Pharmacology Reasoning Case Study; Susan Jones, 42-year-old female

Susan Jones, 42-year-old female

Medication Categories Concepts

Antihypertensives Perfusion

NCLEX Client Need Categories Percentage of Items from

Each

Category/Subcategory

Covered in

Case Study

Safe and Effective Care Environment

• Management of Care 17-23% ✓

• Safety and Infection Control 9-15%

Health Promotion and Maintenance 6-12% ✓

Psychosocial Integrity 6-12%

Physiological Integrity

• Basic Care and Comfort 6-12%

• Pharmacological and Parenteral Therapies 12-18% ✓

• Reduction of Risk Potential 9-15% ✓

• Physiological Adaptation 11-17% ✓

I. Initial Presentation:

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Susan Jones is a 42-year-old African-American female with a past medical history of diabetes mellitus type II.

She works in a manufacturing plant in her hometown. While at work, she feels faint and has to sit down. The

occupational nurse is contacted to assess her.

Susan Jones is married and a mother of two elementary age children. She has been employed in her current

position for two years.

1. What data from the present problem are RELEVANT and must be NOTICED as clinically significant by the

nurse? (NCSBN: Step 1 Recognize cues/NCLEX Reduction of Risk Potential)

RELEVANT Data from Present Problem: Clinical Significance:

Past history of DM II

Feels faint, dizzy, and has to sit down

Might be suffering hypoglycemia

The patient could be dehydrated, or could be related to her DM.

Need to assess the client for further investigation of CV system.

As the nurse responsible for this patient, you promptly review the medical history

and note that she has NKDA. This is her PMH and current home medications

documented in the employee’s medical record:

1. What is the RELATIONSHIP of the past medical history and current medications? Why is your

patient receiving these medications? (Which medication treats which condition? Draw lines to connect)

Medical History (PMH): Home Medications:

Hypertension

GERD

Type II diabetes mellitus

ASA 81 mg PO daily HTN

Lisinopril 40 mg PO daily HTN

HCTZ 25 mg PO am HTN

Metformin 875 mg PO BID DM II

Omeprazole 20 mg PO daily GERD

Applying your knowledge of pharmacology, to provide safe patient

care, answer the following essential information:

2. List each home medication from the scenario and answer the following: (NCLEX Pharmacologic and

Parenteral Therapies)

Home

Medication:

Pharm. Class: Indication(s): Mechanism

of Action In

OWN

WORDS:

Body

System

Impacted

Common

Side Effects

Nursing

Assessments:

ASA 81mg NSAID

Antipyretic

salicylate

Anticoagulant/bloo

d thinner

Decreases the chance

of occlusion in blood

vessels by platelet

aggregation

CV Bleeding,

hemorrhage,

nausea,

bruising

Watch for

hypersensitivity

reactions.

Assess for

salicylate

Lisinopril 40

mg

ACE inhibitor HTN Prevents conversion

of angiotensin I to

angiotensin II

Renal Hypotension,

dizziness

Monitor B/P

frequently,

I&O, weights

HCTZ 25 Thiazide diuretic HTN A loop diuretic that CV, renal Electrolyte Monitor B/P

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