Drug Therapy

Case Scenario

Jolene is a 33-year-old woman living with her husband on a cattle farm in Dalby. She presents to the Dalby emergency department complaining of a racing heart, palpitations, shortness of breath and a headache. On examination Jolene has Tachycardia, Tachypnoea, Angina, Hypertension, anxiety and tremor.

Questions

1. Explain these terms and provide examples of what observation data could be charted to represent these signs and symptoms  You are the emergency nurse.

2. What immediate action would you take to assess and monitor these signs and symptoms?  Jolene’s medical record discloses that she has had several earlier admission’s for asthma since she was an adolescent.

3. Explain the pathophysiology of Asthma Jolene advises you that she usually takes Ventolin, Serevent and Atrovent.

4. Provide the generic details of these medications and explain their indication and action On examination the other signs and symptoms that Jolene exhibits are excessive weight loss over the past 3 months, occasional unexplained diarrhoea, thinning hair and brittle nails. You also notice a small goitre. The provisional diagnosis from the emergency physician is Graves’ disease. Once stabilised, Jolene is discharged to her GP for further treatment. A referral to an Endocrinologist is completed.

5. What is Graves’ disease?

6. Describe antithyroid drug treatment for Graves’ disease The Endocrinologist prescribed an antithyroid medication regimen and included Beta-Blockers.

7. Explain the rationale for this combination of drug therapy and discuss the interactions with the bronchodilators already used. You are now the nurse at the GP clinic and Jolene discusses with you that she and her husband, Jack, want to have a baby.

8. How would you respond to Jolene? What advice would you give her about her existing condition and drug therapy related to pregnancy? Write your response as if you were speaking to Jolene. That is in clinical conversation language instead of academic language. Consider your professional codes and standards when writing your response (200 words).