Before J. picks up the prescription, the nurse assesses for contraindications to scopolamine. What are the contraindications to the use of the scopolamine patch? Case summary: J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

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Answer 1

Question

Chapter 21, Problem 1CS

(1)

Summary Introduction

To determine:

Before J. picks up the prescription, the nurse assesses for contraindications to scopolamine. What are the contraindications to the use of the scopolamine patch?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(2)

Summary Introduction

To answer:

The nurse provides patient education and J. indicates that she understands how to use the patch. On the first day of the cruise, she applies the patch 4 hours before they board the ship. That evening, J. and L., go to dinner. J. is feeling somewhat drowsy, but thirsty. The waiter asks if they would like to have champagne as part of the first-night-of-the-cruise celebration. How should J. respond?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(3)

Summary Introduction

To determine:

The next morning, while out on the deck, L. is taking pictures of the bright, snow-covered shoreline views. L. looks at J. and exclaims, “Look at your eyes! Is that a side effect of that patch? What has L. noticed about J.’s blue eyes? What would you suggest for J. because of what L. has noticed?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(4)

Summary Introduction

To determine:

Later that day, J.tells L. “I’m feeling great! I don’t think I need this patch. I’m going to take it off, but I’ll save it for later in case I get nauseated,” Is this a good idea. Explain your answer.

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

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Considering the kcals the patient is receiving from propofol and D51⁄2NS, what should be the rate (ml/hr) of the tube feeding you selected? 30 ml/hr 45 ml/hr 55 ml/hr 65 ml/hr

You are seeing a 68 year-old male patient admitted to the ICU. He is sedated on the ventilator with propofol at 20ml/hr, D51⁄2NS running at 75ml/hr. and a past medical history of DM2, obesity, CAD, HTN, and Pneumonia. Ht 172cm, Wt 72kg, Alb 2.3, VE=7.9 L/min, Tmax =38.4 C 4.1 What is the total kcal this patient is receiving before the initiation of TF (Hint: include propofol and D51⁄2 NS in calculation)? 306 kcal 528 kcal 678 kcal 834 kcal What is the estimated kcal goal for this patient? 1787 kcal 1847 kcal 1927 kcal 2317 kcal What is the estimated protein need for this patient? 45 – 50 g/day 86 – 108g/day 108 – 180g/day 144 – 188 g/day What type of tube feeding formula would you recommend for this patient? Standard 1.5 kcal/ml formula Glycemic control product, 1.0 kcal/ml Low residue, high protein, nutritionally balanced,1.2 kcal/ml High protein, calorie control product, 2.0 kcal/ml

You are seeing a 68 year-old male patient admitted to the ICU. He is sedated on the ventilator with propofol at 20ml/hr, D51⁄2NS running at 75ml/hr. and a past medical history of DM2, obesity, CAD, HTN, and Pneumonia. Ht 172cm, Wt 72kg, Alb 2.3, VE=7.9 L/min, Tmax =38.4 C 4.1 What is the total kcal this patient is receiving before the initiation of TF (Hint: include propofol and D51⁄2 NS in calculation)? 306 kcal 528 kcal 678 kcal 834 kcal Which estimated prediction equation will you recommend to calculate the kcal need for this patient? Penn State Equation (2003b): Mifflin(0.96)+ VE (31) + Tmax (167)-6212 MifflinStJeor =(10xW)+(6.25xHt)–(5xAge)+5 Harris-Benedict equation: kcal/day (male) = 66 +13.8 (W) + 5.0(H) – (6.8 x A) Ireton-Jones equations (1992)(ventilator-dependent): 1925 – 10 (A) + 5 (W) + 281 (S) + 292 (T) + 851 (B) What is the estimated kcal goal for this patient? 1787 kcal 1847 kcal 1927 kcal 2317 kcal What is the…

Answer 2

Question

Chapter 21, Problem 1CS

(1)

Summary Introduction

To determine:

Before J. picks up the prescription, the nurse assesses for contraindications to scopolamine. What are the contraindications to the use of the scopolamine patch?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(2)

