NUR231: Case Study Assignment Help
Question
NUR231: This case study assignment aims to engage students with reliable pharmacological resources and clinical evidence to guide their clinical decision-making journey. The students are required to apply their understanding of pharmacotherapeutics and the quality use of the medicines to safe medication practice, and answer the questions related to various criteria in the case study.
Solution
The solution requires the students to analyse the case study and respond to the various questions in the assignment which are broadly divided under three sections:
Section 1
Firstly, the students are expected to employ their knowledge related to pathophysiology and pharmacotherapeutics and answer the questions corresponding to decision-making and safe medication practices related to the case study. This section is further divided into four sub-sections which are as follows:
The first sub-section demands the student to collect information related to the cause of problem. This includes the questions which are mentioned below and our experts depict evidenced responses to these questions, which you can find below.
The first question requires students to describe the source of the problem for Mr. Hodges and elaborate on the various potential risk factors to the clinical facilitator. Keep reading to know how our experts have depicted skills of collecting significant clinical information related to cause of problems for the patients.
Q1: Mr. Hodges has an atrial fibrillation (AF), which is the most common cardiac arrythmia, characterized by rapid and irregular beating of the atria (Chung et al., 2020). It has resulted from his medical history of hypertension and dyslipidemia- two of the most common risk factors for AF.
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The second question for this sub-section in turn incorporates three questions, related to the pathophysiological basis for the data which is collected in the previous question. These include both subjective and objective data.
In question 2 Part a, our experts elaborate on how Mr Hodges’ condition improved through action plan relating to the amiodarone’s mechanism.
Q2a: On intravenous administration, amiodarone relieves the fast-pounding heartbeats in Mr. Hodges by lengthening action potentials and effective refractory period of cardiomyocytes by blocking potassium rectifier currents, delaying heart’s repolarization (Istratoaie et al., 2021; deSouza et al., 2020).
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Question 2 part b requires the student to elaborate on why a thyroid function test was necessary for Mr. Hodges. Our experts have elaborate in detail about this.
Q2b: Amiodarone is an iodine-rich-benzofuran-derivative, causing iodine overload in the body which is far beyond the daily iodine requirements of WHO.
This is only a snippet of the answer written by our expert. Mail us at onlineassignmentservices1@gmail.com.
Part c for question 2 demands an explanation of why the restoration of electrolytes is a priority in patients suffering with AF, which is presented in-depth by our experts.
Q2c: Early after-depolarizations are caused by hypokalemia, which causes intracellular calcium overload and prolonged action potential duration (Cacioppo et al., 2022).
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The next sub-section for the assignment is also divided into five parts, which are centered around the processing of information in the clinical domain.
Question 3 part a inquires the reason behind why it is unacceptable to administer two drugs like digoxin and amiodarone together.
Q3a: Since digoxin decreases AF rate by slowing atrioventricular conduction. However, in combination with amiodarone, the bioavailability of digoxin exceeds the advisable limit which augments its neuro-inhibiting properties.
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Part b for question 3 demanded an explanation for the lighthededness felt by Mr. Hodges after the dose of amiodrane.
Q3b: When given intravenously for acute AF, amiodarone can cause hypotension by causing vasodilation and depressing cardiac contractility, which presents as lightheadedness in Mr. Hodges.
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Our experts have answered the question of the complications related to the amiodarone infusion, and what can be done in-detail. Read 50% of the answer below.
Q3c: Amiodarone is a highly acidic solution that is ideally administered through large central lines. Its administration through peripheral veins, especially in the flexures.
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Part d for question 3 requires the student to explain the pharmacodynamics which may lead to a clinical condition in which a blocking agent Bisoprolol can cause bradycardia. Read the answers written by our experts below.
Q3d: Bisoprolol is a cardio selective 1-adrenergic blocking medication that is used to treat high blood pressure. It can be used once daily to cut down on the number of antihypertensive medication dosages required (Nawarskas et al., 2017).
