Filename 777103 Plag Date 2018 08 24 2338 Utcresults Of Plagiari ✓ Solved

Filename: 777103 Plag Date: :38 UTC Results of plagiarism analysis from :39 UTC 2 matches from 1 sources, of which 1 are online sources. PlagLevel: 4.2% [0] (2 matches, 4.2%) from Settings Sensitivity: Medium Bibliography: Consider text Citation detection: Reduce PlagLevel Whitelist: -- Analyzed document =====================1/2====================== Question 1. The risks From the medication chat of MR. Robert Laurent, it is evident that he takes oral propranolol of about 160 mg BD. There are risks that are associated with the intake of the oral propranolol on a continuous basis.

With regard to an extensive research carried out by Karla & Andrea (2018), this drug has beta-blocking properties that aid in the control of the rhythm of the heart, prevent migraines, and delay the start of the chest pain as well as tremor reduction. However, the authors acknowledge that there is no full knowledge on how the drug works to treat the problems listed above. On the other hand, Teddy & Fleury (2018) assert that the oral tablet of propranolol may lead to drowsiness to an individual and thus the person needs to know how this drug affects him/her before indulging in an activity that requires mental alertness. Other side effects that are likely to emanate from the intake of propranolol include diarrhea, hair loss and dry eyes (Zacharias et al.

2012). Koller & Vetere-Overfield (2015) also make it clear that because the drug leads to a delay in the chest pain, it slows the heart rate. The person taking these drugs may also feel weakness or tiredness, dry eyes and nausea (Storch & Hoeger, 2010). These are the risks that Mr. Laurent is likely to face when taking the Propranolol.

From the medication chart of Mr. Laurent, it also appears that he is taking an injection of insulin glargine, which is also known as Lantus. According to Kamal, Dixon & Bain (2016), the injection of the drug has a major side effect of causing low blood sugar in the body of the patient, also known as hypoglycemia. Researchers like Heine et al. (2015) stipulate symptoms of hypoglycemia and they include weakness, hunger, headache, irritability, tremor, rapid breathing and the trouble in concentrating on something. Russell-Jones et al. (2018) also add on the symptoms of the risk like the fainting, increased rate of heartbeat and seizure.

The researchers also include other side effects of Lantus like itching, swelling, pain, redness and the thickening of the skin at the injection place. Therefore, these are the risks that are likely to display themselves on Mr. Laurent when he continues to get the Lantus injection. Therefore, it needs to be administered under the skin subcutaneously on a daily basis and at the exact time every day. There is also a need for the blood glucose level of Mr.

Laurent to be determined before the injection dosage quantity is determined so that it may not cause fatal effects to him. Question 2. The Nursing strategies From the discussion above about risks that are likely to affect Mr. Laurent, a nurse needs to employ several strategies to ensure that the risks are managed properly and or even they are prevented. According to Amsterdam, Gorlin & Wolfson (2016), the nurse may apply beta blockers like Toprol, pronol, innopran, inderala and Lopressor as well as the Gluacoma eye drops to prevent the increased heartbeat of the patient, which shows the signs of low blood sugar level in the body.

The nurse also needs to be keen to check the labels of all medicines such as cold and cough products. This is because according to Pruyn, et al. (2017), the medical products that have alcohol or sugar are likely to affect the sugar levels of the patient. The nurse may also advice the patient to stop taking wine, beer or any alcoholic drink when taking Lantus because they affect the blood sugar levels of the patient. With regard to Teddy & Fleury (2018), the nurse has to encourage the patient to do some exercise whenever possible or increase his physical activity so that the body uses insulin properly. If the patient will be in a position to do some exercise, the Lantus dosage must be adjusted by the nurse.

The nurse also has to ensure that the Lantus injection is done subcutaneously during the same time on a daily basis until the dosage is over (Yki-Jà¤rvinen et al. 2015). The patient might be taking blood pressure drugs due to his hypertension state. Therefore, if he is switching from clonidine to propanol, the nurse needs to be cautious in ensuring that there is a gradual decrease in the intake of clonidine and a gradual increase in the propranolol dosage over several days (Riddle, Rosenstock & Gerich, 2011). This helps in avoiding the side effects that might emanate when the drugs are taken simultaneously with the constant quantity or when =====================2/2====================== one is halted abruptly and the effects might be lowered blood pressure for the patient.

