Case Study Assignment 1

Case Study Assignment

Cherryl Banzon

NURS 363 – 01

Johanne Hayes

October 28, 2010

 Case Study Assignment 2

A. Medical History

Initials: Mrs. R

Sex: Female

Age: 72 years old

Allergies: Penicillin, Quine, Adalat

Code Status: CPR

Mrs. R was presented to Toronto Western Hospital on September 9, 2010 complaining of

a two week history of fatigue and weakness. She was diagnosed with right lower lobe

pneumonia aw as rapid atrial fibrillation. Previous to her admission, she had been seen at

York Central Hospital with rapid atrial fibrillation and started on Dronedarone by a

cardiologists and had reported feeling very unsteady on her feet since that time. While in

Toronto General Hospital, she was treated for Right Lower Lobe Pneumonia and sepsis

as well put on Sotalol for her rapid atrial fibrillation and the Dronedarone was

discontinued. Mrs. R experienced one fall which was mechanical in nature. She was

consulted on by Neurology and an MRI was performed, which revealed moderate

microangiopathic change and posterior inferotemporal/cerebellar atrophy. Mrs. R goals

while at Toronto Rehab Institute are to be able to walk unassisted, improve coordination,

and prevent falls.

Past Medical History:

Coronary Artery Disease (CAD)

Type 2 Diabetes Mellitus

Hypertension

Atrial Fibrillation rate controlled

 Case Study Assignment 3

Seizure disorder

Dyslipidemia

Abnormal Gait and mobility

B. Medications

Generic Name Brand Name Classification

ASA Aspirin Antiplatelet
Atorvastatin Lipitor Antilipidemic
Calcium Carbonate Caltrate Antacid
Metformin Glucophage Antidiabetic
Sotalol Sotocar Nonselective beta-blocker
Warfarin Coumadin Anticoagulant
Irbersartan Avapro Antihypertension
Amlodipine Norvasc Calcium channel blocker
Valproic Acid Stavzor Anticonvulsant
Acetaminophen Tylenol Nonopioid Analgesic
Docusate Na Colace Laxative
Ferrous Fumarate Palafer Hematinic
Dimenhydrinate Travamine Antiemetic
Nitroglycerin Nitrodisc Coronary vasodilator
Sennosides Senokot Laxative-stimulant

Medication: Sotalol (Cardiac Drug)

Drug Action Blockade of beta 1 and beta 2 receptors

Drug Interaction
Therapeutic Effects
Common Side Effects
Side Effects Experienced by the Client
leads to antidysrhythmic effect, prolongs
action potential in myocardial fibers
without affecting conduction, prolongs QT
interval, no effect on QRS duration.
Increase: hypotension – other
hypertensives, nitroglycerin
Absence of life threatening dysrhythmias
CNS: Dizziness, drowsiness, fatigue
CV: Hypotension, bradycardia, chest pain
GI: Nausea, vomiting, diarrhea
INTEG: rash
MS: muscle cramps, pain
The patient feels drowsiness after she takes

the medicine.
Health Teaching
Effectiveness of the Medication
Case Study Assignment 4
• Not to discontinue product abruptly;
taper over 2 week or may precipitate
angina, take exactly as prescribed
(Mosby’s Nursing Drug Reference, 2010,
p. 998)
• To report bradycardia, dizziness,
confusion, depression, fever (Mosby’s
Nursing Drug Reference, 2010, p. 998)
• To take pulse at home, advise when to
notify prescriber (Mosby’s Nursing Drug
Reference, 2010, p. 998)
• To avoid alcohol, smoking, sodium
intake (Mosby’s Nursing Drug Reference,
2010, p. 998)
• Ask your doctor or pharmacist before
using any other medicine, including the
OTC medicines, vitamins, and herbal
products (Alberta Health Services, 2008)
• Lowers the blood pressure from 179/85
to 140/82. Decreases rapid irregular
heartbeat.

Medication: Calcium Carbonate (Gastrointestinal Drug)
Drug Action
Drug Interaction
Therapeutic Effects
Common Side Effects
Side Effects Experienced by the Client
Health Teaching
Effectiveness of the Medication
Case Study Assignment 5
Neutralizes gastric acidity
Administration of calcium carbonate with
aspirin may decrease the serumsalicylate
concentrations in patients.
Absence of pain and decrease acidity
GI: Constipation, upset stomach, vomiting,
stomach pain, belching, dry mouth
Patient experiences dry mouth. Water is
given to relieve patient.
• To increase fluids to 2 L unless
contraindicated, to add bulk to diet
for constipation, notify prescriber of
constipation. (Mosby’s Nursing
Drug Reference, 2010, p. 998)
• Not to switch antacid unless
directed by prescriber, not to use as
antacid for <2 wk without approval
by prescriber. (Mosby’s Nursing
Drug Reference, 2010, p. 998)
• Tell your doctor if you have or have
ever had kidney disease or stomach
conditions. (MedlinePlus Drug
Information, 2010)
• Tell your doctor or pharmacists if
you are allergic to calcium
carbonate or any other drugs.
(MedlinePlus Drug Information,
2010)
• No complains of abdominal pain or
gastric acidity.
 Case Study Assignment 6

References

Anonymous, (2010). Calcium Carbonate: MedlinePlus. Retrieved October 28, 2010 from

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601032.html

Anonymous, (2008). Sotalol (Sotacor): Alberta Health Services. Retrieved October 28,

2010 from

http://www.capitalhealth.ca/EspeciallyFor/HeartSchool/HeartMedications/Sotal

ol.htm

Skidmore-Roth, L. (2010). Mosby’s nursing Drug Reference. St. Louis, MO: Mosby Inc.