Summary Introduction

To answer:

The nurse provides patient education and J. indicates that she understands how to use the patch. On the first day of the cruise, she applies the patch 4 hours before they board the ship. That evening, J. and L., go to dinner. J. is feeling somewhat drowsy, but thirsty. The waiter asks if they would like to have champagne as part of the first-night-of-the-cruise celebration. How should J. respond?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(3)

Summary Introduction

To determine:

The next morning, while out on the deck, L. is taking pictures of the bright, snow-covered shoreline views. L. looks at J. and exclaims, “Look at your eyes! Is that a side effect of that patch? What has L. noticed about J.’s blue eyes? What would you suggest for J. because of what L. has noticed?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(4)

Summary Introduction

To determine:

Later that day, J.tells L. “I’m feeling great! I don’t think I need this patch. I’m going to take it off, but I’ll save it for later in case I get nauseated,” Is this a good idea. Explain your answer.

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Expert Solution & Answer

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Check out a sample textbook solution

See solution

Answer 3

Question

Chapter 21, Problem 1CS

(1)

Summary Introduction

To determine:

Before J. picks up the prescription, the nurse assesses for contraindications to scopolamine. What are the contraindications to the use of the scopolamine patch?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(2)

Summary Introduction

To answer:

The nurse provides patient education and J. indicates that she understands how to use the patch. On the first day of the cruise, she applies the patch 4 hours before they board the ship. That evening, J. and L., go to dinner. J. is feeling somewhat drowsy, but thirsty. The waiter asks if they would like to have champagne as part of the first-night-of-the-cruise celebration. How should J. respond?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(3)

Summary Introduction

To determine:

The next morning, while out on the deck, L. is taking pictures of the bright, snow-covered shoreline views. L. looks at J. and exclaims, “Look at your eyes! Is that a side effect of that patch? What has L. noticed about J.’s blue eyes? What would you suggest for J. because of what L. has noticed?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(4)

Summary Introduction

To determine:

Later that day, J.tells L. “I’m feeling great! I don’t think I need this patch. I’m going to take it off, but I’ll save it for later in case I get nauseated,” Is this a good idea. Explain your answer.

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Expert Solution & Answer

Want to see the full answer?

Check out a sample textbook solution

See solution

Answer 4

Question

Chapter 21, Problem 1CS

(1)

Summary Introduction

To determine:

Before J. picks up the prescription, the nurse assesses for contraindications to scopolamine. What are the contraindications to the use of the scopolamine patch?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(2)

Summary Introduction

To answer:

The nurse provides patient education and J. indicates that she understands how to use the patch. On the first day of the cruise, she applies the patch 4 hours before they board the ship. That evening, J. and L., go to dinner. J. is feeling somewhat drowsy, but thirsty. The waiter asks if they would like to have champagne as part of the first-night-of-the-cruise celebration. How should J. respond?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(3)

Summary Introduction

To determine:

The next morning, while out on the deck, L. is taking pictures of the bright, snow-covered shoreline views. L. looks at J. and exclaims, “Look at your eyes! Is that a side effect of that patch? What has L. noticed about J.’s blue eyes? What would you suggest for J. because of what L. has noticed?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(4)

Summary Introduction

To determine:

Later that day, J.tells L. “I’m feeling great! I don’t think I need this patch. I’m going to take it off, but I’ll save it for later in case I get nauseated,” Is this a good idea. Explain your answer.