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The last part e for question 3 demands an exploration of what are the harmful impacts of ceasing the administration of bisoprolol suddenly. Our experts have described the impacts in detail through the principle of receptor upregulation, a snippet of which you can find below.
Q3e: As bisoprolol might result in rebound hypertension and tachycardia, it should not be suddenly discontinued.
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The next sub-section is based on the identification of issues related to the patient’s current condition and the logical approach which needs to be followed.
Q4: The most popular anticoagulant in history, warfarin, is intended to prevent clotting of blood (Girolami et al., 2018). On the other hand, Vitamin K, a micro-nutrient found in abundance in green-leafy vegetables is responsible for the synthesis of a number of clotting factors (Campbell, 2017). However, the action of warfarin is intended to interfere with Vitamin K dependent clotting mechanism.
This is only a small part of the complete answer. Please mail us at onlineassignmentservices1@gmail.com to get the complete answer.
The last sub-section incorporates questions relating to the evaluation of outcomes for Mr. Hodges’ case. It includes three questions which you can find below:
Question 5 requires the students to describe three significant patient education aspects related to Mr Hodges’ long-term anticoagulation therapy of dabigatran. Our experts demonstrate back up this answer through in-depth pharmacotherapeutic knowledge.
Q5: Three important points that Mr. Hodges must be educated about regarding dabigatran therapy are as follows: He must never discontinue the WV12044 therapy without consulting his cardiologist as abrupt cessation of the therapy may put him at a risk of developing stroke. In case he misses a dose and recalls taking it <6 hours prior to the next scheduled dose, he must skip the missed dose (Spinler & Willey, 2011).
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Question 6 calls for an explanation of the impact grapefruit juice can have on the use of atorvastatin. Our experts describe this through highlighting the risk which might accompany if the patient takes grapefruit juice with atorvastatin.
Q6: Atorvastatin is a common medication that is used to lower the blood levels of lowdensity lipoproteins (LDL). The amount of ‘statins’ reaching the blood stream is regulated by the enzyme, CYP3A, which acts by breaking down statins in the liver (Lee at al., 2016).
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In addition to patient education, it is also important that the student evaluate the education provided to Mr. Hodges’. Our experts provide detailed strategies which could be used for evaluation of the patient’s knowledge related to the education provided to him.
Q7: In order to evaluate Mr. Hodges’ understanding of the education, several techniques may be employed. One technique is to ask him questions or have him repeat the printed instructions.
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In the next section, our experts have discussed the practices of safe medication through the lens of the ACSQHC Medication Safety Standards and principles relating to the Quality Use of Medicine. Read the answers relating to this section below.
Section 2
Section 2: As per the ACSQHC Medication Safety Standards, 2 important Standards that need to be followed here are: Action 4.11: Enforces that patients must have access to medical information that is understandable to them and sensitive to their unique requirements. This involves giving patients a package containing pertinent medical information when they are discharged, using patient-specific written information to help educate the patient about the medication, and talk to the patient about the advantages and potential hazards of any medications (Australian Commission on Safety and Quality in Health Care, 2023; Lim et al., 2022).
We have provided only one of the standards proposed to be significant for the case study by our experts. Do you wish to read more? Please reach out to us at onlineassignmentservices1@gmail.com
The assignment also requires the students to apply codes and standards relating to the nursing profession relating to the case study. Our experts have identified four standards which proved to deliver high quality nursing care to the patient. Read a snippet for the standards below.
Section 3
Section 3: As per the NMBA standards of practice for registered nurse, the following standards have been identified to deliver high quality nursing care to Mr Hodges. These include: Firstly, as per the standard 1.6, the nurse must document and plan assessments and apply critical thinking to deliver exceptional care to Mr Hodges as his prescription includes certain medications, like Dabigatran, that are high risk medications associated with gastrointestinal hemorrhage and bisoprorol that is associated with high risk of hypotension and bradycardia. He therefore needs frequent cardiovascular assessment.
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