Pharmacology Case Study
Case Study: MN 553 Unit 7
July 2, 2013
This is an application of the knowledge from Unit 7 to a case study involving a 60-year-old man who presents to my clinic with complaints of a productive cough and shortness of breath for 2 weeks. The patient has smoked at least one pack of cigarettes a day for the last 45 years. He denies fever or chest pain except with his cough. This paper will include a discussion of the assessment data gathered upon which his treatment and education plans are based. It will include practice guidelines from the literature as evidence for the treatment and education plans. Finally, I will conclude with a summary regarding this case study.
Assessment Date
Here is a 60-year-old man presenting with complaints of a productive cough and shortness of breath for 2 weeks. He has smoked at lease one pack of cigarettes a day for the last 45 years. He denies fever or chest pain except with coughing. He has been using his albuterol inhaler at least 6 times a day. His past medical history includes hypertension and chronic obstructive pulmonary disease (COPD). His lung sounds are coarse to auscultation throughout, and there are audible wheezes. The patient coughs with deep inspiration, and there is mild retracting noted. His blood pressure is 126/80 mmHg, his respiratory rate is 20 per minute, and his heart rate is 80 beats per minute. His oxygen saturation is 91% on room air. Currently, his medications include albuterol HFA and atenolol XL 50mg daily at bedtime.
Findings
In reviewing this client’s medications, I have some concerns. First of all, he is taking the maximum recommended dosage of albuterol HFA. Albuterol HFA is a short-acting beta agonist that is used to relieve bronchoconstriction by relaxing smooth muscle in the respiratory tract (Gutierrez, 2008). The usual dosage of albuterol for adults is two puffs every 4 to 6 hours (DailyMed, 2008). Some patients taking albuterol HFA who exceed the
July 2, 2013
This is an application of the knowledge from Unit 7 to a case study involving a 60-year-old man who presents to my clinic with complaints of a productive cough and shortness of breath for 2 weeks. The patient has smoked at least one pack of cigarettes a day for the last 45 years. He denies fever or chest pain except with his cough. This paper will include a discussion of the assessment data gathered upon which his treatment and education plans are based. It will include practice guidelines from the literature as evidence for the treatment and education plans. Finally, I will conclude with a summary regarding this case study.
Assessment Date
Here is a 60-year-old man presenting with complaints of a productive cough and shortness of breath for 2 weeks. He has smoked at lease one pack of cigarettes a day for the last 45 years. He denies fever or chest pain except with coughing. He has been using his albuterol inhaler at least 6 times a day. His past medical history includes hypertension and chronic obstructive pulmonary disease (COPD). His lung sounds are coarse to auscultation throughout, and there are audible wheezes. The patient coughs with deep inspiration, and there is mild retracting noted. His blood pressure is 126/80 mmHg, his respiratory rate is 20 per minute, and his heart rate is 80 beats per minute. His oxygen saturation is 91% on room air. Currently, his medications include albuterol HFA and atenolol XL 50mg daily at bedtime.
Findings
In reviewing this client’s medications, I have some concerns. First of all, he is taking the maximum recommended dosage of albuterol HFA. Albuterol HFA is a short-acting beta agonist that is used to relieve bronchoconstriction by relaxing smooth muscle in the respiratory tract (Gutierrez, 2008). The usual dosage of albuterol for adults is two puffs every 4 to 6 hours (DailyMed, 2008). Some patients taking albuterol HFA who exceed the
References: American Lung Association (2011). Chronic obstructive pulmonary disease (COPD) fact sheet. Retrieved from http://www.lung.org/lung-disease/copd/resources/facts-figures/COPD-Fact-Sheet.html Booker, R. (2005). Chronic obstructive pulmonary disease and the NICE guideline. Nursing Standard, 19(22), 43. The COPD Foundation (2013). Pulmonary rehabilitation. Retrieved from http://www.copdfoundation.org/What-is-COPD/Living-with-COPD/Pulmonary-Rehabilitation.aspx DailyMed (2008). Proventil® HFA (albuterol sulfate): Inhalation aerosol. Retrieved from http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=9803 Global Initiative for Chronic Obstructive Lung Disease, Inc. (2013. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Retrieved from http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf Gutierrez, K. (2008). Pharmacotherapeutics: Clinical reasoning in primary care (2nd ed.). St. Louis, Missouri: Saunders/Elsevier. MedlinePlus (2013). How to use an inhaler – with spacer. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000042.htm