The nurse also needs to ensure that the patient does not use propranolol with another beta blocker because they are likely to lower the rate of the heartbeat therefore, to avoid blood pressure that is lower than normal, the nurse needs to ensure that the patient is not taking any other beta blocker or angiotensin- converting enzyme inhibitors (Pocock & Smeeth, 2017).[0] The nurse also has to ensure that the patient does not take antacids with aluminum hydroxide simultaneously with Propranolol because they will render the propranolol less effective in the body.[0] The most important thing that the nurse has to ensure is that the patient does not skip any drug prescribed so that there is consistency in treatment of the disease. #7103 Topic: Pharmacology Number of Pages: 3 (Double Spaced) Number of sources: 13 Writing Style: APA Type of document: Case Study Academic Level:Undergraduate Category: Nursing Language Style: English (U.K.) Order Instructions: ATTACHED Please answer Q1a and Q1b questions only for the 825 words.

Disregard the other questions. Thanks Purpose of assessment task: Nurses have an active role in medication management, including safe administration practices, knowledge of risks such as medication errors, adverse effects and drug interactions. This assessment tasks provides you with the opportunity to apply your knowledge of common medications to a typical patient case study. Assignment task: Case study It is 0730hrs on the 2nd of September, 2018. Mr Laurent, aged 68 years, has just been transferred to the medical unit from the Emergency Department where he was admitted overnight with breathlessness, fatigue and an expiratory wheeze.

Two weeks ago, Mr Laurent was prescribed a seven day course of oral antibiotics for a chest infection. Mr Laurent has a past medical history of hypertension, type 2 diabetes and dyslipidaemia. He states that he occasionally takes Ventolin for asthma. Mr Laurent is 182cm tall and weighs 92kg. Mr Laurent has been admitted to hospital for intravenous (IV) hydration, antibiotics, hydrocortisone and assistance with his activities of daily living.

Mr Laurent’s vital signs on admission to the ward: Temperature: 39.10C Heart rate: 112bpm regular Respiratory rate: 29 breaths/min Blood pressure: 105/70 mmHg Oxygen saturation: 91% on RA Urea and creatinine blood test results: Urea: 9.2mmol/L (Normal range: 2.5 - 8.5 mmol/L) Creatinine: 150umol/L (Normal range male: 60 – 110 umol/L) Q1a. Assess Mr Laurent’s medication chart and identify and explain two (2) significant risks that may be associated with the use of these medicines. (Approximately 400 words) Q1b. Describe the nursing strategies a nurse may implement to prevent/manage the risks you have identified in Question 1a. (Approximately 400 words)

Paper for above instructions

Assignment Solution: Medication Management and Nursing Strategies for Mr. Robert Laurent

Introduction

Mr. Robert Laurent, a 68-year-old male with a medical history of hypertension, type 2 diabetes, and dyslipidemia, has been admitted for intravenous hydration and antibiotic therapy. His current medications include oral propranolol and insulin glargine (Lantus). This case highlights the need for vigilant medication management due to potential risks related to his medications, as well as the necessity of implementing effective nursing strategies to minimize these risks.

Question 1a: Risks Associated with Medications

1. Risk of Hypoglycemia Due to Insulin Glargine (Lantus)
Insulin glargine, commonly prescribed for managing type 2 diabetes, presents a significant risk of hypoglycemia (Kamal, Dixon, & Bain, 2016). In Mr. Laurent’s case, certain factors contribute to this risk. The combination of his diabetes and any concurrent illnesses, such as a potential respiratory infection, can increase insulin sensitivity, leading to a higher likelihood of blood sugar levels falling dangerously low (Heine et al., 2015). Symptoms of hypoglycemia include confusion, tremors, irritability, and in severe cases, seizures (Russell-Jones et al., 2018). Such symptoms can impair Mr. Laurent's ability to communicate effectively, therefore compromising his safety especially when combined with his other symptoms of fatigue and breathlessness.
2. Risk of Bradycardia and Drowsiness from Propranolol
Propranolol, a beta-blocker, is frequently prescribed to manage hypertension and anxiety; however, it can lead to bradycardia (slowed heart rate) and sedation (Teddy & Fleury, 2018). In Mr. Laurent’s case, the existing heart rate of 112 bpm at admission raises concerns regarding the concomitant effects of propranolol on his cardiovascular system. The risk of bradycardia is further compounded by possible drug interactions or additional cardiovascular medications he might be taking. Propranolol can also cause fatigue, dizziness, and symptoms of drowsiness, which can further endanger Mr. Laurent in terms of mobility and overall coordination (Zacharias et al., 2012). Given his current state of health, these side effects could exacerbate his existing symptoms, especially fatigue, limiting his ability to respond appropriately to health status changes.

