Instruction: This is an individual piece of work.
Task: NUR231 Drug Therapy Case Study
In your future role as a nurse or midwife, you will be required to interpret and use contemporary drug therapy information and evidence to support patients or the pregnant woman in the quality use of medicines. You will interpret and use evidence to inform evidence-based and responsive practice when managing a medication regime. In this task, you will provide a response to the Case Study. There are 2 case studies; you will select and answer questions for only one Case Study (Case Study A OR Case Study B). Ensure that you specifically apply and integrate your answers with the information from your case study; avoid simply describing a disease or a drug.
Case Study A: 78-year-old male Nigel is a 78-year-old male who has primary stage 4 non-small cell lung cancer, which is widespread throughout his lungs, and he has substantial liver metastases. Nigel experiences shortness of breath, and pain in his chest. The pain in his right upper quadrant also pain causes him significant discomfort. He is currently taking cisplatin and docetaxel IV to treat his cancer. He is unsure whether he wants to continue with his chemotherapy, as he is very nauseous most days, and vomits in the days after each dose, and knows that his overall condition is worsening. His current medications include
• Cisplatin and docetaxel, IV infusion, every 3 weeks
Even though he is taking ondansetron, he continues to experience ongoing nausea and is aware that his cancer is not improving. He is so unwell most days, that Nigel is considering declining all cancer medications, and remaining at home with his family until his approaching death.
1. From your knowledge of pathophysiology, explain the links between Nigel’s lung cancer, difficulty breathing, and metastases.
2. Consider Nigel’s secondary liver cancer – how might this impact on the pharmacokinetics of his chemotherapy medications? Ensure that you include appropriate consideration of hepatic first-pass metabolism in your answer.
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Case Study B: 32-year-old pregnant female Kelly is a 32-year-old female, who is in her second trimester of pregnancy. In her previous pregnancy, she suffered from hyperemesis and sciatica. Sciatica continued after her pregnancy. Since becoming pregnant this time, she has ceased her regular sciatica pain medication, and now is experiencing significantly increased sciatica pain and discomfort. She is currently taking paracetamol (orally) for pain management. Since she was approximately 8 weeks gestation, Kelly has been suffering from hyperemesis again and is finding that this seems to be of increasing intensity. She has had a hospital admission for rehydration and is now taking metoclopramide (Maxolon). Kelly is now 18 weeks pregnant and is finding sciatica and hyperemesis frustrating. She had hoped that it would have resolved by now, and the challenge of caring for her 3-year-old son is difficult.
1. Explain two main reasons why Kelly’s sciatica has increased during her pregnancy. Ensure that you include relevant pathophysiology in your answer.
2. Consider Kelly’s liver dysfunction – how might this impact on the pharmacokinetics of her paracetamol and metoclopramide. Ensure that you include appropriate consideration of hepatic first-pass metabolism in your answer.
Format: NUR231 Drug Therapy Case Study
• 2500 words (+/- 10%). Word count includes in-text citations and excludes reference list.
• Please start a new WORD document, and then type your answers to each question within this document. Answer each question as Q1 … (answer); on a new line start Q2 …(answer), and so on. Do not copy the actual questions into your document. Include your reference list at the end on the final page/s of this document (do not attempt to submit references as a separate document, as SafeAssign will only accept one document).
• 1.5 line spacing and Times New Roman 12 point font.
• Individual assessment item (NO group submission).
The Case Study will be assessed on the following criteria:
• Application of pathophysiological concepts.
• Application of pharmacokinetics and pharmacodynamics to explain how medications work and interact with the human body.
• Relate the drug mechanism of action to the main adverse effects of the drug and, discuss benefits, risks, and management of adverse reactions.
• Evidence-based argument and justification of decisions, coherent written expression, and presentation.