frequency & Time/s Due:Dose and Form: (pill capsule, ml, units, etc.)Route:Pt. diagnosis for this drug:Indication Uses:Common side effects:Adverse life-threatening effects :Action:Nursing Implications:Assessment:What do you need to assess before giving?Implementation:What do you need to know about this medication regarding food, other medications, crushing, route, etc.
Toxicity and Overdose:If applicable:Therapeutic Serum Level and Antidote:Source/Page:Appendix BLAB/DIAGNOSTIC TESTS: Only list abnormal results for each test. (Examples: blood test, x-ray, etc.…)Label each test separately with the date it was performed. Obtain this information from the client’s record.
Source/s: Mosby’s Diagnostic & Laboratory Test ReferenceName of Lab/Diagnostic Test Blood Date of Test 2/17/2020ABNORMAL COMPONENTS(List components below separately in each box)CLIENT’S RESULTSNORMAL RANGE FOR FACILITYREASON FOR ABNORMALITYMUST PERTAIN TO CLIENT’S DIAGNOSISInclude page # of source usedAppendix CDrug:Trade name/Generic Name:MetforminAlbuterolSimvastatinNexiumClassification:Angiotensin II Receptor Blockers.
BiguanidesBronchodilatorsHMG-CoA Reductase inhibitorsProton pump inhibitorsFrequency & Time/s Due:one pill per dayOne pill twice a dayTwo puffsOne pill a dayOne pill a dayDose and Form: (pill capsule, ml, units, etc.)100mg500mg180mg10mg20mgRoute:OralOralInhaled drugOralOralPt. diagnosis for this drug:HypertensionDiabetesAsthmaHyperlipidemiaGastro-esophagealrefluxdiseaseIndication Uses:Once a week for five daysOnce a week for five days4-6 hours with12inhalations/24hrsUsed once a day for five daysUsed twice a day forFour weeks.
Common side effects:DiarrheaStomach painDizzinessHeadacheTirednessDiarrhea ,nausea ,flatulence,Indigestionand abdominal pain.
WheezingLeg crampsExtreme thirstBlurred visionDiarrheaAbdominal bloatingMuscle crampingFlatulenceconstipationHeadacheNauseaFlatulenceAdverse life-threatening effects :VasodilationIt decreased Blood pressure.
Allergic reactionKidney damageLactic acidosisNauseaChest painsConvulsionsTremorsCause muscle myopathiesDecrease liver functionInhibits the gastricProton pump andPrevent the formation ofHydrochloric acid.
Action:Block the binding of angiotensin II to receptor cells.
Lower blood glucose levels by decreasing liver glucose productionPrevent bronchospasmLowering LDL-C levelsIt controls acidic reflux and its symptoms.
Nursing Implications:Assessment:What do you need to assess before giving?Monitor the blood pressureDo not give drugs without checking with the health care provider if systolic Blood pressure is below 100.
The patient does not receive the drug after the procedure requiring IV contrast material.
To teach patient to monitor heart rateThe patient should not have active liver disease or pregnant.
Nexium should not begiven with other IVdrugsImplementation:What do you need to know about this medication regarding food, other medications, crushing, route, etc.?Avoid foods high in potassium because they can cause hyperkalemia.
Patients should not take alcoholic beverages when taking this drugTo use the drug five minutes before the other inhaled drugs.
To avoid grapefruit and grape juice in their diet.
To reduce alcohol orcaffeine consumptionSmoking and fasting.
Toxicity and Overdose:If applicable:Therapeutic Serum Level and Antidote:It can lead to death due to the blocking of adrenalineVisit the nearest hospitalLactic acidosis.
Treatment include; sodium bicarbonate infusion and hemodialysisChest pain, irregular heartbeat to control the use of a ventilator.
If inactivated, it remains in patients’ bloodstream leading to kidney failure, heart failure, G.I. bleeding. Visit the nearest hospitalDizziness, fast heartbeat, and increased fractures of the hip, wrist.
Visit the nearest hospital for treatmentSource/Page:(Ignatavicus et al., 2018),(Ignatavicus et al., 2018),(Ignatavicus et al., 2018),(Ignatavicus et al., 2018),(Ignatavicus et al., 2018),OCtech LPN- ADN Flex Program Clinical Drug Information NUR 201X - 2020Student Name: Khadijah Green, ADSN Pt.’s Initials: M.B Date of Care: 2/17/2020.
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