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    Nursing case study with general knowledge medications/pharmacy

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    This is a discussion question for this Thursday. I thought that high blood pressure medication was acceptable if your NPO but still needed consent from the anesthesiologist or physician? Is there a protocol to remembering which is acceptable to give and which isn't? Your answer may be brief or extensive. I'm just trying to gain a better understanding of pharmacology. This discussion was given prior to class even starting, so I'm not sure how I would know this. If you can help that would be great. Thanks!

    Adult Case Study

    Mrs. Tell is scheduled for an open cholecystectomy for symptomatic gallstones. She has a history of Obesity, Hypertension, Coronary Artery Disease, and Diabetes Type 2. She is scheduled for surgery today at 10:00 AM and you are her primary nurse. Mrs. Tell was NPO after midnight last night and it is now 6:00 AM on the day of her surgery.

    Below is her MAR:

    Colace 100mg po BID 0900
    2100

    Lopressor 50mg po BID 0600
    1800

    Lipitor 10mg po every PM 2200

    Insulin Humulin NPH 0700
    10 units SQ every AM

    Heparin 5,000 units SQ BID 0900
    2100

    1. Prior to Mrs. Tell's 10am surgery, which medications will you administer and which medications would you anticipate holding? Please give the rationale for your answer.

    2. After reviewing the MAR, identify the nursing assessments required prior to the administration of each medication. Discuss why these assessments are necessary.

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    Solution Preview

    Hi,

    I have given detailed information below based on the problem above. References are stated below. I have also attached a MS word document of the text below.

    Cholecystectomy is a surgical removal of gall bladder for patients experiencing extreme pain due to gall stones blocking the flow of bile. Small incisions are made in the abdomen of the patients from where surgical tools, which also include a camera, is inserted to effectively remove the gall bladder. Patient is kept under general anesthesia during the surgery.

    At least 8 hours prior to anesthesia a patient must be NPO (Nothing by mouth). Since anesthesia uses several drugs a patient can feel nauseated and that might result in vomiting. If there is food in the patient's stomach, the food particles might get aspirated into the lungs or airways causing suffocation, hypoxia and even brain death. To avoid such a situation patients before a major surgery that requires whole body anesthesia are in NPO.

    The Medication Administration Record (MAR) of the above patient, Mrs. Tell, gives us the information about which medication to give before the surgery and those to hold.

    The medicines Colace 100 mg, Lopressor 50 mg and Lipitor 10 mg are all PO i.e. need to be administered by mouth or orally. The other two drugs in the patients MAR are Insulin Humulin NPH 0700 10 units SQ every AM & Heparin 5,000 units SQ BID 0900 2100; SQ means subcutaneously given, hence these last two drugs should be given before the surgery. Below is a detailed explanation of rational behind ...

    Solution Summary

    The material above gives the justification behind using certain drugs to patient. It is a specific specific case study meant for nursing students. The passage also states the general medical administration guidelines that nurses need to follow before giving drugs to patients.

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