Essay on Case Study 8 DVT - Winningham

a normal manner and it may take longer to clot. If prescribed this medication they will attend a Anticoaglant

Mary is a 50 year old female admitted with shortness of breath and chest pain that started early this am. She is overweight, takes hormone replacement therapy. Her right lower leg is edematous and is diagnosed with deep vein thrombosis and pulmonary embolus. She is given an infusion of Activase in the emergency room and then started on a heparin drip at 1200 uints per hour intravenously once she arrives to the floor. She is going home on Coumadin . The following are the things I will teach Mary to do or observe while taking Coumadin at home.

Avoidance of other nephrotoxic drugs is equally important; therefore, the other 3 answer choices are incorrect.

When the sign and symptoms of Anaphylaxis noted following vaccination. First and foremost we have to placed the patient flat to promote venous blood return to the heart, then place the patient in left lying position and maintain clear airway if the patient is unconscious (PSA 2014). If patient is conscious put them in supine position with head down and elevate legs. Call for assistance and never leave the patient alone to prevent risk of injury. Dial 000 and book for the ambulance. Without any delay administered Inj. Adrenaline Intramuscular on anterolateral thigh if respiratory or cardiovascular symptoms noted. Adrenaline is life saving drug and it is not for intravenous use (ASCIA 2015). Recommended Adrenaline dose is 0.01ml/kg body weight of adrenaline 1:1000 of maximum 0.5 ml (PSA 2014 and ATGI 2016). Mistakenly administering of Adrenaline won’t do any serious harm. Administration of Adrenaline is the key of anaphylaxis

10 mg four times a day intravenously. On the other hand, it might not be really

Invokana is initially administered 100 mg by mouth every day before the first meal of the day. The dose can be increased to 300 mg every day in patients tolerating the initial dose who have a GFR greater than 60 mL/min/1.73m2 in need of additional glycemic control.3 Adverse effects that have been noted with this medication include increased urination, yeast infections, and negative gastrointestinal effects.4,6 Safety considerations include dehydration, vaginal yeast infections in women and men, and it is not advised to take Invokana if you are allergic or have severe renal impairment and/or are on dialysis.4 It is therefore imperative that patients are screened appropriately before being placed on this medication, and that monitoring is performed in certain disease states, particularly those involving renal disease.

Taking the advisable dosages each few hours will enable you to to continue your day-to-day activities. A heating pad positioned around the region with the organ may also be useful in minimizing the discomfort you happen to be enduring.

“I’ll start him on a small dosage in the morning. I’m going to start him at 5mg, three times a day,” Karl explained. “It should start working in a week or so. If we don’t see improvement than, I’ll double the dosage.”

Therapeutic Dosage; Adult, child over 45 kg:300-600mg/day PO, or 0.4 mg/kg/hr. Child under 45 kg

The enoxaparin dose should be 1 mg/kg twice daily and given subcutaneously, if it is used for this purpose. Bridging will be resumed 24 hours or later after surgery, as well as warfarin and continued until the anticoagulation level (INR) is therapeutic. Once the INR is within desired therapeutic range, it must stay therapeutic for 24 hours before removal.

In known cases of AT III deficiency, administration of AT III concentrate can help achieving the target aPTT levels and reduce heparin use. 1000 international units of AT III concentrate is usually given if ACT is less than 400 seconds despite administration of total dose of 750 units/kg of heparin. Due to AT III high cost, administration of 2-4 units of fresh frozen plasma is another approach in these cases. However, the latter has its own drawback of increased risks associated with blood products

Periodic surveillance and evaluations are to be maintained in order to assess risks, especially during pregnancy. Aside from blood thinners, individuals with Factor V Leiden Mutation may minimize their risk of blood clots by: living a healthy lifestyle, avoiding prolonged periods of immobility, keeps preexisting medical complications under control, and avoid smoking. Anyone who has a family member that has had a DVT or PE that is unexplained, recurrent, or developed in an unusual site may find it beneficial to be tested for factor V

• The physician should start you on the lowest effective dosage if possible, if need be, he increases the dosage gradually as the body become used to the injection, instead

The standard dosage of drospirenone-ethinyl-estradiol has a range of 0.02-0.03 mg of ethyinyl-estradiol and the dosage of drospirenone is consistent at 3 mg (Blode, Kowal, Roth, & Reif, 2012). For this patient, I would prescribe 0.03 mg ethinyl-estradiol/3 mg drospirenone.

Concerning the administered basic therapy, all patients received MTX dose 17.5 mg/week. In addition, patients received hydroxychloroquine