NR 508 Week 3 DQ 1
discussion part one
elliot is a 74 year-old male who presents to your clinic with complaints of frequent nosebleeds (4 in the past week) and several severe bruises scattered variously throughout his anatomy. the patient is also complaining of a runny nose, cough, and head/chest congestion. he has a history of chronic atrial fibrillation and is currently prescribed and taking warfarin. approximately 3 weeks previously, he started taking over-the-counter cimetidine for heartburn he was experiencing. below is a list of the patient’s medications, his physical examination, and his laboratory findings:
digoxin 0.25 mg qd cimetidine otc bid
pseudoephedrine sr 120 bid warfarin 7 mg qd
vs: bp: 180/95, hr 75, irregularly irregular, rr 17
weight: 95 kg
abd: + bowel sounds ext: bruising on arms and legs
neuro: alert & oriented x 3 gen: well developed, well-nourished male
ecg: atrial fibrillation
na 143 meq/l k 4.5 meq/l
cl 99 mmol/l co2 25 meq/l
bun 18 mg/dl scr 0.9 mg/dl
inr 4.8 hct 42%
hbg 15 mg/dl digoxin 3.8 ng/ml
what problems should be identified in this patient?
what are the precise mechanisms of action of each drug?
what do you think is contributing to the patient’s hypertension?
are there any drug interactions that you can identify as associated with this current drug regimen, and if so how, mechanistically, are they occurring?
what is the clinical significance of these interactions?
APA Writing Checklist
Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.
☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.
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☐ The introduction is present. APA format is applied correctly. There are no errors.
☐ Topic is well defined.
☐ Strong thesis statement is included in the introduction of the paper.
☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.
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Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.
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