You are working on a medical ward and are a new registered nurse to this area. You are required to administer medication to one of the patients assigned to you (which represent one of the supplied case studies below). You are unsure of how to give this medication and seek out the unit’s protocol or policy for help but are unable to find one for this medication. You approach the Nurse Unit Manager who suggests you develop a drug protocol for this medication to be utilised on the ward which takes in consideration the patient when discharged. Instructions: 1. You are to choose ONE of the following case studies below to write for your assignment. 2. The assignment consists of 2 parts (see point 3. for further information below). Introduction Part A: Development of a drug protocol utilising the supplied template. Part B: Justification and Critical Discussion. Conclusion 3. You are required to download the Template (which will form Part A of your assignment) supplied in a word document format which will allow you to directly add-in the information to each section. Any information supplied in italics on this template is to be deleted and replaced with your information. No section of this template is to be left blank. Information supplied needs to be referenced using APA format. If no information is available then ‘N/A’ (indicating ‘not applicable’) is to be used. Information supplied needs to be referenced using APA format. A minimum of 10 up-to-date references used including 5 up-to-date journal articles as well as relevant books and web sites. 4. Do not submit or convert the template to a PDF. The completed template (Part A), along with your discussion (Part B), is to be submitted as a word document. Part A: Development of Drug Protocol Your task for this part of this assignment is to utilise the template supplied (which contains all the headings directing the information required and develop a drug protocol that is specific for the illness or disease stated in your chosen case study. You are to only choose 1 (ONE) case study. This means that if you choose: Case study 1: You need to develop a drug protocol for the administration of trimethoprim for treatment of urinary tract infections. Case study 2: You need to develop a drug protocol for the administration of salbutamol for treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD). Case study 3: You need to develop a drug protocol for the administration of paracetamol for treatment of a fever in children (1 to 12 years). Part B: Justification and Critical discussion (1200 words MAX) NB: This section needs to adhere to an Academic essay format and therefore requires an introduction and conclusion. References are required to be in APA format. Instructions: For the first part of this section, you are required to justify and critically discuss why this medication has been prescribed for treatment of your disease/illness in the case study you have chosen. This means if you choose Case study 1, you need to discuss why administration of Trimethoprim is appropriate in the treatment of urinary tract infections (UTIs). For example you need to critically examine literature and/or evidence available that supports the administration of trimethoprim for treatment of UTIs? What are the main causes of UTI that would suggest trimethoprim would be appropriate? You may also want to discuss whether guidelines exist and if they are appropriate in supporting current literature. Suggested word length for this section: 500-600words. Additionally, you are also required to critically discuss how applicable this protocol is in administration of this medication to your patient. As you are aware protocols need to fit with the patient. Therefore, you need to justify and discuss how this protocol is or is not applicable to your patient. You need to consider the individual, and specific cultural and teaching aspects e.g. the section of your drug protocol titled ‘Patient Advice & Education’ may guide your discussion for this section: e.g. in this section you may have included a pamphlet, it so then you need to discuss whether or not this pamphlet would be appropriate, taking into account the patient’s culture or background. Is it educationally appropriate for the age of the patient? What additional interventions would you need to consider? In your discussion as well you may need to consider the laboratory testing and or other medications prescribed that may be supplied in your case study. These are only suggestions and are to be used as a guide as each case study will have its own characteristics. Suggested word length for this section: 500-600 words. Total word count for both sections of Part B = 1000 – 1200 words. Please review the exemplar supplied. Case