Assignment Problems Difficulties

Question: What are the assignment Problems? Explain. Answer: 1. Prescription of inhalers to Ms. Bremmer The patient Ms. Bremmer depicts breathing difficulties indicated by the lung sounds with bilateral wheezes and diminished sounds at bases. The assessment of bronchospasm in the patient leads to the prescription of albuterol inhaler for her. Albuterol acts as a bronchodilator and facilitates the relaxation and opening of the air passages to lungs easing the scope of breathing for the patient (Nlm.nih.gov, 2015). It thus provides relief to the asthma patients and those with reversible obstructive airway disease. The flunisolide inhalant is prescribed to control wheezing and breathe shortness (Laube et al. 2011). Since, Ms. Bremmer is identified with wheezing and shortness in breath, she is correctly prescribed with the flunisolide inhalant. It works by entering the lungs directly and reducing irritation and swelling of the airways that cause bronchospasm. 2. Contraindications/precautions eliminating the use of prescribed drugs for Ms. Bremmer Allergy to albuterol is a major contraindication that can eliminate the use of albuterol inhaler prescribed to Ms. Bremmer. An overdose of this medication is fatal (Nlm.nih.gov, 2015). Intake of medicines in the category of beta blockers, diuretics, epinephrine, antidepressants and other drugs for cold and inhalers for relaxing air passages can interfere with the actions of the albuterol to produce side effects. The other drug flunisolide also needs to be checked for allergic contraindications. Inactive ingredients as methanol contained in this drug is potential to stimulate allergic reactions or other associated health problems (Chow et al. 2013). Unusual tiredness and weight loss are associated with flunisolide as contraindications. This drug increases the patients exposure and vulnerability to infections by causing the vaccines to fail to work properly. 3. Patient variables to consider for Ms. Bremmer during assesing her drug therapy The variables such as the heartbeat, blood pressure, temperature, the existence of diseases as thyroid, diabetes and seizure disorder are vital to consider for assessing the drug therapy for Ms. Bremmer. The presence of any allergy to albuterol or flunisolide is also important to consider in assessing the drug therapy prescribed to Ms. Bremmer. 4. Core drug knowledge to consider avoiding interaction with patient variables The knowledge of the components of the drug composition is very important to enable the avoiding their interaction with the patient variables. For instance, the methanol component of flunisolide can interact with the patients body and produce an allergic reaction. Albuterol is sold under trade name AccuNeb with less than 20% absorption ability of Tmax as 0.5h and Cmax as 2.1ng/mL. It works through relaxation of bronchial smooth muscle by stimulating beta-2-receptor (Gardenhire, 2013). Flunisolide belongs to adrenal glucocorticoid class of drugs controlling asthma and improving lung functions as necessary in Ms. Bremmers. 5. Nursing assessment findings depicting effectiveness of drug therapy Findings derived from the nursing assessment procedure identify the vitals of the patients as heartbeat, blood pressure (BP), pulse rate, respiration rate, temperature, and oxygen saturation (pulse oximetry). This information is essential to understand the current health status of the individual. As opined by Polit and Beck (2013), the changes in the vitals with a focus on the breathing pattern of the patient starkly depict the effectiveness of the drug therapy. Assessing Ms. Bremmer with a decreasing pulse from 110 to normal range of 60-100 beats/minute, respiration from 26 to a rate of 18-24 (normal) and BP from high to the normal range of 120/80 will indicate the efficacy of the drug therapy on the health of the patient. 6. Nursing assessment findings demonstrating adverse effects of drug therapy Adverse effects can be easily identified from the findings of the nursing assessment. An increase in the respiration rate of Ms. Bremmer, further fastening of the pulse beat and heightening of BP will indicate the adverse effects of the drug therapy on the patient. As pinpointed by Potter et al. (2013), the depiction of a headache, coughing, swallowing difficulty and chest pain are other adverse effects that can be evident in Ms. Bremmer. 7. Nursing actions indicating maximization of therapeutic effects The therapeutic effects of the albuterol and flunisolide can be maximized by the execution of nursing actions as the correct assessment of the changes in the vitals of the patient after intake of the drugs. Efficient hourly observation of the patient and recording the health details are other effective nursing actions that can maximize the therapeutic effects of the drugs (Laube et al. 2011). The nurses can also drive Ms. Bremmer towards the exercises as meditation and other cardiological activities to calm down her heart and thus enabling a better therapeutic effect on the breathing pattern of the patient. 8. Nursing actions indicating minimization of adverse effects The asthma patients are identified to be at high risk of oxygen toxicity from receiving inspired oxygen concentration (F1O2) over 0.5-0.6 for a long period. The close monitoring and oxygen titration by the nurse minimizes the risk of adverse effects on patients health (Polit and Beck, 2013). Regular monitoring and close assessment action of nurse enable early detection of any unusual symptoms thereby preventing the occurrence of any detrimental effect on patients health. The nursing action of administering fluid replacement of Ms. Bremmer as per need can help reduce the adverse effect of dehydration due to decreased oral intake in the asthma patient. 9. Teaching for Ms. Bremmer about drug therapy Ms. Bremmer needs to have a sound knowledge of the dosing and precautions regarding the use of the prescribed drug. The Proper procedure of intake of the drug is an essential aspect that the patient needs to know (Mayoclinic.org, 2015). Ms. Bremmer must use the aerosol inhaler of albuterol as many times the label states (number of inhalation it contains) after which it needs to be discarded. Since it is a therapy to control the health issues relating to asthma but do not cure the issue, so the patient need to talk to the doctor before stopping the intake of the medicine. Ms. Bremmer must also know about the symptoms of overdose or underdose of the medications of flunisolide and albuterol intake to be able to recognize detrimental or unseals effects on her health and immediately contact the physician. References Chow, C. M., Chow, M. P. Y., Luk, D., Hon, E., and Sugunan, V. K. (2013). Clinical Guidelines.HK J Paediatr (new series),18, 96-104. Gardenhire, D. S. (2013).Rau's respiratory care pharmacology. Elsevier Health Sciences. Laube, B. L., Janssens, H. M., de Jongh, F. H., Devadason, S. G., Dhand, R., Diot, P. and Chrystyn, H. (2011). What the pulmonary specialist should know about the new inhalation therapies.European Respiratory Journal,37(6), 1308-1417. Mayoclinic.org, (2015).Albuterol (Inhalation Route) Precautions - Mayo Clinic. [online] Available at: https://www.mayoclinic.org/drugs-supplements/albuterol-inhalation-route/precautions/drg-20073536 [Accessed 1 Aug. 2015]. Nlm.nih.gov, (2015).Albuterol Oral Inhalation: MedlinePlus Drug Information. [online] Available at: https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682145.html#side-effects [Accessed 1 Aug. 2015]. Polit, D. F., and Beck, C. T. (2013).Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams Wilkins. Potter, P. A., Perry, A. G., Stockert, P., and Hall, A. (2013).Fundamentals of nursing. Elsevier Health Sciences.