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Answer and analyze the case study questions.
Sarah goes to the local pharmacy and presents her prescription for a month’s supply of diclofenac. She is 63 years old and is not currently working. She has bilateral hip and knee osteoarthritis (OA) with occasional pain. She has been taking diclofenac 50mg three times/day for several years.
Six years ago she suffered a confirmed Helicobacter pylori-negative duodenal ulcer which has healed with conventional proton pump inhibitor (PPI) therapy. She suffers mild indigestion periodically but manages this herself with alginates and antacids (brought over-the-counter) when required. She also has hypertension and currently takes bendroflumethiazide 2.5 mg/day, ramipril 10 mg/day, and aspirin 75 mg/day; her blood pressure (BP)is maintained at around 142/92 mmHg. She does not smoke.
7. Would using a COXib with a PPI reduce Sarah’s GI risk still further, compared with a traditional NSAID plus a PPI?
8. Moving on to consider Sarah’s CV risks, what concern do you have about Diclofenac?
9. Still thinking about Sarah’s hypertension and CV risks, what would be the effect of changing her NSAID to a COXib (eg Celecoxib or Etoricoxib)?
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- Answer and analyze the case study questions. Sarah goes to the local pharmacy and presents her prescription for a month’s supply of diclofenac. She is 63 years old and is not currently working. She has bilateral hip and knee osteoarthritis (OA) with occasional pain. She has been taking diclofenac 50mg three times/day for several years. Six years ago she suffered a confirmed Helicobacter pylori-negative duodenal ulcer which has healed with conventional proton pump inhibitor (PPI) therapy. She suffers mild indigestion periodically but manages this herself with alginates and antacids (brought over-the-counter) when required. She also has hypertension and currently takes bendroflumethiazide 2.5 mg/day, ramipril 10 mg/day, and aspirin 75 mg/day; her blood pressure (BP)is maintained at around 142/92 mmHg. She does not smoke. 4. Still thinking about Sarah’s GI risks, what are the merits of changing to meloxicam or etodolac? 5. What are the merits of changing the NSAID to a COX-2 inhibitor…Please answer these questions in depths base on the labs and medication. Medications: These are the patient medications: Atorvastatin 40 mg, cholecalciferol 1'000u, furosemide 40mg, Lisinopril 40mg, metoprolol sucinate 24 hrs, vancomycin 1.25g, psyllium 1 packet, lactobacillus acidophilus, pantoprazole 40mg, calcium carbonate 500mg, clotrimazole, Aztreonam 28, sucralfate 100mg, levifloxin 500mg, minocyclin 100mg, tramadol 50mg, Tylenol 650mg, vitamin D3 10004, Lasix 40mg, pericolace 2tabs, miralax 17g, Coumadin 1mg, torpol XL 50mg. Patient labs: 4-20-23 4-26-23: Creatinine: 1.69. 1.07 BUN: 85. 53 Na: 142. 145 K: 3.2. 4.2 CI: 102. 112 CO2: 24. 21 Glucose: 81. Ca:8.3. WBC: 15.4. 8.0 12.9 Hgb: 17. CPK: 82 Troponin: 28 Coags: 33.4/2.8 PLT: 280 MCV: 96.2 UA: 1.0 RBC: 2. 4.23 Egpr: 49 Anioncap: 12 AST: 23 Alt: 26 Abul: 4.6 What is causing the abnormal lab values in YOUR PATIENT? 2. Are the abnormal lab values at the patient's baseline, or worse? 3. What labs that were drawn specifically…1. Order: Acetaminophen elixir 10 mg/kg po. Child weighs 10 pounds. Available: Acetaminophen elixir 160 mg/ 5ml. How much Acetaminophen will you administer? 2. Order: Amoxicillin 100 mg po q6 hr. Child weighs 15 lbs. Safe range is 25 – 30 mg/kg/24 hrA. What is the safe 24-hr range? B. Is the ordered dose safe for a 24-hr period? C. How many mg/day is the patient receiving? 3. Order: Ferrous Sulfate 9 mg po tid. Child weighs 13 lbs. The safe dosage is 3 –6 mg/kg/24 hrs. A. What is the safe 24-hr range? B. Is the ordered dose safe for a 24-hr period? 4. Order:Digoxin 18 mcg po bid. Child weighs 7 lbs.The safe dose range is 10 – 12 mcg/kg/24 hrs. A. What is the safe 24-hr range? B. Is the ordered dose safe for a 24-hr period? C. If the medication is supplied 50 mcg/ml, how many ml will you administer per dose? 5. Order: Phenytoin 40 mg po q 8 hr. Child weighs 27 lb. The safe range is 8–10 mg/kg/24 hr A. What is the safe 24-hr range?B. Is the dose safe for a 24-hr period? C.…
- Please help me answer the questions below. Thank you so much! Case Study #4Romina Jackobs is a 45-year-old morbidly obese French woman who moved to theUS one year ago for a job promotion. She lives alone with her two cats. She says thatshe has made a lot of friends in the apartment building that she lives in, and herneighbor has called her and let her know that she will take care of her cats. Becauseshe has only been in her new position for a year, she is worried that she will get intotrouble if she has to miss too many days. As a regional public relations manager forDelta airlines, she has to travel a lot, she is worried she will miss a lot of her reports.She presented in the ER this morning complaining about pain in her right calf. Onassessment her calf was red, edematous and hot to the touch. There was a palpablemass in the calf, so Romina was sent to ultra sound. Ultra sound revealed that therewas an encapsulated