jermain-jones-vsim-vsim-with-answers
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Jun 11, 2024
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Jermain Jones Vsim - VSIM with answers
Pharmacology (Washtenaw Community College)
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Jermain Jones Vsim - VSIM with answers
Pharmacology (Washtenaw Community College)
Scan to open on Studocu
Studocu is not sponsored or endorsed by any college or university
Downloaded by Sally Cobb (sallyc3951@gmail.com)
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Pharmacology Scenario 7: Jermaine Jones
Guided Reflection Questions
Medications administered: No medications were administered in this vsim. I completed a medication reconciliation with this patient, and looked for any potential interactions, allergies, and contraindications. The patient reported that he does not take any herbal or over the counter medications, but that he does take a prescription medication for depression and he had taken another medication prescribed for his wife.
Labs monitored: The patient had his blood drawn for a BMP, CBC, and blood alcohol level before I came to see him. All of his results for his BMP and CBC labs came back within normal ranges. His blood alcohol level came back as 0.27, which is beyond the level of legal intoxication for a man of his weight. According to the blood alcohol chart, this level would suggest that he had consumed approximately ten alcoholic beverages, even though he reports drinking three beers. Calculations: No calculations were necessary in this vsim, as no medications were ordered to be administered. Teachings: I educated the patient on the importance of avoiding alcohol while taking sertraline and/or benzodiazepines, and about drug interactions. I taught him that the symptoms he was in the hospital for were caused by the combination of benzodiazepines and alcohol, which could potentially be lethal. This patient should be taught to not take medications that have not been prescribed to him. Scenario Analysis Questions
[1]
PCC What priority problem(s) did you identify for Jermaine Jones?
The priority problem that I identified for Jermaine Jones was the combination of alcohol with the medications sertraline and alazopram. The patient reports taking his prescribed 50mg sertraline once a day, but he also took one of his wife’s alprazolam tablets. The patient reported that he thinks the tablets are 0.5mg. Alprazolam is a benzodiazepine that binds to GABA receptors in the brain and is used to treat anxiety. Sertraline is an SSRI (selective serotonin reuptake inhibitor) that works to treat depression by inhibiting the uptake of serotonin by neurons in the brain. PCC What potential problems could arise due to combination of alcohol with Downloaded by Sally Cobb (sallyc3951@gmail.com)
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SSRI’s and benzodiazepines?
Alcohol should not be consumed when taking alprazolam or sertraline. The combination
of alcohol with SSRI’s and benzodiazepines can lead to decreased consciousness, slurred speech, reduced coordination, drowsiness, and depressed respirations. Benzodiazepines and alcohol are both central nervous depressants. This mixture can cause marked central nervous system depression, coma, and can even be fatal. Mr. Jones should be assessed frequently to ensure that his level of consciousness is appropriate. The patient should have a neurological assessment done, and his vital signs should be closely monitored with extra attention to his respirations. PCC/S Discuss the importance of support from his family in Jermaine Jones’s care.
Mr. Jones is reportedly coping with the anniversary of his father's death, which is likely increasing his depression lately. Support from his family could be very important and help him tremendously during this difficult time. His family should also monitor his drinking, and make sure to not give him any medications that have not been prescribed to him. They should ensure that any of their prescription medications are stored safely in
a place that is not easily accessible to Mr. Jones, and look for any odd changes in his behavior which could signify a worsening in his depression. PCC/S Identify potential patient safety issues related to altered mental status due
to the combination of alcohol with SSRI’s and benzodiazepines.
The combination of SSRI’s, benzodiazepines, and alcohol can cause altered mental status in addition to poor coordination. Mr. Jones could experience a lapse in judgement that may lead to him harming himself, either intentionally or unintentionally. If Mr. Jones was to drive a vehicle with this combination in his system, he could harm himself and others. The loss of coordination from this combination could also potentially cause Mr. Jones to suffer falls. S/EBP Identify the antidote for benzodiazepine overdose and discuss the risk for using this antidote.
The medication used as an antidote for benzodiazepine overdose is flumazenil. Flumazenil is a benzodiazepine receptor antagonist. The risks of this medication include seizure, cardiac events, and death. The use of this medication is contraindicated in patients with a lowered seizure threshold or history of seizures. It is also contraindicated for those on long term benzodiazepines, patients with tachycardia, and those with a widened QRS complex. Side effects and complications of this drug include blurry vision, tinnitus, headache, tremors, dizziness, weak and shallow breathing, panic attacks, fear, and fast or uneven heart rate. This medication should be administered slowly, over 15 seconds. T&C What other interprofessional team members should be involved in Jermaine Downloaded by Sally Cobb (sallyc3951@gmail.com)
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Jones’s care?
In addition to the provider, nurses, and medical staff in the hospital, other interprofessional team members involved in his care should include his primary care physician. A pharmacist could help Mr. Jones identify potentially dangerous combinations of medication. A psychiatric doctor could help manage his anxiety and depression, and make sure that his medications are working effectively. Mr. Jones should see a therapist or counselor to help him develop healthy coping habits for his depression. [1]
The Scenario Analysis Questions are correlated to the Quality and Safety Education for Nurses (QSEN) competencies: Patient-Centered Care (PCC), Teamwork and Collaboration (T&C), Evidence-Based Practice (EBP), Quality Improvement (QI), Safety (S), and Informatics (I). Find more information at: http://qsen.org/
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