NURS 6521 Week 9 Patients Education And Health Needs Discussion
Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders
As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?
For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.
- Review the Resources for this module and reflect on the different health needs and body systems presented.
- Your Instructor will assign you a complex case study to focus on for this Discussion.
- Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.
By Day 3 of Week 9
Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.
You will respond to your colleagues’ posts in Week 10.
Week 9 Discussion Sample
HH is a 68 yo M who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV/day (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.
Ht: 5’8” Wt: 89 kg
Allergies: Penicillin (rash) Patient health needs:
Aside from the continuation of the patient’s antibiotics as first priority, this patient will need assessment and treatment for nutrition since he is not tolerating a diet at this time. Malnutrition is associated with an increased risk of complications in hospitalized patients, and parenteral nutrition (PN) is used when oral or enteral feeding is not possible TPN should be considered if the patient cannot tolerate a diet (Comerlato, Stefani, Viana, & Viana, 2020).
TPN is also considered high risk in a patient with an already known infection as TPN has high sugar content and infection feeds on sugar. The patient is also diabetic and blood sugars will need to be checked at least every 6 hours. Another consideration is with the allergy to penicillin, the provider will cover this patient with Ceftriaxone and azithromycin until the patient’s sputum and blood cultures result.
Cultures are important to be sure the patient’s specific infection is covered and treated effectively. Blood cultures are one of the most important specimens managed by the clinical microbiology laboratory and are the primary and most sensitive method for diagnosing bloodstream infections (bacteremia, fungemia, and sepsis), in addition to influencing appropriate antimicrobial therapy (Snyder, 2015).
Depending on what the sputum and blood cultures result, the provider will likely start the patient on vancomycin. The patient will also be assessed by the nutrition team to determine if the patient is a candidate for TPN or if an NG/OG is appropriate. The provider should also consider pre-treating the patient with an antiemetic prior to meals or at least a nutrition supplement drink. Antiemetics to consider could be: Zofran, Granisetron, Dolasetron, Haldol, Phenergan, Reglan, ect (Rosenthal & Burchum, 2021).
Thorough education on the importance of nutrition and compliance with prescribed medications must be emphasized. The patient must be set up for success before discharge. The nurse and provider must be congruent to be sure that the patient understands the importance of their plan of care at home.
This plan of care must include an adequate understanding of what nutritional needs need to be met at home, when to take his antibiotics and nausea medications, proper hand hygiene, and ways to prevent community-acquired infections. The patient must also be educated on the importance of following up with a primary care provider to ensure the patient is in compliance with his home care plan.
- Comerlato, P. H., Stefani, J., Viana, M. V., & Viana, L. V. (2020). Infectious complications associated with parenteral nutrition in intensive care unit and non-intensive care unit patients. Brazilian Journal of Infectious Diseases, 24(2), 137–143. https://doi-org.ezp.waldenulibrary.org/10.1016/j.bjid.2020.02.002
- Rosenthal, L. D. & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
- Snyder, J. W. (2015). Blood Cultures: the Importance of Meeting Pre-Analytical Requirements in Reducing Contamination, Optimizing Sensitivity of Detection, and Clinical Relevance. Clinical Microbiology Newsletter, 37(7), 53–57. https://doi-org.ezp.waldenulibrary.org/10.1016/j.c…