Example Of Essay On Medical Procedures On A Patient

1. COPD: COPD exacerbation (in-patient): Administer Duoneb (albuterol/ipratropium) q6H once the patient is stable to prn, prednisone 40mg qd x 5days, abx (IV levo). Similarly, once the stable switch to po. Closely monitor the patient for any side effects of fever. Follow up the patient in 7-10days to assess infection.
Discharge: when discharging the patient, give her Tiotropium / Olodaterol 2.5 – 2.5 mcg to be taken once daily while at home. Also give the patient to carry home 90 mcg albuterol rescue inhaler, to take 1-2 puffs every 4-6 hours prn
2. Chronic COPD: Continue giving the patient Tiotropium / Olodaterol 2.5 – 2.5 mcg once daily. Make the patient aware that it might take up to 1 week to take effect and to rinse mouth after each use. While rinsing the mouth, advise patient not to swallow rinse but spit it out. For the sake of first time users, educate the patient on how to properly use the inhaler as well as on the importance of adhering to the medication regimen also, advise the patient to continue with the treatment even if she feels fine. Counsel the patient on side effects of the treatment such as a headache and dizziness. Continue administering albuterol 90 mcg 1-2 puffs po q 4-6 hours prn. Also teach the patient on proper inhaler technique and create an asthma action plan, besides, counsel the patient on the side effects such as jitteriness and tremor. Monitor FEV1, peak flow, asthma symptoms, BP, HR, increased use of albuterol inhaler. Follow up in 2 weeks.
3. Continue to orally administer atenolol 50mg by PO daily for rhythm control. Take the patient through the importance of keeping a consistent diet with foods that contain Vitamin K. Monitor the patient for instances of INR, increased risk of bleed, bruising, possible signs and symptoms of orthostatic hypotension and hypoglycemia. In the case of bleeding, consider holding one dose Warfarin 7.5mg po once per day to prevent clots and bleeding risks. Follow up in 3 to 5 days to check if in INR goal is in range of 2-3
4. Hyperlipidemia: Increase the atorvastatin dose from 20mg PO every evening to 40mg po every evening. Insist to the patient the significance of looking for signs and symptoms of increased muscle weakness and myalgia. Once again, carry out the recommendation associated with hypertension for lifestyle modifications. Monitor the patient’s LDL, HDL, total cholesterol, and triglycerides. Follow up in 2 weeks if there is no any myopathy present.

5. Hypertension: Give D /c atenolol 25 mg every day patients showing symptoms of fatigue and taking statin therapy. Also administer hydrochlorothiazide 12.5 mg daily. Thereafter, it is prudent to advise the patient on some common S/Sx such as orthostatic hypotension. Also encourage the patient to rise from sitting position or bed slowly so as not to initiate dizziness or fainting. Further educate the patient on S/Sx hyperglycemia such as high blood glucose and increased thirst. Encourage the patient to report difficulties with glycemic control to PCP. Patient should also be advised to take HTCZ when she wakes up as it helps avoid excessive urination during the night. Most patients require that they are suggested to and provided with DASH diet and meal options. Again, closely observe BP, BUN and electrolyte levels. Request the patient to return to clinic in 7-10 days to check BP, BUN and electrolytes.
6. Osteoarthritis: Carry on with the current regimen. Additionally, advise the patient to avoid taking more than 6 tablets within a period of 24 hrs. Similarly, counsel the patient on other non-prescription curative drugs that may contain acetaminophens such as cold medicines and pain medicines not exceeding 4 g in a day. Closely examine the patient for pain management and follow-up in 7-10 days.
7. GERD: Continue administering famotidine 20mg orally every night at bedtime. Also discuss with the patient some of the probable side effects such as constipation, diarrhea, and dizziness. Advise and insist that the patient to refrains from eating 2-3 hours prior to sleeping so as to prevent incidences of heartburn. In the event that chest pains persist even after a change in eating habits, advise the patient to immediately seek medical attention. Follow up in 3 weeks to reassess chest pain for a possible improvement.
8. Adherence: it is advisable to make the patient aware that failure to have come would have been fatal as either her COPD or hypertension or even both would have been missed. Further insist on the significance of attending all follow-up appointments and annual examinations. Also, advise the patient to contact PCP in the event that some of the certain discussed S/Sx re-occur persist or get worse.