Overview
▪ There should be a minimum of ONE (1) paragraph (five to ten complete sentences) per response.
Scenario #1
Mrs. Coulter is a new patient at the health clinic. A nurse working at the clinic is performing an initial health history and assessment on Mrs. Coulter. Mrs. Coulter has brought a list of the medications she takes daily and a list of OTC medications that she takes as needed. Mrs. Coulter’s medications include: acetaminophen, oral morphine, zolpidem, and carbamazepine.
• The nurse sees that one of the analgesic medications listed for Mrs. Coulter is acetaminophen. Discuss patient teachings and nursing assessment for this drug?
• An overdose of acetaminophen may result in which complication? Discuss measures to prevent overdose and the antidote for acetaminophen.
• Mrs. Coulter takes oral morphine for a previous back injury. Mrs. Coulter might experience which adverse effects of this medication? Include the nursing assessment and priority interventions for each adverse effect.
• Discuss the indications for zolpidem and carbamazepine. Include the patient teachings specific to these medications.
Scenario #2
Ms. Wilson is a 22-year-old female patient who is seen in the pain clinic with complaints of stiffness in her neck, limited cervical range of motion, and shooting pains down her right arm accompanied by some numbness and tingling in the index finger of her right hand. She has experienced this discomfort for approximately 3 weeks and has participated in physical therapy twice weekly without any relief. The health care provider prescribes cyclobenzaprine 5 mg PO tid prn for muscle spasms. A magnetic resonance image (MRI) of the cervical spine has been ordered, and Ms. Wilson has been instructed to return to the clinic after the MRI to meet with the health care provider for follow-up.
• Discuss the mechanism of action and adverse effects of cyclobenzaprine.
• The nurse plans to provide patient teaching to Ms. Wilson regarding cyclobenzaprine. Which information would the nurse share with Ms. Wilson? Be specific.
• Since she is taking cyclobenzaprine, what other interventions should she do to alleviate the spasms? Include your rationales for each intervention.
Scenario #3
Nala is a 13-year-old girl in the 7th grade and plays the clarinet in the after-school’s band. Her parents and teachers noticed she has trouble focusing on the school assignments and music practice for the past four months. She went to the pediatrician, she was diagnosed with attention deficit hyperactivity disorder (ADHD) and was prescribed with methylphenidate (Ritalin) 5 mg twice a day for two weeks and then increase the dose to 10 mg twice a day, if no improvement.
• What are the therapeutic effects of methylphenidate?
• What are the adverse effects of this medication?
After three weeks, Nala’s mother calls the pediatrician to say that Nala has been doing better in school, however the band teacher reports that Nala is restless during after-school band rehearsal.
Nala’s mother also reports that Nala seems unable to sleep at night and has been staying up past 1:00 am in the morning.
• What you do anticipate the physician will propose?
please use the book for assignment and all reference should be from the book