Mr Smotherman Case Study

(DoH, 2005, p8). A diagnosis and treatment plan is agreed on by the independent prescriber and from this the supplementary prescriber can review and amend doses as seen appropriate with the patient. DoH (2005) initially suggested supplementary prescribing was more appropriate for a longer-term setting because an agreed CMP is required prior to prescribing. Nuttall & Rutt-Howard (2011) states many professionals often feel limited in supplementary prescribing as they are boundaried by the CMP. By adopting this outlook, patient’s presentations in the longer-term setting would then be classed as all being uncomplicated and predictable. DoH (2005) reports supplementary prescribing allows clinicians to develop their confidence. By understanding not all patients are the same and that complex cases are common, the supplementary prescriber can therefore exercise skills in observing and reviewing any changes in clients and report back to the independent prescriber in a safe manner and develop their

Mr. Botts, age 76, reports to his physician that he is not feeling well and is fatigued. He has a history of a myocardial infarction 6 years ago, glaucoma, and intermittent ankle swelling. His medications are pilocarpine (Pilocar) and timolol (Timoptic) eye drops bid 1 drop both eyes; digoxin (Lanoxin) 0.125 mg daily PO (oral administration), and furosemide (Lasix) 20 mg daily

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

no further medication changes. K.N. is instructed to fi nish the remaining 2 days of

Cherron session was interrupted when patient #2141 arrived to be dose, but was placed on HOLD. It is noted that the patient boyfriend had made a complaint against Cherron on her behalf but it is considered as hearsay as the patient did not address the issue on her own with a Supervisor. Cherron addressed concerns of the patient non-compliance with her counseling appointments as the patient haven’t been seen for the month of March, ongoing use of illicit benzos/other drugs, and non-compliance with daily dosing.

When making the decision to prescribe there are a number of influence you have to consider. It is important to have an awareness of these influences and take them into consideration when issuing a prescription. It is importance to have knowledge of the DOH (2006) Medicines Matters this give guidance on the mechanisms available for prescribing and administration and supply of products. Team trends and external company’s and there representatives promoting their products have a big influence on your prescribing practice Bradley (2006) found that these influences were of concern to some nurses feeling that their colleague may ask them to prescribe for patients they haven’t seen. Thomas (2008)

Rarely any physician intends to harm patients when he or she provides treatment to them. Patients see physicians and specialists in full faith that they will get help with a condition. What complicates the patient-doctor relationship is that the outcome of each patient’s treatment is different because of individual health conditions and the course of treatment chosen by the doctor. Problems arise when a patient is not satisfied with care provided by the doctor or in extreme cases when a patient dies. Since most of the time it is hard to clearly determine whether the outcome was solely a result of the course of treatment chosen by the doctor or whether other factors played a role too, quite often patients take their

A courtesy 90 day supply of refill of Lotrel and Labetalol was ordered. Please complete fasting lab for a full renewal on medications. Also, please do not forget to drop you blood pressure log as requested by Dr. Wells at you last appointment.

Mr. Farmer on Day 5, is discharged home and recommended to take daily exercise and improve his diet. Mr. Farmer had previously consumed regular take-away food, smoker of 35years and led a sedentary lifestyle. Discharge medications prescribed include aspirin, metoprolol, an ACE inhibitor (perindopril) and a statin (simvastatin)

According to the guidelines, there are three important principles to follow for the improvement of patient safety and care. Non-Opioid therapy is suggested if patients are non cancer chronic pain patients or in hospice care. Additionally, if opioids are needed, the lowest dose possible for the shortest amount of time is recommended to reduce risk of opioid overdose. Lastly, clinicians must monitor all patients carefully when they prescribe them opioid analgesics. Prescription opioid use is not solely the responsibility of the health care providers. There are a few guidelines patients should follow regarding chronic pain to ensure their safety. Patients should become informed about prescription opioids and learn the risk factors involved. Before going to the doctor about pain, they should consider physical activity, non opioid medications, or cognitive behavioral therapy before automatically thinking they are in need of painkillers (CDC Guideline for Prescribing Opioids). Continuing education (CE) is another regulation. While Continued Medical Education (CME) is required in most states in the U.S. for physicians every ten years, there should be a continuing pain medicine education requirement for all physicians due to the heavy increase in prescription

4. The patient has been taking Sudafed and wants to know if he should continue to take it. What is your response? No, the patient should not continue taking Sudafed and should eliminate it immediately. The patient has been prescribed APAP for pain and another for allergies. Sudafed is not recommended to be taken if patient has any heart related health problems.

If the harm outweighs benefits for a patient, other therapies, lower doses and discontinuation of the prescription is advised.

I believe that the anti-federalist structure of government is the right choice of government in our country. My position is to stand as an anti-federalist, is because I believe that the majority of the power should reside within the state level rather than the federal government. I believe in not only having one government but having each state make its own rules and regulations that best suite its citizens.

It is important for physicians to take into account the various outcomes that happen when prescribing pain medications. Aside from having the burdensome responsibility of relieving a patient’s pain, a physician could also be responsible for the possibility of negative outcomes like sickness and even death as a result of pain medications often prescribed. Because of the risks

Throughout my study of “Othello”, I have learnt of the many aspects of Othello’s character. He is noble and strong, yet he has many insecurities and is recognised for trusting others too easily. This causes him to obtain the famous title of ‘tragic hero’. According to Greek philosopher Aristotle there are certain characteristics of a tragic hero. These include a noble birth, a tragic flaw that eventually leads to his downfall, a reversal of fortune brought about by the hero’s tragic flaw, his actions results in an increase of self-awareness and the audience must feel pity or fear for the character.