Pharmacology in Nursing - Short answer topics

Pharmacology in" rel="nofollow">in Nursin" rel="nofollow">ing - Short answer topics Order Description There are topics to address two min" rel="nofollow">ini essays if you will the first topic is below. 1st -Read this clin" rel="nofollow">inical summary This case study is a summary of where a medication error contributed to the cause of death. It is a real life in" rel="nofollow">incident of a coronial in" rel="nofollow">investigation obtain" rel="nofollow">ined from public documents. A document becomes public once the coronial in" rel="nofollow">investigation process has been completed and closed. All in" rel="nofollow">individuals and facilities are de-identified. Some details have been removed which was deemed unnecessary for this Assessment piece. CLINICAL SUMMARY Mrs C was a 69-year-old female with a complex medical history of stroke with a residual left side weakness and ongoin" rel="nofollow">ing risk of aspiration, atrial fibrillation, and in" rel="nofollow">insulin" rel="nofollow">in-dependent diabetes mellitus. She was more recently diagnosed with a suspected left ear tumour. Mrs C had a planned admission to a metropolitan hospital for a biopsy. Mrs C was commenced on oral antibiotics (ciprofloxacin" rel="nofollow">in) after the biopsy results suggested an in" rel="nofollow">infection. One day after the procedure, her oxygen saturation levels dropped and staff suspected she had aspirated. A nasogastric tube (NGT) was in" rel="nofollow">inserted but was pulled out by Mrs C a day later. Despite advice from healthcare professionals about the risk of further aspiration and sub-optimal oral nutrition, neither Mrs C nor her immediate family would consent to the rein" rel="nofollow">insertion of a NGT. Three days later, followin" rel="nofollow">ing another episode where Mrs C’s oxygen saturation levels dropped, x-rays showed acute pulmonary oedema with right lower lobe consolidation and an ECG demonstrated Mrs C had rapid atrial fibrillation. For these reasons, Mrs C was transferred to the Intensive Care Unit (ICU), where a NGT was re-in" rel="nofollow">inserted. The nurse-in" rel="nofollow">in-charge (NIC) left in" rel="nofollow">instructions that Mrs C’s oral ciprofloxacin" rel="nofollow">in ought to be crushed and admin" rel="nofollow">inistered through the NGT tube. Later that same evenin" rel="nofollow">ing, blood tests were required, and the nursin" rel="nofollow">ing staff realised that Mrs C’s evenin" rel="nofollow">ing medications, in" rel="nofollow">includin" rel="nofollow">ing the oral ciprofloxacin" rel="nofollow">in and in" rel="nofollow">intravenous frusemide, had not yet been admin" rel="nofollow">inistered. The nurse (RN. R) lookin" rel="nofollow">ing after Mrs C was asked to take the bloods via a peripherally in" rel="nofollow">inserted central catheter (PICC), and to admin" rel="nofollow">inister the medications. As she had not had prior experience of PICC lin" rel="nofollow">ines, she was supervised by another nurse (RN. C). RN. R was in" rel="nofollow">instructed to crush the ciprofloxacin" rel="nofollow">in to enable NGT admin" rel="nofollow">inistration, but then drew the paste in" rel="nofollow">into a standard sized non-luer lock syrin" rel="nofollow">inge even though she in" rel="nofollow">intended to admin" rel="nofollow">inister the medication via the NGT, which required a larger nozzle. RN. C drew up the frusemide and both medications were placed in" rel="nofollow">into a kidney dish. At the bedside, RN. R took blood from the PICC lin" rel="nofollow">ine, and admin" rel="nofollow">inistered the in" rel="nofollow">intravenous frusemide. The NIC was present at the time, attendin" rel="nofollow">ing to Mrs C’s NGT feedin" rel="nofollow">ing. The NIC in" rel="nofollow">informed RN. R that medications admin" rel="nofollow">inistered via a PICC needed to be drawn up in" rel="nofollow">in a luer lock syrin" rel="nofollow">inge. RN. R returned to the drug room and transferred the crushed up ciprofloxacin" rel="nofollow">in in" rel="nofollow">into a luer lock syrin" rel="nofollow">inge, in" rel="nofollow">injectin" rel="nofollow">ing it in" rel="nofollow">into the PICC lin" rel="nofollow">ine. A short time later, Mrs C became cyanosed and hypoxaemic, then unresponsive. Sin" rel="nofollow">ince Mrs C was subject to a NFR (not for resuscitation) order, a code blue was not called. She was pronounced deceased soon after. An autopsy performed later found foreign material in" rel="nofollow">in the vessels of the brain" rel="nofollow">in, lungs and heart. INVESTIGATION Lookin" rel="nofollow">ing primarily at the circumstances in" rel="nofollow">in which Mrs C had died, the coroner at in" rel="nofollow">inquest focussed on several issues. 1 of these specifically in" rel="nofollow">included: • The adequacy of remedial measures taken by the health service to min" rel="nofollow">inimise the risk of such errors in" rel="nofollow">in drug admin" rel="nofollow">inistration. The Director of Medical Services gave evidence that a number of safety measures had sin" rel="nofollow">ince been implemented by the hospital followin" rel="nofollow">ing an in" rel="nofollow">internal in" rel="nofollow">investigation. . Write 500-600 words addressin" rel="nofollow">ing the followin" rel="nofollow">ing questions: a) Discuss and describe the type of medication error that occurred in" rel="nofollow">in this scenario. b) The Director of Medical Services gave evidence that a number of measures had been implemented followin" rel="nofollow">ing an in" rel="nofollow">investigation usin" rel="nofollow">ing a root cause analysis of this in" rel="nofollow">incident. Discuss 1 (one) or 2 (two) safety measures that you feel would have been implemented to min" rel="nofollow">inimise the risk of such an error in" rel="nofollow">in drug admin" rel="nofollow">inistration occurrin" rel="nofollow">ing again" rel="nofollow">in. 2nd Topic- Understandin" rel="nofollow">ing pharmacokin" rel="nofollow">inetics (PK) is important for safety admin" rel="nofollow">inistratin" rel="nofollow">ing medications to patients. However the PK of drugs are altered by age i.e. in" rel="nofollow">in the elderly population group, when compared to adults. Discuss PK i.e. absorption, distribution, metabolism and excretion that in" rel="nofollow">includes one aspect (for each part) that differs in" rel="nofollow">in the elderly in" rel="nofollow">in comparison to adults. Include in" rel="nofollow">in your discussion at least 2 (two) to 3 nursin" rel="nofollow">ing implications/in" rel="nofollow">interventions to ensure safety in" rel="nofollow">in admin" rel="nofollow">inisterin" rel="nofollow">ing medications to this population group. \