Ase Study Assignment Nurse Practitioner paper

Felician College
Division of Nursing and Health Management
Department of Graduate Nursing
MSN Program
NU540MSDL Pharmacology and Prescriptive Practice
Assignment # 2 Guidelines
Case Study Assignment

Value: 20 Points Due Date 10/31/09

The purpose of this assignment is to introduce the student to decision making and prescribing medication for common illnesses encountered in primary care.
Read the information in the case study below.
Answer the questions, providing clear rationale for treatment decisions.
Provide appropriate references.
This assignment must be submitted in the appropriate drop box in week 8 as a Word Doc. attachment. No other format will be accepted

Mr. M, a 48 year old black male is being seen at your office as a new patient because of an insurance change.
Mr. M C/O fever 101.+ x 5 days, Sinus pain and pressure with green nasal discharge.
Mr. M states she feels hot and cold and has a headache and fatigue.
He denies blurred vision, dizziness, chest pain, nausea, vomiting and diarrhea.

PMH: Mr. M has a history of asthma and has been having symptoms 3-4 times per week, occasionally at night since this illness. He feels short of breath on exertion since he has been ill. Mr. M has a past Hx. of Pneumonia. He denies having a Pneumonia or flu
His current Asthma therapy is Albuterol MDI 2 puffs TID which he is using more frequently since this illness.
Mr. M . had recently been diagnosed with hypertension for which he is on the DASH diet and takes Hydrochlorothiazide 25 mg daily.
Mr. M . admits to taking OTC Sudafed 30 mg BID x 3 days for the headache and sinus pressure.
Mr. M . is allergic to PCN (anaphylaxis at age 16).
FH: Negative for COPD, Asthma, DM, HTN, CAD.
SH: Married with 2 children. Denies smoking & illicit drug use.
Occasional (on holidays) glass of red wine.

Physical Exam:
BP 168/94
P 80
R 20
T 102.0
WD BM alert and oriented and in no apparent acute distress.
Color good, skin very warm and slightly moist. Capillary refill brisk
EENTPERRLA, EOM intact. Fundoscopic exam reveals slight AV nicking bilaterally.
TMs injected bilaterally w/o bulge or retraction. Good light reflex bilaterally.
Nasal Turbinates inflamed bilaterally.
Maxillary tenderness on palpation L>R
Throat mildly inflamed with post nasal drip, L tonsillar enlargement 1+, no exudate.
Neck supple without adenopathy.
Lungs: Exp. Wheeze RLL
Heart S1 S2
Abdomen: Bowel sounds present in 4 quadrants, soft and nontender
no masses or oganomegaly. No CVA tenderness.
Extremities no deformity, weakness, edema.

Assignment #2 Case Study Total Points 20 Earned Points
What is the problem list? Include the three top issues in the care of this client with rationale. 3 Points

Would you order an antibiotic, and if so, which class of antibiotic? Either way, provide the rationale to support your decision 3 Points

According to Asthma guidelines which type of asthma is Mr M experiencing? Provide rationale
What is the appropriate treatment for Mr. M s current asthma? Provide rationale.
3 Points

It appears that Mr.M is experiencing beginning retinopathy.Would you continue her current HTN therapy or prescribe another medication. Give your rationale 3Points
Considering Mr. M s overall health, what other recommendations would you make in the role of APN? 3 Points

Graduate level effort, writing and conformity to APA 5th ed. (see rubrics for scholarly writing below) References must be from 2007-2009. 5 Points