Rasmussen NUR2407 Module 5 Assignment Latest 2021 August

NURS2407/NURS-2407/NURS 2407

NUR2407 Pharmacology

Module 5 Assignment

Critical Thinking Case Studies

This assignment will encourage you to use your knowledge about some different types of medications we have reviewed and help develop your critical thinking skills regarding the administration of these medications to your patients.   

Please read through each case study and answer the questions that follow (yes, please complete the questions for all three scenarios ????). You do not need to use APA formatting on the document you submit, but please use complete sentences when answering the questions and provide APA formatted references.

Critical Thinking Case Study #1

R.J., a 79-year-old man, underwent abdominal surgery for resection of his colon. After the surgery, his physician prescribed morphine 10 mg every 3 to 4 hours as needed. R.J. did not ask for pain medication because he worried he might become addicted. A day after the surgery, R.J.’s nurse noted that he was restless and grimaced whenever he moved in bed. He refused to breathe deeply or cough when instructed to do so. The nurse compared R.J.’s vital signs with his baseline findings and noted an increased pulse rate and a drop in systolic blood pressure.

1. Should the nurse give morphine? Explain your answer.

2. What would your reaction be to R.J. in regard to his restlessness, grimacing, and refusal to breathe deeply and cough?

3. What is the significance of the change in vital signs?

4. What classic side effects of opioid analgesics should the nurse assess?

5. What are some possible nonpharmacologic measures that might be helpful in alleviating R.J.’s pain?

The second postoperative day, R.J. began asking for morphine every 3 hours. On the fifth day, the physician discontinued R.J.’s morphine and prescribed acetaminophen with codeine.

6. Why was the opioid analgesic order changed?

7. R.J. does not want to ambulate. What is an appropriate nursing response?

Critical Thinking Case Study #2

C.J., a 41-year-old homeless man, has had a constant cough and night sweats for several months. He consumes about a fifth of liquor over 2 days. Acid-fast bacilli (AFB) smear on the sputum is positive. The health care provider orders a 6- to 9-month antitubercular drug regimen, with the time of therapy to be determined according to sputum and radiograph test results. For 2 months, C.J. takes isoniazid (INH), rifampin, and pyrazinamide daily. For the next 4 to 7 months, C.J. takes INH and rifampin biweekly.

1. What are some of C.J.’s risk factors for contracting tuberculosis (TB)? Give other risk factors for contracting TB.

2. C.J. received first-line antitubercular drugs for treatment of TB. How can the health professional determine whether the drugs are effective in eradicating the bacillus Mycobacterium tuberculosis? Explain your answer.

3. What is the nurse’s role in patient teaching concerning the drug regimen?

4. Name at least two serious adverse reactions that can occur when antitubercular drugs are given over an extended period.

5. What laboratory tests should be monitored while C.J. takes isoniazid and rifampin? Why?

6. The health care provider orders pyridoxine to be given daily. Give the rationale for the use of pyridoxine.

Critical Thinking Case Study #3

R.R., a 22-year-old college student, is in the wellness clinic with her 3-month-old daughter and her 13-year-old sister. They live with R.R.’s grandmother, who is 68 years old. R.R. requests immunizations for her daughter and asks if there are any immunizations she and her sister need.

1. R.R. says her daughter needs her “regular shots.” The infant received her first hepatitis B vaccine while in the newborn nursery but has not had any shots since coming home. What is the hepatitis B vaccine catch-up schedule for the infant; what is the routine schedule for hepatitis B vaccine in infants?

2. R.R. is worried that she will need to start her immunizations over because “she’s so far behind.” How should the nurse respond to her concern? When would her infant be due for another series of immunizations?

3. Which vaccines is R.R.’s daughter due for today?

4. The nurse asks R.R. about her vaccine history. R.R. says she had her “baby shots” a long time ago but did not keep her personal vaccine record; however, she remembers receiving a flu shot 2 years ago. What immunizations will she need at this point? How can she best keep track of her immunizations?

5. After administering R.R.’s meningitis vaccine, R.R.’s 13-year-old sister mentions that she heard that high school students should get a vaccination for human papillomavirus (HPV). She wants to know if she should get one or if it is too late. Who is eligible to receive the HPV vaccine, and what assessment questions would the nurse ask? What type and dosage of vaccine would the nurse administer?

6. After the visit, how does the nurse ensure that the vaccines were safely administered?