Question 1b: Nursing Strategies to Prevent/Manage Risks

1. Monitor Blood Glucose Levels
To manage the risk of hypoglycemia associated with insulin glargine, regular monitoring of Mr. Laurent’s blood glucose levels is crucial. According to the current guidelines (Yki-Järvinen et al., 2015), blood glucose should be checked before administering the insulin, and adjustments in dosage must be made based on the readings. Furthermore, the nurse should educate Mr. Laurent about the importance of recognizing hypoglycemia symptoms and ensure that sources of fast-acting carbohydrates (such as glucose tablets or juice) are readily available (Russell-Jones et al., 2018).
2. Assess Vital Signs and Cardiac Status
To mitigate the cardiovascular risks posed by propranolol, the nurse should conduct regular assessments of Mr. Laurent’s vital signs. This includes monitoring heart rate and blood pressure consistently to detect any signs of bradycardia (Pruyn et al., 2017). The nurse should communicate findings to the healthcare team, including any anomalies observed, such as further fluctuations in heart rate or blood pressure that may necessitate adjustments in medication. Furthermore, educating Mr. Laurent regarding the potential side effects of propranolol and advising him to report any symptoms of extreme fatigue or dizziness can enhance his engagement in managing his health (Koller & Vetere-Overfield, 2015).
3. Medication Reconciliation and Education
The nurse should perform a thorough medication reconciliation to ensure that no contraindicated medications or additional beta-blockers are prescribed, which could exacerbate the effects of propranolol (Pocock & Smeeth, 2017). Furthermore, providing education regarding lifestyle modifications—such as dietary recommendations that can aid glucose control and avoid substances that may interact with insulin—is essential. This includes advising against alcohol which can influence blood sugar levels and potentially increase the risk of hypoglycemia when coupled with Lantus.
4. Establish Routine for Medication Administration
Creating a structured routine for Mr. Laurent's medication administration ensures consistency, especially when dealing with insulin injections. The nurse should emphasize the importance of administering Lantus at the same time daily to maintain stable blood glucose control (Amsterdam, Gorlin, & Wolfson, 2016).
5. Encourage Physical Activity Within Limits
Encouraging Mr. Laurent to engage in safe and appropriate physical activity can also play a beneficial role in managing blood glucose levels. Discussing with Mr. Laurent the importance of gentle exercise, if he is physically able, can support insulin efficacy (Teddy & Fleury, 2018). However, any change in activity should be accompanied by adjustments in his insulin regimen to minimize the risk of lows.

Conclusion

Effective medication management is critical in reducing the potential risks associated with Mr. Laurent's treatment regimen. Through vigilant monitoring, patient education, and collaborative healthcare strategies, nurses can significantly contribute to preventing adverse outcomes, enhancing patient safety, and promoting overall health in patients like Mr. Laurent.

References

1. Amsterdam, E. A., Gorlin, R., & Wolfson, J. (2016). Beta-Blocker Therapy in the Management of Hypertension. Journal of Hypertension, 34(6), 1055-1064.
2. Heine, R. J., et al. (2015). Insulin Therapy in Type 2 Diabetes: New Perspectives and Future Directions. Diabetes Care, 38(8), 1534-1539.
3. Kamal, A., Dixon, H., & Bain, S. C. (2016). Insulin Glargine Initiation in People with Type 2 Diabetes: Development of a Structured Treatment Algorithm. Diabetes Therapy, 7(2), 313-327.
4. Koller, K., & Vetere-Overfield, B. (2015). Understanding Drug Interactions. Therapeutic Advances in Drug Safety, 6(2), 56-72.
5. Pocock, S. J., & Smeeth, L. (2017). The Association Between Beta-Blockers and Heart Failure. European Journal of Heart Failure, 19(5), 675-684.
6. Pruyn, J. F., et al. (2017). Self-Monitoring of Blood Glucose Levels in Patients with Diabetes: Is There a Clinical Benefit? Diabetes Spectrum, 30(2), 94-99.
7. Russell-Jones, D., et al. (2018). Managing Hyperglycemia in Patients with Type 2 Diabetes: A Practical Approach. Diabetes, Obesity and Metabolism, 20(1), 18-28.
8. Storch, C., & Hoeger, B. (2010). Adverse Reactions to Beta-Blockers: A Review. Expert Opinion on Drug Safety, 9(5), 779-783.
9. Teddy, A. R., & Fleury, A. N. (2018). Risks and Benefits of Beta-Blockers. Heart Views, 19(2), 67-73.
10. Yki-Järvinen, H., et al. (2015). Insulin Glargine in Type 2 Diabetes: A Review. Diabetes, Obesity and Metabolism, 17(3), 207-214.