Nursing Case Study on Mr Ferguson

The client has past medical history of Non-ST elevated myocardial infarction, hypercholesterolemia, and hypertension. On admission, the patient is put on medical prescriptions as a way of managing the presenting condition. The medical prescriptions included 300mg Aspirin, 50mg Metoprolol, Rosuvastatin, Morphine Sulphate, Low Molecular Weight Heparin infusion, glycerin Trinitate spray and Fentanyl. The paper seeks to provide a detailed analysis describing the patient presenting problem, the pharmacokinetics of medications, their indications, and nursing management for the patient. Finally, it will cover patient education on drug interactions, long-term drug effects and ways of combating adverse effects of the medications. The reduced supply of nutrients and oxygen to the heart muscles causes progressive damage to the muscles with a manifestation of pain. There is resulting reducing the supply of blood to other body tissues thus resulting in other manifestations such as paleness, diaphoresis and shortness of breath.

The shortness of breath results in the increased partial pressure of oxygen as seen in this case. The interplay between the pathological and physiological changes account to the presenting problem. Pharmacokinetics and Indications of Prescribed Medications Aspirin In pharmacokinetics, absorption of aspirin occurs through the intestines and the stomach via passive diffusion. Administration of aspirin served as prophylaxis for any thromboembolic issues that may worsen the presenting problem. Metoprolol In pharmacokinetics, the absorption of the drug occurs via the gastrointestinal tract through active absorption. The drug is then distrusted throughout the body via body fluids and blood. Metoprolol has a half-life of about 3-4 hours. The drug is then undergoing breakdown in the liver by hepatic enzymes. The major indication of the opioid is the management of chronic pain for instance in the case of myocardial infarction and angina related coronary artery disease.

Rosuvastatin Rosuvastatin is an anti-cholesterol drug that is usually used in the management of cholesterol and lipid issues. Their common preparation is the oral medications. After ingestion, the drug is rapidly absorbed in the stomach and the small intestine. Distribution occurs vial body fluid and fluid compartments. The drug is then distributed to other body organs via body fluids especially the blood plasma. Excretion of heparin occurs in the kidney. The major indication of the drug is prophylaxis for thrombo-embolic complications in heart disease. In the case scenario, the patient has a history of hypercholesterolemia hence probable high levels of cholesterol in the blood. The cholesterol is possible emboli that may block the cardiac vessels worsening the underlying myocardial infarction. In the case scenario, use of both pharmacological and non-pharmacological are important in holistic pain management.

Administering the prescribed painkillers is important. The nurse will assess the pain of the patient, rate the pain and then decide on the best painkiller to give. The nurse can weigh out whether to give Morphine Sulphate or Fentanyl. The decision depends on pain assessment. The success of the therapy depends on effectiveness in the use of medications. Monitoring and reporting complication is a nursing role. For instance, use of Morphine Sulphate cause respiratory depressions. Such side effects of the drugs should be motored and presenting complication be aggressively addressed. The vital signs; blood pressure, pulse, reparations, and PCO2 should be put in close check. The patient should understand the prescriptions in line with the potential effects of the therapy. The understanding of such medication issues will prepare the client psychologically and equip the client with the best approach towards the developing challenges.

In the case of Ferguson, we have several prescriptions of drugs on admission, and this might affect overall therapy. The knowledge about the side effects not only target identification of the long-lasting effects of the prescriptions but only assisting the client to cope with such issues. The knowledge on drug interactions enables him to understand how the various drugs in the prescription list affect the function of the other. The drug commonly causes the elevation in liver enzyme levels. There is need to visit the doctor for routine laboratory checkups to monitor the state of your liver while using the drug. Morphine as part of the prescription has a long-term effect on addiction. This is called opiate addiction. This may occur within a short period that the person is using the drug.

Awareness about this may assist the client to raise complains in case the situation worsens to see whether to substitute the drug with alternatives. When one sees such untoward signs, they should inform their caregivers. Rosuvastatin has no common long-term effects. In drug interactions, Rosuvastatin has documented drug interaction with blood thinners such as aspirin. There is need to adjust the doses of the drug to ensure that the therapeutic effect of Aspirin will not be affected. The adverse effects may be serious to the extent that may lead to death. Clinical considerations and decision-making are important in preventing or addressing the adverse effects of the prescribed medication (Aronson, 2015). One important step is an assessment of the integrity of the vital organs.

In the case scenario, the integrity of the vital organs is a major clinical consideration especially in the case of a 76-year old client like Ferguson. This age-related clinical consideration can prevent dose-related adverse effects of the drugs. The caregiver should monitor the progress of therapy with interest on any adverse effects of the drugs. Knowledge about drug interactions is important in making the clinical decision for therapy. This is the basis for clinical consideration in combating adverse effects of drugs. Educating the patient on long-term effects and drug interactions will promote self-awareness of the patient about his therapy. References Aronson, J. Burger et al. Clinical management of drug-drug interactions in therapy. Challenges and Solutions, Journal of Hepatology, 58 (4), 792-800. Guthrie, B.