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Directions: For each of the scenarios
below, answer the questions below using your required learning resources,
clinical practice guidelines, and medscape. Explain the problem and explain how
you would address the problem. When
recommending medications, write out a complete prescription for each
medication. What order would you send to a pharmacy? Include drug, dose, route,
frequency, special instructions, # dispensed (days supply), refills, etc. Also
state if you would continue, discontinue or taper the patient’s current
medications. Use at least 3 sources for each
scenario and cite sources using APA format.
SCENARIO 1:
Mary
is a 35-year-old woman that has been diagnosed with hypothyroidism. Her labs
today show a TSH of 20, MCV 78, MCHD 26, Ferritin 9, TIBC 418. She has a
history of iron deficiency anemia for 2 months. Current medications include
Kelp tablets daily, ibuprofen 400 mg daily as needed, and ethinyl
estradiol/norgestrel one tablet daily.What medication would you start this
patient on for her hypothyroidism? How would you monitor this patient’s
response to the medication? What education would you provide regarding her
medications and their interactions?
SCENARIO 2:
Joe
is a 48-year-old male diagnosed with Type II Diabetes Mellitus for a year ago.
He has controlled his blood glucose through dietary changes. He has
hypertension and is currently on Lisinopril 20 mg po daily. He has no known
allergies. His lab work includes these results: fasting BG is 225 mg/dL; HgA1C
= 7.5%. Basic Metabolic Profile (BMP) is normal except for a Cr of 2.0 and eGRF
of 28. What treatment plan would you implement for Joe? What medications would
you prescribe and how would you monitor them? What education would you provide
regarding his treatment plan?
SCENARIO 3:
Jose
is a 55-year-old truck driver being evaluated for his commercial driver’s
license. He has a known history of diabetes mellitus type II. Current
medications include Metformin 1000 mg Bid, Glipizide 20 mg po daily. Diltiazem
120 mg po BID. He is allergic to sulfa. Lab results show a fasting blood
glucose of 325 mg/dL, HgA1C = 10.6%. Basic metabolic Profile is normal. What
treatment plan would you implement for Jose? What medications would you
prescribe and how would you monitor them? What education would you provide
regarding his treatment plan?
SCENARIO 4:
Jenny
is a 63-year-old woman with complaints of heartburn 4 to 5 times a week over
the past 3 months. Her symptoms are worse at night after going to bed. Her
heartburn is worse, and she coughs a lot at night. She has tried OTC Prevacid
24 hour once daily for the past 2 weeks. This has helped the symptoms some, but
she is still bothered by them. Current medications include Diltiazem CD 120 mg
PO once daily, Hydrochlorothiazide 25 mg PO once daily, Metformin 500 mg PO
twice daily, Aspirin 81 mg PO daily, Fluticasone/salmeterol DPI 100 mcg/50 mcg
one inhalation twice daily. Your working diagnosis for this patient is GERD.
What treatment plan would you implement for Jenny? What medications would you
prescribe and how would you monitor them? What education would you provide
regarding her treatment plan?
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