Shadow Health Basic Questions and Answers Scored A

Shadow Health Basic Questions and Answers Scored A "What is this?"; Let the patient know which medication you are giving & what it is intended to treat. Model Response: This is lisinopril, which you are getting to help control your high blood pressure. "I guess I'm not supposed to take this with food. Is that right?"; This is an opportunity to teach the patient whether this medication should be taken with food. Model Response: Lisinopril can actually be taken with or without food, whatever fits your routine best. What is most important is to take this at the same time everyday. "Is it okay to take this with the blood thinner they're giving me?"; Inform your patient whether there is an interaction between these drugs. Model Response: I'm glad you asked. There is no interaction between these drugs, so it's okay to take them together. It's actually very important to keep your high blood pressure well controlled while you are receiving blood thinners like warfarin and enoxaparin, which means you'll want to keep taking your lisinopril regularly while you are on those medications. "So, this is the Lipitor then?"; Let your patient know about the generic medication he is receiving. Model Response: Yes, this is atorvastatin, which is the generic name for lipitor. I'm giving it to you to help keep your cholesterol levels under control. "So, I just keep taking this stuff and it'll do it's magic for my cholesterol, huh?"; This is an opportunity to educate your patient on the lifestyle adjustments he can make to improve the desired outcomes of this medication. Model Response: To manage your cholesterol levels effectively, it is important to work on this in your lifestyle too. Having a regular exercise regimen, eating a diet that is low in fats, carbohydrates, and alcohols, and not smoking can help this medication do its job. Mr. Larson's general practitioner advised him to take 2g of fish oil per day. The capsules Mr. Larson purchased are 1,000mg. How many fish oil capsules should he take each day? 2g x (1,000 mg/ 1 g) x (1 capsule/ 1,000 mg) = 2 capsules per day Before his surgery, Mr. Larson was taking tramadol, prescribed as 50 mg by mouth every 6 hours as needed for pain. If he took it every available dose in a 24-hour period, how many mg tramadol would he ingest? 24 hours x (1 dose/ 6 hours) x (50 mg/ 1 dose) = 200 mg tramadol While in the hospital, the orders call for Mr. Larson to take atorvastatin 20 mg, 1 tablet, by mouth once a day. However, the pharmacy only has 10 mg tablets. How many tablets of atorvastatin should be administered to him? (20 mg/ 1 day) x (1 tablet/ 10 mg) = 2 tablets atorvastatin per day While in the hospital, the orders call for Mr. Larson to take lisinopril 10 mg, 1 tablet, by mouth once a day. The pharmacy only stocks 5 mg tablets of lisinopril. How many tablets of lisinopril should be administered to him? (10 mg/ 1 day) x (1 tablet/ 5 mg) = 2 tablets lisinopril per day The Davis's Drug Guide reports a potential drug-drug interaction with acetaminophen and warfarin. If a patient is taking warfarin, more than 2 g/ day of acetaminophen may increase bleeding. Because Mr. Larson is ordered both, he should receive no more than 2 g/ day of acetaminophen. If Mr. Larson takes acetaminophen 325 mg, 2 tablets, by mouth every 4 hours for mild pain, what is the maximum number of tablets you can give him so that he doesn't exceed 2 g/ day? (Assume you will only give him whole tablets) 2 g x (1000 mg/ 1 g) x (1 tablet/ 162.5 mg) = 12.3 → 12 tablets per day; Error on key: 2 g x (1000 mg/ 1 g) x (1 tablet/ 325 mg) = 6.15 → 6 tablets per day At 0800, Mr. Larson reports a moderate pain level of 5, and so you administer oxycodone 5 mg/ acetaminophen 325 mg, 1 tablet, by mouth. At 1200, Mr. Larson reports mild pain rated 3, so you administer acetaminophen 325 mg, 2 tablets, by mouth. At this point, how much acetaminophen