Module 5/6 -

Due No Due Date
Points 100
Submitting a file upload

Choose one of the two case studies listed below

Case study choice #1

Read the assigned chapters in your text. Complete the case study below and submit via this assignment tool. Your final write up should be submitted as single document, submitted as a “Word” or “PDF” document. The submission is limited to 6 pages (title page, no more than 4 pages body of paper, and a reference page). Remember brevity is the key…Clear & Concise. The grading rubric for this assignment is attached to this assignment. It should be noted that use of APA style is expected. If you are not familiar with APA style, refer to a reference (APA manual or web-based source such as Purdue OWL Links to an external site.). Remember that according to APA style every source cited in text must appear on the reference list and vice versa; so, no more listing in one place but not the other. There is a specific APA title page and reference list… use them to ensure that these points are not lost.

Generally speaking use of headings is a really good idea. If I may suggest the following for a template when completing case study assignments in this course: INTRODUCTION: this section will include the analysis of the case presented to you (remember you’ve been given the diagnosis, you just have to figure out what’s likely going on at this point of contact and layout a reasonable plan—supported by evidence of course); next use the rubric for a guide to minor headings: Pharmacokinetics/Pharmacodynamics…. Dosing/Cost/Other Economic Considerations… Follow up/Evaluation Plan. This is just a suggestion based on how my brain works but hopefully you get the idea. Using a process similar to this helps ensure content coverage and aids in clear and concise presentation of thought.

Assignment Instructions

Case Study: Patient is 75 year old retired male who presents to the ER accompanied by his daughter. He has been experiencing dyspnea upon exertion for over 1 month. He denies any chest pain. He quit smoking 25 years ago. He has not been to his doctor in over 1 year because he has been “feeling good until now.” His appetite has been fair.

Assessment Data:

Physical examination

Vital signs: BP 158/72; HR 120 irregular; RR 24; T 98.7 Weight: 225lbs.

General-well groomed, tired appearing, dyspnea with conversation

HEENT: normal

CV: irregular rhythm, grade 1/6 systolic murmur,

Lungs: clear in upper lobes, crackles in bilateral bases

Abdomen: +BS, soft and non-tender

Neuro: alert and oriented, speech clear

Extremities: 2+ pitting edema; peripheral pulses intact

Laboratory Data

CMP, TSH, UA, all normal

12-lead EKG: atrial fibrillation

None fasting cholesterol: 220

Echocardiogram: EF 40% and LVH

CXR: pulmonary congestion; no infiltrate

BNP: elevated at 550

Family Hx: Mother died of breast cancer; Father died of stroke

Past Medical Hx: elevated blood sugar, BPH, seasonal allergies, HTN

Allergies: NKDA

Current Medications: Tylenol prn, Multivitamin, Claritin prn

Patient admitted to cardiology

Diagnosis CHF and new onset atrial fibrillation

No pediatric option if you choose this study

Using this information respond to the following:

What pharmacological agent(s) will you prescribe for this patient?

Be specific if outlining your prescription. Don’t select a class of medication and provide a laundry list of possible selections but rather pick a medication. Provide the rational for the chosen agents.

Discuss the pharmacokinetics & pharmacodynamics of this/these drug(s)

Discuss absorption, distribution, metabolism and excretion of the drug (Include detail regarding the half-life and binding sites)

What is the correct dosage and frequency for this patient?

Discuss dosing, cost and other economic issues

Discuss non-pharmacological therapies will you include in your plan of treatment?

Discuss how you will follow-up with this patient?

Rubric

The grading rubric for this assignment is attached.

Content Coverage is worth 80% and includes pharmacodynamics (selected agents clearly identified, appropriate, EB rational provided) and pharmakinetics (absorption, distribution, metabolism, excretion); dosing, cost & other economic issues identified; non-pharmacological therapies discussed; follow-up/evaluation plan discussed.
Scholarliness is worth 20% and includes APA style; spelling & grammar.

Case study choice #2

Read the assigned chapters in your text. Complete the case study below and submit via this assignment tool. Your final write up should be submitted as single document, submitted as a “Word” or “PDF” document. The submission is limited to 6 pages (title page, no more than 4 pages body of paper, and a reference page). Remember brevity is the key…Clear & Concise. The grading rubric for this assignment is attached to this assignment. It should be noted that use of APA style is expected. If you are not familiar with APA style, refer to a reference (APA manual or web-based source such as Purdue OWL (Links to an external site.)). Remember that according to APA style every source cited in text must appear on the reference list and vice versa; so, no more listing in one place but not the other. There is a specific APA title page and reference list… use them to ensure that these points are not lost.

Assignment Instructions

Case Study: A 68 year old female presents to your clinic. She presents today for evaluation of a productive cough of yellow mucous for 2 weeks. She is short of breath and is wheezing. She is a smoker but has been “cutting back.” She does have some nasal congestion, postnasal drainage, but no sore throat. She denies chest pain. Her weight is stable. Her appetite has been poor. She denies nausea, vomiting, or change in bowel habits.

Assessment Data:

Physical examination

Vital signs: BP 148/70, HR 88 regular, RR 24, T 99.5 weight 135lbs

General: ill looking female slightly dyspneic

Skin: pink, warm, and dry

HEENT: bilateral ear canals clear, TMs clear, no cervical lymphadenopathy, throat red, no exudate, nasal mucosa slightly hyperinflated, diffuse wheezing throughout; crackles in left base

CV: regular rate and rhythm, normal S1 and S2

Abdomen: +bs, soft, non-tender

Extremities: no edema; no clubbing, cap refill sluggish

Extremities: 2+ pitting edema; peripheral pulses intact

Laboratory & Imaging Data

CBC with diff: normal,

BMP: normal,

CXR: LLL infiltrate

Family Hx: mother deceased, colon cancer; father deceased

Past Medical Hx: seasonal allergies, COPD, colon polyps, IBS, anxiety, GERD