Pharmacological Questionings
These pharmacological inquiries focus on a 62-year-old patient whom I will refer to as Bob Smith. Bob was medevac’d to OHSU from his home in Grants Pass, Oregon. He has been a paraplegic since the age of 19 after a motor vehicle accident. His current diagnosis happened as a result of falling and being left for three days. He has extensive pressure ulcers that were infected and needed immediate surgery. Bob also has type 2 diabetes.
Bob has a current prescription list of 31 medications. After reviewing his chart, I have decided to focus on the role vitamins play in his wound healing, how Lovenox dosings vary based on his sex and age, and if Piperacillin/tazobactam is the preferred course of antibiotics. The questions I will be researching are as follows: (a) How are ascorbic acid supplements contributing to his wound healing? (b) Based on patient’s Vancomycin-Resistant Enterococci infection, is this patient on the correct course of antibiotics? and (c) What are the influences of gender on wound healing?
Research Findings
Vitamin C’s role in wound healing
Traditionally, vitamin C has been thought to be a cure for many ailments. In wound healing vitamin C helps to rebuild collagen. “Vitamin C is a co-factor in proline and lysine hydroxylation, a necessary step in the formation of collagen. Hydroxyproline and hydroxylysine are essential for stabilizing the triple helix structure of collagen with strong hydrogen bonds and crosslinks.” (Collins, 2009) Vitamin C gives tensile strength to this newly laid down collagen. This is crucial for pressure ulcer healing because then the regeneration of skin will not tear as easily.
However, more recent research challenges these assumptions. A randomized double-blin...
... middle of paper ...
...c effects on wound healing may lead to a pharmaceutical outcome of prescribing estrogen creams. “Topical and systemic estrogen treatments have been shown to increase the rate of acute healing in men, and particularly in elderly women, by reducing the inflammatory response.” (Gilliver et al., 2007, p. 56)
Conclusion
Based on my research findings an appropriate course of action for Mr. Smith would be to continue the piperacillin/tazobactam as an effective and non-bacteria resistant forming antibiotic. Further, Mr. Smith should also continue Vitamin C in conjunction with other supplements and protein to promote maximum wound healing. Based on Mr. Smith’s stagnant wound healing and the potential gain he could receive seeing as he is a male, an appropriate next step in pharmaceutical care would be to look into the potential benefits he might gain from topical estrogen.
scrutiny of others regarding upcoming test. Table 5-3 in Bickley, Szilagyi, and Bates (2013) Pharmacological interventions NONE Non-pharmacological interventions Recommendation to see a Behavioral Health Therapist for cognitive behavioral therapy (CBT): A meta-analysis by Mitte (2005) that assessed 124 studies, showed CBT is as effective as a pharmacological intervention in panic disorder. With the patients upcoming test CBT offers a select advantage in that it may become effective in as little as
ADHD (Attention deficit hyperactivity disorder) is a psychological disorder prone to ethical issues within its treatments through the use of Methylphenidate otherwise known as Ritalin, Ritalin is the current leading form of pharmacological treatment for Attention Deficit Hyperactivity Disorder (ADHD), and there has seen a dramatic increase in prescription rate over the past ten years, which have raised some ethical issues with its prescription. There are no present biological basis for ADHD diagnosis
individual in diabetic patients and develop recommendations to improve portfolio of services, and achieve more adherence to pharmacological treatments and long-term modifications in the lifestyle of our patients. Each year more and more people are diagnosed with type 2 diabetes, which has alerted health workers in search of new methodologies to approach these patients to reduce the likelihood of developing complications in the future or even prevent the death of these patients. Bad eating habits,
happen to anyone and at any time during life’s journey. Within the nursing profession, it is important to understand grief and loss experienced by the patients and families and response professionally. In this essay, discussion will be focus on middle adulthood age group and their reaction to grief and loss. This essay will also discusses the analysis of these effects using Kubler Ross and her theories to explain the stages of grief and loss that a 42 year old male is going through after being recently
where the benefits outweigh the risks, for both the mother and unborn child. There is a growing body of studies on complementary and alternative treatments (or non-pharmacological) for the treatment of mental disorders during pregnancy. This systematic review and multiple treatment meta-analysis was selected to explore non-pharmacological interventions to treat mental disorders during pregnancy. Design Approach The research paper is a systematic review of antepartum mental disorder (AMD) and nonpharmacological
regarding substance abuse. All my years within the medical field, I never looked at substance abuse patients as unique, delicate, and should be treated with care. I have increased my level of understanding and now have the tools to have substance abuse conversations with my patients, family members, or friends. What gave me a different outlook on substance abuse treatment is understanding that some patients have a co-occurring diagnosis that may change their treatment plan. I always thought that one treatment
Despite the availability of standardized pain management methods such as using analgesics and opioids, patients might inadequately managed for pain if pain assessments are done inefficiently. Nurses are in a unique position to assess pain as they have the most contact with the child and their family in hospital. Getting a thorough pain assessment occasionally hard for nurses with the patients whom cannot collaborate. For example, pain in infants and children can be difficult to assess.