mass in the calf, and pt was sent to CT scan. CT revealed thatthere…Please help me answer the questions below. Thank you so much! Case Study #4Romina Jackobs is a 45-year-old morbidly obese French woman who moved to theUS one year ago for a job promotion. She lives alone with her two cats. She says thatshe has made a lot of friends in the apartment building that she lives in, and herneighbor has called her and let her know that she will take care of her cats. Becauseshe has only been in her new position for a year, she is worried that she will get intotrouble if she has to miss too many days. As a regional public relations manager forDelta airlines, she has to travel a lot, she is worried she will miss a lot of her reports.She presented in the ER this morning complaining about pain in her right calf. Onassessment her calf was red, edematous and hot to the touch. There was a palpablemass in the calf, so Romina was sent to ultra sound. Ultra sound revealed that therewas an encapsulated mass in the calf, and pt was sent to CT scan. CT revealed thatthere…A community health nurse is conducting a tuberculosis (TB) screening clinic at a homeless shelter. Which assessment finding would indicate a positive TB skin test? a) Redness and swelling at the injection site measuring 3 mm in diameter b) Induration at the injection site measuring 6 mm in diameter c) Absence of any reaction at the injection site d) Blister formation at the injection site
- MAKE 5 OBJECTIVES FOR THIS DX. Main Dx: Imbalanced nutrition less than body requirements related to Lacto-Ovo vegetarian diet as evidenced by lack of essential minerals & nutrients (Iron, Zinc & Omega Fatty-acids) OBJECTIVES: (ex. after 10 mins, the patient will.. after nursing shift, the patient will.. THE OBJECTIVES ARE ALL ABOUT THE PATIENT.) again, PATIENT-BASED OBJECTIVE PLEASE DO NOT WRITE NON-SENSE ANSWERS AND COPIED ANSWERS. I WILL REPORT YOUR TUTOR ACC TO BARTLEBY. 1. 2. 3. 4. 5. SCENARIO: Aubrey, 19 years old, an incoming college freshman student went to Ateneo De Manila Health Services for physical examination. The nurse gathered the following information: Height: 5 ft Weight: 48 kg Vital signs: Temp 37.2C, Pulse rate: 95 beats per minute, Respiration rate: 12 breaths per minute, and BP: 100/70mmHg. Family History of illness: Father (+) Hypertension (HPN), and Diabetes Mellitus (DM) Present Health History: Aubrey never experienced to get hospitalized as far as…MAKE 5 OBJECTIVES FOR THIS DX. Main Dx: Imbalanced nutrition less than body requirements related to Lacto-Ovo vegetarian diet as evidenced by lack of essential minerals & nutrients (Iron, Zinc & Omega Fatty-acids) OBJECTIVES: (ex. after 10 mins, the patient will.. after nursing shift, the patient will.. THE OBJECTIVES ARE ALL ABOUT THE PATIENT.) again, PATIENT-BASED OBJECTIVE 1. 2. 3. 4. 5. SCENARIO: Aubrey, 19 years old, an incoming college freshman student went to Ateneo De Manila Health Services for physical examination. The nurse gathered the following information: Height: 5 ft Weight: 48 kg Vital signs: Temp 37.2C, Pulse rate: 95 beats per minute, Respiration rate: 12 breaths per minute, and BP: 100/70mmHg. Family History of illness: Father (+) Hypertension (HPN), and Diabetes Mellitus (DM) Present Health History: Aubrey never experienced to get hospitalized as far as she can remember. Her mother ensures that she takes daily supplemental vitamins such as vitamin C and…What are the alternatives for treatment when a patient has VRSA and the target for VRSA? Minimum of 300 words There must be citations in the report and each citation should be found in a reference list that follows your report. There must be heading of paragraphs that indicate the contents NOTE: please concentrate only on VRSA
- A dentist must have how many trained individuals to assist during intavenous (moderate) sedation? A. One, whos must have current certificaiton in BLS B. Two, one of them whom must have the current certification in BLS. C. Three, all of them whom must have current certificaition in BLS. D. Two, both of whom must have current certification in BLS.MAKE SHORT TERM GOAL AND 5 OBJECTIVES FOR THIS DX. Main Dx: Imbalanced nutrition less than body requirements related to Lacto-Ovo vegetarian diet as evidenced by lack of essential minerals & nutrients (Iron, Zinc & Omega Fatty-acids) SHORT TERM GOAL: OBJECTIVES: (ex. after 10 mins, the patient will.. after nursing shift, the patient will.. THE OBJECTIVES ARE ALL ABOUT THE PATIENT.) 1. 2. 3. 4. 5. SCENARIO: Aubrey, 19 years old, an incoming college freshman student went to Ateneo De Manila Health Services for physical examination. The nurse gathered the following information: Height: 5 ft Weight: 48 kg Vital signs: Temp 37.2C, Pulse rate: 95 beats per minute, Respiration rate: 12 breaths per minute, and BP: 100/70mmHg. Family History of illness: Father (+) Hypertension (HPN), and Diabetes Mellitus (DM) Present Health History: Aubrey never experienced to get hospitalized as far as she can remember. Her mother ensures that she takes daily supplemental vitamins such as vitamin…Egg white and milk are used as an antidote for heavy metal poisoning. Explain 2-3 sentences
