Dual Antiplatelet Therapy Case

Deep Vein Thrombosis (DVT) is a serious medical condition that affects certain hospitalized patients. The healthcare team, especially the registered nurse, must understand what this condition entails, who it affects, and how to prevent and treat this condition. The proper knowledge and training will allow the registered nurse to be able to keep the patients safe and help prevent complication from deep vein thrombosis.

The patient was admitted to the hospital by her daughter after discovering that she had abandoned her medication and was significantly experiencing adverse effects from the withdrawal. The patients’ medical history included renal dysfunction, anemia, malnourishment, back pain, and a family history of mental health. The patient has a psychiatric history of being previously placed in the same clinical structure eight months ago due to related issues including the failure to take her medication and increased levels of mental health conditions that led

According to the member’s insurance plan, the preferred short-acting insulin analog of choice is Humalog. They note that Novolog is covered if “the member has had previous treatment, contraindication, or intolerance to Humalog.” It further states that this needs to be documented by filling out a specific form. Per the records submitted, no such documentation of “previous treatment, contraindication, or intolerance to Humalog” had been

During the discharge process, Mr. K was instructed to follow-up with his primary care provider. The inpatient team also gave Mr. K prescriptions for a new anti-hypertensive medication. Sadly, they did not provide any instructions about his previous anti-hypertensive drugs. As a result, Mr. K continued to take the old and the new anti-hypertensive medications. Since his next appointment was within three weeks, he decided to wait instead

The wife of Bisclavaret was once fully dedicated and loved her husband very dearly. She was surely happy to be beside her husband and the couple mutually did not keep secrets from each other. However, people change over time in marriages; unfortunately, the static person in marriage has difficulty in swaying their partner in the right direction. In this case, the wife continuously stayed the loving and devoted wife was while Bisclavaret changed. For example, the wife expresses her concern for her husband here: “Husband and fair, sweet friend, I have a certain thing to pray of you. Right willingly would I receive this gift, but I fear to anger you in the asking”. In this quote, the wife expresses worry and fee, an example of pathos,

1). Chest X-ray was normal. Initial laboratory studies were remarkable for white blood cells count of 12.1K, a creatine kinase MB fraction of < 3 mm was associated with significant reductions in restenosis and the rate of target vessel revascularization19. In SES-SMART trial patients were randomly assigned to receive a Sirolimus-eluting or bare-metal stent in small coronary artery. Sirolimus stent was associated with significant reductions in the rates of angiographic restenosis (primary outcome), target lesion revascularization and MI at 8 months20. The composite clinical endpoint ( death, non-fatal MI, ischemia- driven target lesion revascularization, and cerebrovascular accidents) was significantly lower with the sirolimus-eluting stent21. In the TAXUS V trial, in the subset of patients with small coronary arteries, the paclitaxel stent was associated with significant reductions in angiographic restenosis and target lesion revascularization at nine months compared to bare metal stents22. Although DES improves target lesion revascularization rates compared to bare-metal stents in small vessels, the absolute rates are still higher in small vessels than large

The clinical practice project I chose to write about and research is dual antiplatelet therapy. Dual antiplatelet therapy is the combination of aspirin and a P2Y12 inhibitor such as Plavix, Effient, or Brillinta after stent placement in patients who have experienced an ischemic event such as a myocardial infarction or stroke (AHA, 2016). I chose this topic because I work on a telemetry unit that cares for patients who have experienced a myocardial infarction and have undergone stent placement. Part of their post-op care is initiation of dual antiplatelet therapy and education regarding its importance. I feel like more educational materials are needed to assist patients and nurses with this education.

The only concern this writer has is the patient validating his scripts. Please note, the patient did in fact validate few of his scripts, but there's a conflict of his Nexuim. The patient was adamant about validating his scripts to Nursing last month whereas he had given a Nurse the original Rx Script form. It was recommended for the patient to validate his scripts once again. Addressing his prescriber, Ms. Kennedy from Wheeler Clinic, a CS letter was completed last year and will be due again in June of 2017. The patient reports that his prescriber tends to see him once a month before refilling his scipts and provided proof of his appointment card. During the course of the session, the patient appeared to be alert and oriented. No evidence of

In order to evaluate and compare medication compliance the patient’s discharge medication reconciliation were compared to patient’s medication list at time of first office visit. Of the patients in population 1 (N=82), 71 were seen back for follow up and 11 never returned. Of the 71 that returned for follow up 97.18% (N=69) were compliant with discharged core measure medications. Population 2 (N=104), 97 were seen back for follow up with 7 never returned. Of the 97 seen back for office follow up 100% (N=97) were compliant with discharged core measure medications. Statistical analysis of the two population did not find a statistically significant difference (p= 0.0991).

clotting in vessels. This makes the person more vulnerable if when cut for the blood flow to cease in

Mr. Smotherman who was recently dismissed called, and he is concerned about the current medication that Dr. Green prescribed for him. His concern is if he stops it abruptly, are there any signs to look for or precautions he should take? Is it possible to refill meds for thirty days? He stated that he is currently seeking another physician for pain care. Thanks for your

Patient is 52 year male with diagnosed with Schizoaffective disorder, Type 2 diabetes mellitus, Generalized anxiety, Gastro-esophageal reflux Constipation, Alert orient X 3, was and cooperative during SN visit. Denied SI, HI, V/H, A/H, self harm behavior and contracted for safety. Mood/affect flat. pt has poor family dynamic , a family that have not been supporting him. pt has been under CHD for financial managements. and A better life home care with his which provide him with daily skilled visit in provided daily assessments of patient vital signs, medication administration/management (assessing compliance of pre-poured medication), assessing patient’s mood, mental status, coping skills as well as safety which has in turn kept the patient out of any possible hospitalization this period. Patient continue on clozaril which requires to be carefully administered and monitored if any side effect.patient is also continue on Vistaril Oral 25 MG 1 Cap(s) by mouth twice daily AM & PM as needed for anxiety which he requires daily d/t being

NSTE-ACS blah blah and mention statistics and other sources. This research involving current literature was conducted to determine if there is any difference in antiplatelet therapy with Plavix, when compared to Brilinta. With this knowledge, providers can be properly informed about choosing the best treatment for their patients.

Studies have shown that prescribing patients certain medications can aid in cardiac health and keeping coronary stents patent after discharge from the hospital post

The reconciliation should be used in every transition in care, where the new medication is prescribed and old mediations are rewritten. The accuracy of the list can prevent many drug effects and interactions; therefore it is important to ensure proper documentation and communication at all levels of care. Also, many errors occur when doctors fail to write out necessary orders such as, “resume pre-op medication.” The use of this “resume pre-op medication” has been prohibited by the Joint Commission due to the many complications it can produce including increasing the chances of adverse effects. Furthermore, it has been discovered that most discharged patients have been found to have insufficient knowledge regarding their medications upon returning home (Joint Commission, 2006). Medical reconciliation provides the patient with crucial information regarding the dosage, route, therapeutic effect, and reason for administration.