Tuberculosis Disease Essay

Tuberculosis has long been a disease that the human culture has been dealing with which entails significant morbidity and mortality worldwide. With dealing with such a horrific disease over the years, discoveries and evolution on the appropriate ways to contain, diagnose, and challengingly treat the disease has changed. One of the most concerning complications of this worldwide public health issue is the ability for it to quickly spread in high populated areas while becoming ever more resistant to forms of treatment not available in all locations around the world. This is a serious public

Adverse reactions to drugs are common and almost any drug can cause an adverse reaction.

Some of the immediate physical complaints include constantly feeling cold, bloodshot eyes with dark circles, finger calluses, dizziness, weakness, lackluster hair, moodiness, insomnia, no menstruation, swollen glands, weight loss, sore throat, or dry skin. Some of the long-term effects include extreme weight loss, gastrointestinal pain, diarrhea and/or constipation, malnutrition, loss of tooth enamel,

Complete the following questions below and upload your responses in an rtf document to your clinical instructor (Gouldy, Denise) through WT class by 0800 Monday. The medications listed in “X” do not need to be uploaded but will be needed in the clinical setting (you may use the Med Sheet Template found in the OB folder to complete the information needed on the drugs).

2) A nurse conducts an assessment on a patient who is taking Propanolol for supraventriculartachycardia. Which finding is an indication that the patient is having an adverse effect of this drug?

D-This writer met with the patient upon her request to complete the dose change request form to lower her dose as the patient experience she wants to start tapering off methadone as the patient haven't used any illicit drugs for several months. This writer completed the dose change request form with the patient pressence and also, assessed the patient that she has not experience any withdrawals since prior increase based on her order history. The patient denies any cravings and withdrawals. Furthermore, while completing the request, this writer learned that the patient is prescribed with Albuterol inhaler and strongly urges the patient to bring in the RX script tomorrow. The patient complained that no one has ever told her of this and this

D-The patient arrived on time for her appointment. Reported stable on her new current dose. Deny craving and withdrawals. According to the patient, her weekend was good and again, happy to have her take home bottles. Then the patient reported, she continues to keep all appointments with her mental health provider and its going very well. This writer then discussed with the patient about the next step to her recovery. The patient reported, she wants to continue with her methadone until she's ready to start tapering off on the methadone. The patient has some fears to tapering off on her methadone because she does not want to experience any craving and have a relapse.

D-The patient arrived on time for her appointment. Reports stable on her dose and denies the need for a dose increase when offered by this writer. This writer commends the patient complying with daily dosing; however, this writer addressed the patient UDS result patterns of positive and negative. The patient last two urines were positive for cocaine. According to the patient, a lot has been going on in her life. The patient's father has had a heart attack this past month. Also, the patient has an estranged relationship with her mother and her 17 year old daughter. During the course of the session, the patient discussed her drug history and her dysfunctional family. Alternatives and suggestions were discussed as well.

The physiologic effects of the opioids withdrawal syndrome include, arthralgias, diarrhea, myalgias, abdominal cramping, rhinorrhea, piloerection, lacrimation, insomnia, and yawning as well as temperature dysregulation. It is greatly suspected that Mr. HR was experiencing an opioid withdrawal syndrome due to his medical presentations, such as, rhinorrhea, muscle aches, mild sweating and increased lacrimation.

D-The patient reports he is not stable at his current dose to the point he want to taper off. He expressed the need to want to get off on methadone. This writer listened to the patient vent about issues in his personal life and problematic issues with his transportation to ensure he dose daily. This writer then proceeded to discuss with the patient as to why he had entered treatment, his aspiration for his recovery process, and addressing alternatives to his barriers. The patient then reports he hasn't used any illicit drugs for three days, at which this writer commended the patient. When asked about what strategies to used to refrain from illicit drugs, he reports keeping himself busy and continue to care for his parents. The patient was

The patient appears to be happy and focused on her recovery process. This writer discussed with the patient briefly about her treatment plan goals and also, briefly discussed tapering off methadone, at which the patient is willing to pursue but at a seldom pace. There was no evidence of

D-This writer agreed to meet with the patient as he was placed hold to attend group. Reported stability on his current dose and denies the need for a dose increase when offered by this writer. This writer reviewed the patient's record and learned that he obtained his 3rd take home bottle on 01/04/2017. The patient is aware that he in order for him to obtained the 4th take home bottle, he must attend the take home bottle group. Addressing his medication, this writer noticed that the patient has not refilled the following medications:

Side Effects: Frequent urge to urinate, headache (continuing), loss of appetite (continuing), mood or mental changes, muscle pain or twitching, nausea or vomiting, nervousness or restlessness, slow breathing, swelling of feet or lower legs, unpleasant taste, unusual tiredness or weakness

D-The patient arrived on time for her appointment and this writer apologized for meeting with the patient late as this writer was meeting with another patient prior, which interefere with this patient appointment time. The patient was clearly understanding and waited patiently. Reports stable on her dose. Denies cravings/withdrawals. However, the patient is still actively using and reported, it has nothing to do with withdrawals or cravings. The patient is unable to provide a proper reason for her use, besides shrugging her shoulder as she says, " i do not know why." Patient last used was yesterday, cocaine- $40 worth. The patient then reported, she only uses cocaine less then once a month. This writer addressed alternatives.

TCAs have a mechanism of action very similar to that of SNRIs, but are less commonly prescribed due to the risk of side effects. The tricyclics approved by the FDA are amitriptyline (Elavil), clomipramine (Anafranil), doxepin (Sinequan), imipramine (Tofranil), trimipramine (Surmontil), amoxapine (Amoxapine Tablets), desipramine (Norpramin), nortriptyline (Pamelor, Aventyl), and protriptyline (Vivactil). The more common side effects of TCAs are blurred vision, constipation, dry mouth, drowsiness, drop in blood pressure when moving from sitting to standing, lightheadedness, and urine retention. Other less common side effects include increased appetite, weight gain, weight loss, excessive sweating, tremors, difficulty achieving an erection, difficulty reaching sexual climax, and low sex