NR 508 Week 5 Discussions 1 Part 2

NR 508 Week 5 Discussions 1 Part 2

NR 508 Week 5 Discussions 1 Part 2

discussion part two

the patient is diagnosed with a severe urinary tract infection (pyelonephritis), and you decide to prescribe him sulfamethoxazole/trimethoprim (smx/tmp) beginning with 2 g initially as a loading dose, followed by 1 g as a maintenance dose bid. over the next couple of weeks, the symptoms associated with his uti diminish, and his mental status improves. however, ms. webb brings him back to your clinic with symptoms, which scare her yet again, and she explains that she thinks he may have a relapse of his uti. these symptoms include a high fever (103.6°f) and tachypnea, and upon pulmonary examination at your clinic, you hear crackles, and find classic findings of lung consolidation.

what laboratory tests should you order, and what is your primary diagnosis at this point and subsequent steps in his treatment and management?  NR 508 Week 5 Discussions 1 Part 2

once explained, please indicate and describe your chosen pharmacological treatment with inclusion of dose and mechanism of action of your chosen prescription.

NR 508 Week 5 Discussions 1 (Part Three) Recent

discussion part three

upon receipt of laboratory results, you notice that his egfr is ~40ml/min, his serum creatinine is 3.0 mg/dl, and his bun is 50 mg/dl.

how will the medication regimen(s) have to be adjusted given these new laboratory findings, and how should you be monitoring for efficacy and toxicity of this patient’s pharmacological profile with a summary of where this patient currently stands in his medical treatment? NR 508 Week 5 Discussions 1 Part 2

NR 508 Week 6 Discussions 1 (Part One) Recent

discussion part one

jonathon is a 56 year-old retired automobile mechanic who has not been to the doctor in approximately 6-7 years. he presents to your office complaining that 3 weeks ago he was awoken with severe pain and inflammation in his knee, which has been consistent since that initial night. upon physical examination of his knee, it appears swollen and erythematous with periarticular involvement. upon physical examination and laboratory results you notice the following: NR 508 Week 5 Discussions 1 Part 2

physical examination:

gen: well nourished, obese male (310 pounds)

vs: bp 191/112 hr 75 rr 15 t 98.6, ht 5’8”

ext: knee joint inflammation

laboratory (fasting):

na 139 meq/l

k 3.8 meq/l

ca 9.1 mg/dl

cl 102 mmol/l

hco3 22 meq/l

bun 10 mg/dl

scr 0.9 mg/dl

serum uric acid 6.5 mg/dl

alb 4.1 g/dl

cholesterol 300 mg/dl

ua: ph 6.8, uric acid 250 mg/24h

what problems can be identified in this patient? please provide a list of differential diagnoses, as well as indication of your primary diagnosis. NR 508 Week 5 Discussions 1 Part 2

what is your pharmacological plan for your primary diagnosis including the medication, dose, and mechanism of action?

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