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2 pages/≈550 words
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Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Essay
Language:
English (U.S.)
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Topic:

Wanda McKay (Homeless) Case Study: The Tuberculosis

Essay Instructions:

Originality needs to be 5% or less to receive a score for this assignment. Also, you must include citations for your responses and a reference list for your citations in APA format.
Scenario: 
Wanda McKay is 36 years old and homeless, although she sleeps in a shelter nightly and has been going to a day program for the past 5 weeks, where she showers, receives her mail, gets some counseling, and has her meals. She is being treated daily for tuberculosis with directly observed therapy (DOT) and has been receiving this treatment for the last 6 months. She had a tubal ligation 5 years ago with no complications and is not currently sexually active. She was last tested for HIV and hepatitis C two months ago and was negative. She has been vaccinated for hepatitis B. She drinks alcohol, but does not use street drugs, and has not been prescribed any psychiatric medications. When she was admitted into the day treatment program, her hospital records were sent indicating that she is sputum culture negative, so she is not a risk to others in close quarters. When her nurse comes to the day program to administer her meds today, she notices that the sclera of her eyes have a yellow tint to them. She is brought into the mobile center and examined by the nurse practitioner. Data obtained from the nursing assessment include the following:
• The patient complains of abdominal pain, nausea
• The patient is tender to palpation of liver
• Lung sounds clear
• Chest x-ray clear
• Vital signs: temperature, 100.2°F; pulse, 88; respirations, 20; blood pressure, 130/80
The patient’s current medications include: isoniazid, 300 mg daily; rifampin, 600 mg daily; and ethambutol, 800 mg daily.
Questions:
1. Why is Wanda on these drugs?
2. Are there any contraindications or precautions that would eliminate the use of these drugs for Wanda?
3. What patient variables are most important to consider for Wanda when assessing her drug therapy?
4. Are there any aspects of core drug knowledge that are especially relevant to consider because they may interact with the core patient variables?
5. Which findings from the nursing assessment demonstrate the effectiveness of drug therapy?
6. Which findings from the nursing assessment demonstrate possible adverse effects from drug therapy?
7. What actions are indicated to maximize therapeutic effects?
8. What actions are indicated to minimize adverse effects?
9. What teaching is required for Wanda regarding her drug therapy? Do you need any additional data to determine appropriate teaching?
PLEASE JUST ANSWER QUESTIONS 1 TO 9 BASED ON THE CASE STUDY SCENARIO. Number the answer to watch with the numbered question’s asked from 1 to 9 include citations for your responses and a reference list for your citations in APA format.

Essay Sample Content Preview:
                Case Study: Tuberculosis By Institution                   Case Study: Tuberculosis
  1. Wanda is on isoniazid, 300 mg daily; rifampin, 600 mg daily; and ethambutol, 800 mg daily because she is in the continuation phase of TB treatment. Normally, this phase is characterized by the production of only two drugs namely; isoniazid and rifampicin but in cases where there in areas where there is a high incidence of isoniazid resistance then ethambutol is added as part of the regimen (Lawn and Zumla 2011).
  2. Some of the contraindications or precautions that would eliminate the use of these drugs for Wanda include kidney failure, severe drug-induced hepatitis or a case of pre-existing liver disease and in multidrug resistance TB (Horsburgh 2014). In this case, the doses should either be adjusted or completely stopped depending on the severity of the condition.
  3. The patient variables that are most important to consider for Wanda when assessing her drug therapy includes her alcohol and substance abuse, lack of social support system, concerns about being HIV-positive (Lawn and Zumla 2011). In the case of alcohol and substance abuse, refer if possible or accept and support. When it comes to lack of social support, one can identify avenues of support including patient or community groups. Concerns about being HIV-positive can be tackled through offering ongoing support and counseling or where appropriate, referring for additional help.
  4. Aspects of core drug knowledge that are especially relevant to consider because they may interact with the core patient variables include the adverse effects of the drugs. For example, the hepatotoxic nature of isoniazid coupled with alcohol intake may bring about hepatitis. Another aspect of core drug knowledge includes dosage. Dosage is influenced by some patient variables including co-infection by diseases like HIV. Also, the resistance that may be brought about due to non-adherence should also be addressed since it relates to a larger degree to lack of social support.
  5. Findi...
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