Pathophysiology and Pharmacology 1
Group Assignment
INSTRUCTIONS
This is a group assignment worth 10% of your final grade and is due according to the date on topical outline. Groups can include 3-5 members. As outlined below, you are expected to submit a professionally completed assignment with the required sections. The completed assignment must be submitted via Dropbox.
Marks will be deducted for late and/or incomplete submissions.
WHAT YOU NEED TO DO:
- Answer all the questions asked in the scenario, not exceeding five pages while supporting your answer with evidence. Refer to required submissions for further guidelines.
REQUIRED SECTIONS
- Answers to all the questions:
- Typed and double spaced.
- Not exceeding five pages.
- Grammatically correct with proper sentence structure.
- APA 7th ed format.
- Other documents:
- A cover page with students’ and professors’ names.
- Reference page.
- A copy of the APA contract checklist (found on SLATE).
EVOLVING CASE STUDY SCENARIO
Charles is a 35-year-old male and has been reporting daily headaches for 1 month. Today, while working his shift, he had to hold onto a wall to walk straight and reported that his vision was blurred. His friend took him to the emergency department (ED). While lying on a stretcher in the ED, Charles began shaking violently, hyperventilating, and was unresponsive to his name being called. The healthcare provider in the ED ordered lorazepam 4 mg intravenously now and to be repeated after 5 minutes, rush (STAT) laboratory work, a lumbar puncture, and a magnetic resonance imaging (MRI) scan of his head and brain.
Vital signs:
- Blood pressure: 140/60 mm Hg
- Heart rate (HR): 110 beats/min
- Respiratory rate (RR): 30 breaths/min
- Temperature: 38°C
Questions
- What type of seizure do you suspect Charles has experienced support with evidence?
- What type of drug is lorazepam and why is it used in the treatment of seizures? Support your answer.
- What are the most important laboratory values that you and the health care team will monitor while Charles is receiving lorazepam? Support your answer.
- What common adverse effects of lorazepam will you assess for?
The MRI scan of Charles head and brain and his STAT laboratory work have been completed. The MRI initial report shows multiple masses present in the cerebrum. The largest mass is in the frontal lobe and measures 2.4 cm. An electroencephalogram was also ordered; it showed irregular electrical activity. The prescriber orders a loading dose of phenytoin (Dilantin®) 15 to 20 mg/kg intravenously in 3 doses that are 4 hours apart, and then to start administering 300 mg intravenously twice a day.
- Current laboratory test values:
- White blood cell count: 10 × 109/L
- Hemoglobin: 155 g/L
- Hematocrit: 45.9%
- Platelets: 324 × 109/L
- Blood urea nitrogen: 8 mmol/L
- Creatinine: 106 mcmol/L
- Aspartate aminotransferase (AST): 18 IU/L
- Alkaline phosphates: 46 IU/L
- Prothrombin time (PT): 14.4 seconds
- International normalized ratio (INR): 1.06
- Sodium: 138 mmol/L
- Potassium: 4.2 mmol/L
- Human immunodeficiency virus (HIV) nonreactive
- Cerebral spinal fluid negative
- What is the maximum amount of phenytoin that Clifford will receive with each dose if he weighs 185 pounds?
- After several days of receiving phenytoin, Charles’s blood levels are drawn. Which serum drug level would indicate that Charles’s dosing has reached therapeutic ranges?
- Medication errors can occur. Read the news story in the link below and comment on some ways you as a nurse can prevent this type of medication error from occurring. Are there any similarities between the two drugs listed in the article that could have led to the error?
Hospital medication error kills patient in Oregon – CBS News
Good Luck!