has Mr. Larson taken? Dose 1 = 325 mg acetaminophen x 1 tablet = 325 mg acetaminophen Dose 2 = 325 mg acetaminophen 2 tablets = 650 mg acetaminophen; 325 mg + 650 mg = 975 mg acetaminophen In Mr. Larson's orders, the enoxaparin is prescribed for prophylaxis of DVT following knee replacement surgery, and he is ordered 30 mg by subcutaneous injection every 12 hours. Suppose the pharmacy stocks multi-use vials of 300 mg/ 2 mL enoxaparin. How much will you need to draw up to administer a 30 mg dose? Ordered dose = 30 mg Dose on hand = 300 mg/ 2 mL 30 mg x (3 mL enoxaparin/ 300 mg) = 0.3 mL enoxaparin For patients with unstable angina, a potential treatment is enoxaparin administered by subcutaneous injection 1 mg/ kg every 12 hours. Suppose Mr. Larson were being treated for unstable angina. a. If Mr. Larson weighs 227 lbs, how much enoxaparin should be administered? (Round your answer to the nearest whole number) b. If Mr. Larson weighed 180 lbs, how much enoxaparin should be administered? (Round your answer to the nearest whole number) a. 227 lbs x (1 kg/ 2.2 lbs) x (1 mg/ 1 kg) = 103.18 → 103 mg enoxaparin b. 180 lbs x (1 kg/ 2.2 lbs) x (1 mg/ 1 kg) = 81.81 → 82 mg enoxaparin For patients with deep vein thrombosis or pulmonary embolism, a potential treatment is enoxaparin administered 1.5 mg/ kg once daily by subcutaneous injection. Suppose Mr. Larson were being breasted for a pulmonary embolism and weighed 227 lbs. How much enoxaparin should he be administered each day? (Round your answer to the nearest whole number) 227 lbs x (1 kg/ 2.2 lbs) x (1.5 mg/ 1 kg) = 154.7 → 155 mg enoxaparin For moderate pain, Mr. Larsen is able to take oxycodone 5 mg/ acetaminophen 325 mg, 1 tablet, every 4 hours. Suppose he takes all available doses in 24 hours. How many mg of oxycodone will he have ingested? (24 hours/ 4 hours) = 6 doses 5 mg x 6 doses = 30 mg oxycodone Suppose Mr. Larson is in severe pain, and the prescriber's order allows oxycodone 5 mg/ acetaminophen 325 mg, 2 tablets, every 4 hours. He takes all available doses in 24 hours. How many mg of oxycodone will he have ingested? (24 hours/ 4 hours) = 6 doses 5 mg oxycodone x 6 doses x 2 tablets = 60 mg oxycodone Mr. Larsen is ordered 2 mg of warfarin. The pharmacy only stocks 1mg tablets. How many tablets should be administered to him? 2 mg x (1 tablet/ 1 mg) = 2 tablets Mr. Larsen reports constipation. The attending physician prescribes docusate sodium syrup 100 mg PO BID. The concentration is 50 mg/ 5 mL. How many mL of docusate sodium syrup should you administer to Mr. Larsen? 100 mg x (5 mL/ 50 mg) = 10 mL of docusate sodium syrup Mr. Larsen returns home and starts to come down with a cough. He would like to take Mucinex Cold & Flu Syrup, which contains acetaminophen 650 mg/ guaifenesin 400 mg/ phenylephrine HCl 10 mg/ 20 mL dose. a. Assume that Mr. Larsen takes two 20 mL doses of Mucinex per day. How many mg of acetaminophen will he have ingested from the Mucinex? b. He would like to take an additional acetaminophen for pain. He has extra strength acetaminophen tablets, 500 mg each. How many tablets of acetaminophen can he take without exceeding 2 g/ day? (Assume he will only take whole tablets) a. (650 mg/ 1 dose) x 2 doses = 1300 mg acetaminophen b. 2 g x (1000 mg/ 1 g) = 2000 mg 2000 mg - 1300 mg acetaminophen from Mucinex = 700 mg left; = 1 tablet (500 mg acetaminophen) Mr. Larson's home medication list includes acetaminophen, by mouth, as needed. He has extra strength acetaminophen tablets, 500 mg each. He is not to exceed 2 g/ day. How many total tablets of acetaminophen can he take each day? 2 g x (1000 mg/ 1 g) = 2000 mg (2000 mg/ 500 mg acetaminophen) = 4 tablets Suppose the attending physician would like to increase Mr. Larsen's dose of atorvastatin to 40 mg. The pharmacy stocks 10 mg tablets. How many 10 mg tablets of atorvastatin should he be administered? (40 mg atorvastatin/ 10 mg tablets) = 4 tablets