Choose ONE of the following scenarios to discuss in paragraph form with no fewer than six sentences.
Scenario 1
D.K was given alteplase in the emergency department while suffering from an acute myocardial infarction.
D.K inquiries about why this drug was given. Explain why alteplase is given and how it works? (USLO 5.2, 5.3, 5.4)
Explain some of the main concerns with the administration of thrombolytics. (USLO 5.3, 5.5, 5.6, 5.8)
Explain the differences between the mechanism of action of alteplase, aspirin and clopidogrel. What are the indications of aspirin and clopidogrel? (USLO 5.3, 5.4)
Scenario 2
T.M, a 57-year-old man, has thrombophlebitis in the right lower leg. IV heparin, 5000 units by bolus, was given. Following the IV bolus, heparin 5000 units given subQ q6h was prescribed. Other therapeutic means to decrease pain and alleviate swelling and redness were also prescribed.
How does heparin work and why was it prescribed? (USLO 5.2, 5.3, 5.4)
What laboratory test(s) would be monitored for patients taking heparin? Explain your answer. (USLO 5.3, 5.6, 5.8)
Explain the differences between heparin and enoxaparin. Are there advantages to either of these anticoagulants? (USLO 5.1, 5.2, 5.3, 5.4)
Scenario 3
After 5 days of heparin therapy, T.M was prescribed warfarin 5 mg PO daily.
Why was T.M changed to warfarin? What is the pharmacologic action of warfarin? (USLO 5.2, 5.3, 5.4)
What laboratory test(s) would be monitored for patients taking warfarin? Explain your answer. (USLO 5.3, 5.6, 5.8)
Explain the half-life and protein-binding of warfarin. What additional concerns do you have? How does this knowledge impact teaching for patient’s taking warfarin? Explain. (USLO 5.2, 5.3, 5.6, 5.8)
What assessments should be performed before starting anticoagulant therapy? (USLO 5.3, 5.8)
Scenario 4
J.F, a 47 year old male is being treated with digoxin for congestive heart failure. Before administration of the next dose, the nurse notes an apical pulse of 55 beats per minute. J.F complains of nausea and vision changes.
J.F asks how digoxin can help his condition. How does the nurse respond? (USLO 5.2, 5.3, 5.4)
How does right- and left-sided heart failure present differently? (USLO 5.1)
Should the next dose of digoxin be administered? Why or why not? (USLO 5.3, 5.6, 5.8)
What are the complaints of J.F likely a result of and how is this rectified? (USLO 5.6, 5.8)
Scenario 5
D.K, a 72-year-old man, had a myocardial infarction (MI) 5 years ago. He has been diagnosed with classic (stable) angina. D.K is prescribed a beta blocker. His baseline vital signs are blood pressure 108/58; pulse 56 (at times irregular); and respirations 28. His past medical history includes asthma.
How do beta blockers work to manage angina? (USLO 5.3)
What assessments should be made while D.K is taking a beta blocker? (USLO 5.3, 5.6, 5.8)
Select 3 other antidysrhythmics prototypes and explain how each works. (USLO 5.2, 5.3, 5.4)
16 hours ago