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Expert Solution & Answer

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Check out a sample textbook solution

See solution

Answer 5

Chapter 21, Problem 1CS

(1)

Summary Introduction

To determine:

Before J. picks up the prescription, the nurse assesses for contraindications to scopolamine. What are the contraindications to the use of the scopolamine patch?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(2)

Summary Introduction

To answer:

The nurse provides patient education and J. indicates that she understands how to use the patch. On the first day of the cruise, she applies the patch 4 hours before they board the ship. That evening, J. and L., go to dinner. J. is feeling somewhat drowsy, but thirsty. The waiter asks if they would like to have champagne as part of the first-night-of-the-cruise celebration. How should J. respond?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(3)

Summary Introduction

To determine:

The next morning, while out on the deck, L. is taking pictures of the bright, snow-covered shoreline views. L. looks at J. and exclaims, “Look at your eyes! Is that a side effect of that patch? What has L. noticed about J.’s blue eyes? What would you suggest for J. because of what L. has noticed?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

(4)

Summary Introduction

To determine:

Later that day, J.tells L. “I’m feeling great! I don’t think I need this patch. I’m going to take it off, but I’ll save it for later in case I get nauseated,” Is this a good idea. Explain your answer.

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Answer 6

Chapter 21, Problem 1CS

(1)

Summary Introduction

To determine:

Before J. picks up the prescription, the nurse assesses for contraindications to scopolamine. What are the contraindications to the use of the scopolamine patch?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Answer 7

Chapter 21, Problem 1CS

(1)

Summary Introduction

To determine:

Before J. picks up the prescription, the nurse assesses for contraindications to scopolamine. What are the contraindications to the use of the scopolamine patch?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Answer 8

(2)

Summary Introduction

To answer:

The nurse provides patient education and J. indicates that she understands how to use the patch. On the first day of the cruise, she applies the patch 4 hours before they board the ship. That evening, J. and L., go to dinner. J. is feeling somewhat drowsy, but thirsty. The waiter asks if they would like to have champagne as part of the first-night-of-the-cruise celebration. How should J. respond?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Answer 9

(2)

Summary Introduction

To answer:

The nurse provides patient education and J. indicates that she understands how to use the patch. On the first day of the cruise, she applies the patch 4 hours before they board the ship. That evening, J. and L., go to dinner. J. is feeling somewhat drowsy, but thirsty. The waiter asks if they would like to have champagne as part of the first-night-of-the-cruise celebration. How should J. respond?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Answer 10

(3)

Summary Introduction

To determine:

The next morning, while out on the deck, L. is taking pictures of the bright, snow-covered shoreline views. L. looks at J. and exclaims, “Look at your eyes! Is that a side effect of that patch? What has L. noticed about J.’s blue eyes? What would you suggest for J. because of what L. has noticed?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Answer 11

(3)

Summary Introduction

To determine:

The next morning, while out on the deck, L. is taking pictures of the bright, snow-covered shoreline views. L. looks at J. and exclaims, “Look at your eyes! Is that a side effect of that patch? What has L. noticed about J.’s blue eyes? What would you suggest for J. because of what L. has noticed?

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Answer 12

(4)

Summary Introduction

To determine:

Later that day, J.tells L. “I’m feeling great! I don’t think I need this patch. I’m going to take it off, but I’ll save it for later in case I get nauseated,” Is this a good idea. Explain your answer.

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Answer 13

(4)

Summary Introduction

To determine:

Later that day, J.tells L. “I’m feeling great! I don’t think I need this patch. I’m going to take it off, but I’ll save it for later in case I get nauseated,” Is this a good idea. Explain your answer.

Case summary:

J., a 53-year-old schoolteacher, is going on a cruise to Alaska with her husband, L., for their thirtieth anniversary. She is very excited about the trip but is also worried because she gets “very seasick” whenever she is on a boat. She calls her doctor’s office for a prescription for a medicine for motion sickness. Her physician prescribes transdermal scopolamine (Transderm-Scop).

Answer 14

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Answer 15

Expert Solution & Answer

Answer 16

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Answer 17

Ch. 21 - Prob. 1O Ch. 21 - Prob. 2O Ch. 21 - Prob. 3O Ch. 21 - Prob. 4O Ch. 21 - Prob. 1CS Ch. 21 - Prob. 1NERQ Ch. 21 - Prob. 2NERQ Ch. 21 - Prob. 3NERQ Ch. 21 - Prob. 4NERQ Ch. 21 - Prob. 5NERQ

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Chapter 21 Solutions