What is the response to the parent’s request? What’s your rationale?
One thing that is important to realize is that febrile diseases pose a lot of challenge to the physician. This means that it is difficult for the physician to be able to address the root cause of the health complication unless there is a thorough evaluation. However, it is essential to know that most of the febrile related complications are brought about by infection resulting of virus. Therefore, the first important thing that any clinical practitioner needs to at this stage is to identify whether the patient is under low or high risk of contracting bacterial infection (Barnes, 2003, p.63). The cause of the health situation can be identified by carrying out physical evaluations. Since the patient does not have a previous history of cough complications and has been fully immunized, it is important to do an X-ray to be able to see the condition of his or her lateral neck region. This X-ray is important because one is able to width of the area. Narrowness might indicate the risk or the presence of epiglottitis disease. However, it is important that one confirms that the immunization process was adequately followed. This is because parents may at times claim that the patient has been fully immunized while this is not the case. Medical records and not word of mouth is important such as to minimize the chance of error in the treatment process. In case the cause of the condition is caused by bacteria infection like Meningitis, medical treatment should commence immediately.
What pharmaceutical agents would you treat with, if at all? What dose would you recommend?
I would not recommend the use of pharmaceutical agents at all. One of thing that I could do would be the conducting a urinary culture, a chest radiography, and a blood culture. It is essential to understand that many parents would want their children to treat in a way that they endure the smallest of pain. I would therefore try to avoid the blood culture unless there is an imminent risk that the amount of WBC within the patient system is low. For the dosage I would administer an antibiotic like Ceftriaxone so as contain bacteria action in the patient’s system. I would also recommend follow up clinic sessions so as to reduce the risk of the patient contracting serious bacterial infections.
What do the evidence-based guidelines say about management? How will you incorporate these guidelines into the management of this patience?
Edmund and Mayhew write that some of the key guidelines in the management of patient include the idea that the physician has to understand the patient’s health status (Edmunds & Mayhew, 2009, p.3). First of all, I have to be certain that the patient that I am dealing with has undergone all the necessary immunization processes so as to minimize the risk of contracting serious infections. In this case, it is important to get clarification from the parents of the patients that all the clinical sessions that were requires so that the patient could successfully complete immunization sessions were met. The second important guideline that would work in this case scenario is identifying any abnormal conditions of the patient which could be used as being the hint to the cause of a give health complication.
This could include high fever. The third important guideline in determining the real cause of a given condition which is achieved through the administration of a series of tests so as to determine whether the patient is under low or how risk of contracting serious bacterial infections.
What is your response to the patient’s request? What is your rationale?
One of the things to realize in this case is that the pregnancy is just 10 weeks. However, this does not mean that the patient does not face the malformation of the fetus or the risk of losing the infant once it’s born. Therefore, the response to this patient would be to recommend another form of treatment other that codeine. This is because complications during pregnancy might arise even in the early days of pregnancy (White, 2005, p.37). It is therefore not worthwhile to risk based on the mere fact that the pregnancy is at a preliminary stage.
What pharmaceutical agents would you treat with, if at all? If you choose to treat with a prescription, please include the Rx, Sig, and dispensed amount, as well as how many refills you would offer.
It is essential to realize that though some people might argue that some drugs are okay to take during pregnancy, the fact remain that there is no cough medicine that is safe to take during pregnancy(Skolnik, 2012, p.41).If possible, it is worthy avoiding taking medicines during pregnancy so as to protect the growing fetus. However, because the patient in this case insists on taking a drug for the dry cough that she is experiencing. In this case I would prescribe benzocaine. This is because this drug does into get deep into the blood system meaning that it does not put pregnant women in the risk of losing her pregnancy.
Rx
Benzocaine – 4%
Hydrocortisone 3.5%
Aquaphor qs ad 40 g
Ft & M. ointment
Sig: Apply the medicine as required
Refill (1). Signature..
If this patient had a history of drug-seeking behavior, how would it impact your decision today?
If the patient requesting codeine has had a history of seeking drugs, it is the high time that the patient minimizes the level of drug consumption bearing in mind that at this time the patient is pregnant. It is also important to know from the patient whether they are allergic to certain drugs so as to understand the best drug that can be used to treat the dry cough that is facing this patient.
What do the evidence-based guidelines say about management? How will you incorporate these guidelines into your management of this patient?
Evidence based guidelines say that is through evidence that one is able to determine some of the unhealthy lifestyles that a given patient lives in. In this case, if the patient has a history of drug seeking it is important to explain to the patient some of the impacts of the compounds that are found in some drugs to the body system so as to help the patient decide whether there are going to continue with the drug seeking behavior or vice versa.
Response to patient? If the patient is 5, 35, 65 years, or pregnant?
Vitamins are okay to take. Vitamin supplements can be taken at any age because they boost body health in many cases. However, the amount and type of drug is dependent on the body condition and the age of the patient. For 5 years and 65 year-olds vitamins rich in Vitamin C is more necessary because the antibodies begin to weaker at 65 while antibodies are still in the growth process at 5-years old.
What pharmaceuticals would you recommend?
For a 5 year old, I would highly recommend Vitamin C because it helps reduce incidences of cold which is among the illnesses that face many children at this age (Lacher, 2007, p.23). A 5 year old would require about 30 mg of Vitamin C in 24 hours. One of the vitamins that I would recommend is riboflavin. I would recommend Pantothenic acid for 35 and 65 years old. They should take about 165mg in a day. Pantothenic acid can also be taken by pregnant women because it has low risk.
What do evidence-based guidelines say about management? How is it incorporated in this case?
One thing that is important when administering vitamins is that the clinical practitioner has to assess the health status of the patient. This helps the practitioner in identifying some of the vitamin supplements are necessary to boost the immune system in a given way. Understanding the patient’s health status allows minimizes system reactions that might be experienced for instance pregnancy complications.
References
Barnes, K. (2003). Pediatrics: a clinical guide for nurse practitioners. New
York: Elsevier Limited.
Edmunds, M. W., & Mayhew, M. S. (2009). Pharmacology for the Primary Care
Provider. St Louis, Missouri: Mosby Elsevier Inc.
Lacher, B. E. (2007). Pharmaceutical calculations for the pharmacy technician.
Baltimore, MD: Lippincott Williams & Wilkens Inc.
Skolnik, R. (2012). Global Health. Burlington, MA: Jones & Bartlett Learning.
White, L. (2005). Foundations of Nursing. London, UK: Thomson Delmar Learning.