Studies The following case studies are fiction in name and any personal information. Any relevance to any person or place is merely co-incidental. Your requirement for this assignment is to choose ONE case study below. Case study 1: Drug Protocol for administering trimethoprim for treatment UTI Gladys Mayweather is a 50 year old Aboriginal woman who has been admitted to the unit due to a urinary tract infection (UTI). Gladys has been diagnosed with diabetes 10 years ago and had poorly controlled blood sugar levels for most of this time. She has been admitted to hospital as she is finding it even more difficult to control her blood sugar levels with this infection. Gladys comes from her home which is the small town of Katherine about 440klms from the nearest major hospital where she lives with her extended Aboriginal family including her husband. Her doctor has commenced the antibiotic Trimethoprim, ordered regular monitoring of blood sugar levels, and to collect a midstream specimen of urine (MSU). The most recent set of observations: T. 37.5, BP 145/90, P 82, BSL 15mmols. Gladys weighs 85 kgs. Previous medical history includes Type 2 diabetes mellitus, hypertension, and hyperlipidemia. She has an allergy to sulphur and if taken, she develops a red itchy rash. Medications prescribed on admission include: – Trimethoprim 300mg once daily. – Metformin 1 g, TDS – Atorvastatin 40 mg daily – Ramipril 2.5mg once daily – Paracetamol 1 g, 4-6hrly PRN Laboratory Tests Serum creatinine previously stable at 0.15 mmol /L (normal range 0.05 – 0.1 mmoL /L). On admission: – Serum creatinine 0.23 mmol /L. – Creatinine clearance has decreased from 52 mL/min to 35 mL/min. – Sodium 140 mmoL /L (135 -145), – Potassium 4.1 mmoL /L (3.2 – 4.5). Case Study 2: Drug Protocol for administering salbutamol for management of Chronic Obstructive Pulmonary Disease (COPD) Mr Wei LiJun is a 70 year old Chinese man who speaks little to no English. He has been admitted to the medical ward after presenting to the emergency department with exacerbation of his COPD. Mr Wei weighs 48kgs and is 158cms tall. This gives him a BMI of 19.Mr Wei is accompanied by several family members including his elderly wife and his daughter who are always in attendance. His daughter Lilly speaks for Mr Wei in all communications with the staff and translates basic information for him including his menu choices and assisting with ADL’s. Mr Wei is a heavy smoker and has been since the age of 13.The acute exacerbation of his COPD has passed and Mr Wei is being prepared for discharge in the next couple of days. The doctor has charted Mr Wei for 2 puffs every four hours of salbutamol (Ventolin) inhaler PRN. He is for regular 4th hrly observations. All other medications are listed below. Mr Wei has had a sputum sample sent to pathology and has been charted a broad spectrum antibiotic as well. Mr Wei has had bloods attended and his results unremarkable. Past medical history is unremarkable other than COPD and some mild hypertension directly related to his disease. Medications on admission: – metoprolol 50mgs daily – Augmentin duo forte 875/125 amoxycillin and potassium clavulanic acid, 1 tablet daily – salbutamol (Ventolin) inhaler 2 puffs 4hrly PRN – ipratropium (Atrovent) inhaler 2 puffs BD Case Study 3: Drug Protocol for administering paracetamol for treatment of a fever in children You are caring for a 5 year old boy with Down syndrome (trisomy 21) by the name of Robert Small. He lives with his parents and one older sibling, a sister who is 8 years old. As a result of his Down syndrome, Robert has a congenital heart defect, and has difficulty with speaking clearly, but is able to understand most things for his age despite his learning and intellectual difficulties. He presented to the emergency department with a fever 38.5 which comes and goes, for the past 2 – 3 weeks. All other observations are within normal limits for Robert. On presentation Robert was quite lethargic, irritable, and reluctant with food but tolerating small amounts of fluid. His source of his fever is unknown despite several visits to both his local general practitioner and paediatrician previously. His mother is quite anxious and asking lots of questions when Robert is admitted to the ward. Robert weighs 20 kgs. He is on no other medications currently except for the Paracetamol PRN prior to admission to the ward. The Doctor has prescribed 300mg paracetamol 4-6hrly PRN (as required) for the fever and regular 4 (four) hourly observations. He has also been prescribed an antibiotic but this is to be given after urine for culture (MSU), blood tests: FBC (Full blood count), and blood cultures have been collected.
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