TENS device as a supplement to pharmaceutical therapies to improve sleep quality in patients who experience sleep disruption due to nocturnal PDN. This study would provide an extension to current research in the use of a TENS device to manage diabetic neuropathic pain, with the focus on impro... ... middle of paper ... ...ic field use in patients with diabetic neuropathy: Systematic review and meta-analysis. Brazilian Journal of Physical Therapy, 2, 93-104. Retrieved from http://dx.doi.org/10
establishes a certain amount of time a patient is able to sleep and increases that time by 15-20 minutes every week until preferred sleep duration is met (Saddichha, 2010). Relaxation therapies, such as progressive muscle relaxation, biofeedback, imagery training, thought stopping, and other therapies like abdominal breathing and meditating, are used to reduce heightened arousal in patients (Saddichha, 2010). Cognitive therapy works to eliminate deceiving perceptions patients have about sleep and encourages
the nursing staff, at the same time also care for a limited number of patients. They are responsible for evaluating other nurses and acting as an educational resource and as well as accountable for maintaining a high level of patient care. Charge nurses are often experienced registered nurses who not only display leadership, communication skills and management but also are responsible for providing administrative support and patient care. Some of the daily routine responsibilities and actions of the
these proposed changes. The effectiveness of these changes carried out, measurement strategies, costs, and satisfaction with the EMR system implementations are points of analysis in this presentation. This organization in Miami, Florida conducts research to the biotech industry. The upcoming clinical pharmacological testing in a patient with diseases accelerates the needed of the EMR system in this research facility. Some financial issues, inadequate technical support, and government requirements are
Int J Neuropsychopharmacology. http://dx.doi.org/10.1017/S1461145711000460. 25 March 2011. 8. Lebow J, Sim LA, Erwin PJ, Murad MH. The effect of atypical antipsychotic medications in individuals with anorexia nervosa: A systematic review and meta-analysis. Internat J Eat Disord 2013;46: 332-39. 9. Halmi KA, Eckert E, LaDu TJ, et al. Anorexia nervosa: treatment efficacy of cyproheptadine and Amitriptyline. Arch Gen Psychiatry. 1986; http://archpsyc.jamanetwork.com/article.aspx?articleid=493740.
commonly treated in primary healthcare settings. About 10% of patients develop chronic pain, which leads to early retirement and high health care costs (Becker et al.,2010 ). In 1998,total U.S. health care expenditures for low back pain were estimated at $90 billion. Low back pain also incurs high indirect costs due to lost productivity (Chou et al.,2011 ). Reducing unnecessary treatments such as imaging and ineffective pharmacological treatments can decrease costs associated with acute low back pain
Defined Concepts from Good & Moore (2010) acute pain management, major concepts are powerful pain medications, pharmacological practices, non-pharmacological practices, assessment of pain and the side effects associated with medications, goal setting and balance between analgesics as well as side effects (McEwen & Wills, 2011). Overview of
dysfunction (Ward, 2008). Organ dysfunction can occur in one or more organs such as the lungs, liver, kidneys and or heart and often results from a lack of... ... middle of paper ... .... (2012). Severe sepsis in pre-hospital emergency care: analysis of incidence, care, and outcome. American Journal of Respiratory and Critical Care Medicine, 186(12), 1264-1271. doi:10.1164/rccm.201204-0713OC Trautmann, M., Scheibe, C., Wellinghausen, N., Holst, O., & Lepper, P. M. (2010). Low endotoxin release