Pharmacology and the Nursing Process, 8e
Pharmacology and the Nursing Process, 8e
8th Edition
ISBN: 9780323358286
Author: Linda Lane Lilley PhD RN, Shelly Rainforth Collins PharmD, Julie S. Snyder MSN RN-BC
Publisher: Elsevier Science
Question
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Chapter 22, Problem 1CS

(1)

Summary Introduction

To determine:

What type of diuretic was probably prescribed for G. at this time? Explain your answer.

Case summary:

Hypertension was diagnosed in G., who is 30 years of age. Both her mother and sister have hypertension, and both were also in their thirties when it was diagnosed. G’s most current blood pressure reading is 150/96 mm/Hg, and for this reason, the nurse practitioner recommended therapy with captopril (Capoten), light exercise in the form of walking, and relaxation therapy. After a month of therapy, G.’s blood pressure is 145/86 mm Hg. Stress reduction has been the biggest obstacle in her treatment because she is a lawyer with a prominent law firm and has found that her blood pressure is consistently elevated (160/100 mm Hg) whenever she measures it at work. At this follow-up visit, she is also given a prescription for a diuretic to help with her blood pressure control. She plans to consult a therapist to work on stress-reduction techniques and to begin exercising regularly.

(2)

Summary Introduction

To determine:

The possible adverse effects G. needs to be aware of while taking captopril.

Case summary:

Hypertension was diagnosed in G., who is 30 years of age. Both her mother and sister have hypertension, and both were also in their thirties when it was diagnosed. G’s most current blood pressure reading is 150/96 mm/Hg, and for this reason, the nurse practitioner recommended therapy with captopril (Capoten), light exercise in the form of walking, and relaxation therapy. After a month of therapy, G.’s blood pressure is 145/86 mm Hg. Stress reduction has been the biggest obstacle in her treatment because she is a lawyer with a prominent law firm and has found that her blood pressure is consistently elevated (160/100 mm Hg) whenever she measures it at work. At this follow-up visit, she is also given a prescription for a diuretic to help with her blood pressure control. She plans to consult a therapist to work on stress-reduction techniques and to begin exercising regularly.

(3)

Summary Introduction

To determine:

G. tells that she uses an over-the-counter pain reliever for occasional headaches. What potential interaction is her concern?

Case summary:

Hypertension was diagnosed in G., who is 30 years of age. Both her mother and sister have hypertension, and both were also in their thirties when it was diagnosed. G’s most current blood pressure reading is 150/96 mm/Hg, and for this reason, the nurse practitioner has recommended therapy with captopril (Capoten), light exercise in the form of walking, and relaxation therapy. After a month of therapy, G.’s blood pressure is 145/86 mm Hg. Stress reduction has been the biggest obstacle in her treatment because she is a lawyer with a prominent law firm and has found that her blood pressure is consistently elevated (160/100 mm Hg) whenever she measures it at work. At this follow-up visit, she is also given a prescription for a diuretic to help with her blood pressure control. She plans to consult a therapist to work on stress-reduction techniques and to begin exercising regularly.

(4)

Summary Introduction

To determine:

G. states that she and her husband are planning to start a family in 1 year. What will you, as her nurse, tell her about pregnancy and therapy with these drugs.

Case summary:

Hypertension was diagnosed in G., who is 30 years of age. Both her mother and sister have hypertension, and both were also in their thirties when it was diagnosed. G’s most current blood pressure reading is 150/96 mm/Hg, and for this reason, the nurse practitioner has recommended therapy with captopril (Capoten), light exercise in the form of walking, and relaxation therapy. After a month of therapy, G.’s blood pressure is 145/86 mm Hg. Stress reduction has been the biggest obstacle in her treatment because she is a lawyer with a prominent law firm and has found that her blood pressure is consistently elevated (160/100 mm Hg) whenever she measures it at work. At this follow-up visit, she is also given a prescription for a diuretic to help with her blood pressure control. She plans to consult a therapist to work on stress-reduction techniques and to begin exercising regularly.

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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…
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