WOMEN’S AND MEN’S HEALTH, INFECTIOUS DISEASE, AND HEMATOLOGIC DISORDERS NURS 6521

WOMEN’S AND MEN’S HEALTH, INFECTIOUS DISEASE, AND HEMATOLOGIC DISORDERS NURS 6521

In this particular case study is a 60-year-old male admitted to the hospital  for a community acquired pneumonia. Patient’s past medical history consists of COPD hypertension, hyperlipidemia, and diabetes. In this particular case study patient was placed azithromycin 500 mg. THis is  a macrolide drugs class. This type of antibiotic is a broad spectrum and can fight against many gram-positive bacteria. This medication is also known for causing liver toxicity. Some of the side effects of this medication can cause nausea, and vomiting. Patient was also placed on ceftriaxone 1 g. This is a type of beta-lactam class. These particular antibiotics inhibit bacteria by binding covalently to PB P in the cytoplasmic membrane. Many side effects of this medication can include diarrhea, nausea, rashes, and super infections. By combining both antibiotics will provide patient with a broad spectrum of coverage to inhibit further bacteria growth. We don’t know what type of bacteria is caught causing the pneumonia. Until bacterial cultures and sensitivities results come back from the laboratory value to see what type of bacteria and antibiotics will work for this particular patient. The patient is allergic to penicillin but is responding good to the antibiotic.He hasn’t had any hypersensitivity. If patient was to show hypersensitivity patient can also be given doxycycline or cephalosporins , which can also provide a great broad-spectrum coverage for pneumonia.

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 Patients  has a history of COPD, patient’s oxygen saturations must be monitored on a continuous basis. And if needed, patient must be given supplemental oxygen. Patient also has high blood pressure so  blood pressure must be monitored .The type of medication that I would prescribe would be angiotensin receptor blocker for example Losartan, and irbesartan. ARB are the first line of anti-hypertension medication to be prescribed to treat hypertension. This medication works by blocking receptors that act on hormone especially a T-1 receptors by blocking the action of angiotensin two and helps lower blood pressure. Some side effects may be vomiting, diarrhea, and dizziness. Patient also has hyperlipidemia.I would prescribe a statin medication to help lower cholesterol levels. Patient has diabetes. Patient requires monitoring of  blood glucose levels even with pneumonia. I would prescribe Metformin and insulin since patient is not able to tolerate PO, I would prescribe insulin.

Also, since patient is not able to tolerate regular diet or anything PO. I would start  IV fluids administer dextrose and an oral parenteral nutrition as needed for patient’s nutritional needs.

Reference

Farrell D.J., Jenkins S.G. Distribution across the USA of macrolide resistance and macrolide resistance mechanisms among Streptococcus pneumoniae isolates collected from patients with respiratory tract infections: PROTEKT US 2017-2018. J Antimicrob Chemother. 2020;54(S1):i17–i22. 

Li J.Z., Winston L.G., Moore D.H. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis. Am J Med. 2019;120:783–790

 Yanagihara K., Izumikawa K., Higa F. Efficacy of azithromycin in the treatment of community-acquired pneumonia, including patients with macrolide-resistant Streptococcus pneumoniae infection. Intern Med. 2019;48:527–535

Zheng X., Lee S., Selvarangan R. Macrolide-resistant mycoplasma pneumoniae, United States. Emerg Infect Dis. 2016;21(8):1470–1472.

As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?

For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.

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To Prepare

• Review the Resources for this module and reflect on the different health needs and body systems presented.
• Your Instructor will assign you a complex case study to focus on for this Discussion.
• Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.

By Day 3 of Week 9

Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

You will respond to your colleagues’ posts in Week 10.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!