f a young man has these symptoms: •feeling flushed, hot, and can’t stop sweating •blurred vision and has been getting into vitamin supplementation more lately and is taking a variety of high dose supplements What vitamin is he deficient on?
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- A 35 year old man has a diet of processed boxed dinners and soups and has these symptoms: • faint tingling sensation •irritability •calf pain •trouble walking even though conscious and sober which is unusual because he is a heavy alcoholic •memory issues •eyes move in erratic movements •trouble focusing on objects Which vitamin or mineral is he deficient on? What is the toxic level?If a woman has these symptoms: • depressed •tired and irritable •frequent headaches •numbness •tingling in hands and feet •muscle weakness that makes walking difficult •odd lesion And has been taking high dose supplements of B-vitamins because she was told they help with PMS What vitamin is she deficient in? What is the toxic level?While teaching a 76-year-old patient about the adverse effects of his medications, the nurse encourages him to keep a journal of the adverse effects he experiences. This intervention is important for the elderly patient because of which alterations in pharmacokinetics? a )Increased renal excretion of protein-bound drugs b )More alkaline gastric pH, resulting in more adverse effects c )Decreased blood flow to the liver, resulting in altered metabolism d )Less adipose tissue to store fat-soluble drugs
- . An individual with a known deficiency in Vitamin D is considering supplementing their diet to improve their levels. Before proceeding, what is the most important factor they should evaluate to avoid adverse effects?A) The time of the year and their geographical location to estimate sun exposureB) Their body mass index (BMI) to determine the appropriate dosageC) The potential interaction with other fat-soluble vitamins they are consumingD) The levels of calcium in their diet, as Vitamin D increases calcium absorptionMr GB has been receiving ranitidine 50 mg q8h IV whilst in hospital. He is being discharged and will be switched to oral ranitidine 15 mg/mL liquid. The oral liquid is 50% bioavailable, and has been prescribed as a BD dose. How many mL of ranitidine liquid should Mr GB receive each day?Mr Nguyen is an overweight 40 year old who has recently been diagnosed with type 2 diabetes. He has been started on Metformin but has been complaining of diarrhoea, some abdominal pain and loss of appetite. He continues to work as a taxi driver and often works the night shift as he has young school aged children. His HbA1c is 8%. The medical staff are considering adding Exenatide to his medication regime. Outline the mode of action of Metformin and Exenatide and why these drugs may be prescribed together. Describe factors to be considered when administering each of these drugs.
- Explain 4 age-related effects of drugs (medications) on the older person and how you would adjust these effects with consultation with the Registered Nurse. What happens to each Ingestion, absorption, metabolism, excretion (easy and simple, in own words)An elderly gentleman has recently been diagnosed with cirrhosis of the liver. He admits to being a heavy drinker. This man is your patient. Given the damage to his liver, you would have concerns about all of the following except a. regulating his ability to maintain body temperature, because of decreased thyroid hormone levels. b. internal bleeding, because he has impaired ability to synthesize clotting proteins. c. edema, because of impaired synthesis of plasma proteins (e.g., albumin). d. jaundice, because his liver is less efficient at removing bilirubin from the blood.A 68-year-old patient was delivered to the intensive care unit with the suspicion of hyperlactacidemic coma and complaints of severe muscle ache, vomiting drowsiness alternating with stupor, pain in the heart region. Objectively: eye ball tone is lowered, arterial pressure –100/55, pulse - 136beats/minute, glycemia - 14mmol/l, acidosis, blood PH – 7.0, level of lactic acid – 1.9mmol/l. What are you going to do in this case?A. Injecting 1% solution of methylene blueB. Injecting 500ml 5% glucose solutionC. Injecting 0.1% adrenaline solutionD. Introducing 100 mg prednisoloneE. Introducing 500 ml 0.9% sodium chloride
- Explain 4 age-related effects of drugs (medications) on the older person and how you would adjust these effects with consultation with the Registered Nurse. What we can do as an EN. What happens to each Ingestion, absorption, metabolism, excretion Ingestion: The ingestion is a swallowing and digestibility process in the digestive tract. Swallowing and digestion slows down. Absorption: The absorption of a drug or food is the absorption from the gut to the bloodstream. Bioavailability means that if the medicine is completely consumed by the body, the bio-availability of the pharmaceutical product is 100%. The ingestion to swallow medication. Excretion: Any molecule ingested from the gut wall to the fluid beyond the intestine is absorbed into the hepatic portal vein. Metabolism: The metabolism of the medicine reaches the liver from the vein. Often called first-pass metabolism. A food particle or medication becomes a pumping agent in the blood. Metabolism slows.Q. A patient with travellers’ diarrhea is prescribed Azithromycin. The typical dose administered is 3.125 mg/lb every 12 hours. How many total mg of Azithromycin will a patient that weighs 160. lb need if the medication is to be administered for 7 days? Show all your calculations below.The nurse monitoring a patient for a therapeutic response to oral antidiabetic drugs will look for a) fewer episodes of diabetic ketoacidosis (DKA).b )weight loss of 5 pounds.c) hemoglobin A1C levels of less than 7%.d )glucose levels of 150 mg/dL
