Pharmacology Reasoning Case
Study
Susan Jones, 42-year-old female
Initial Presentation:
Susan Jones is a 42-year-old African American female with a past medical history of diabetes mellitus type II.
She works in a manufacturing plant in her hometown. While at work, she feels faint and must sit down. The
occupational nurse is contacted to assess her.
Susan Jones is married and a mother of two elementary age children. She has been employed in her current
position for two years.
1. What data from the present problem are RELEVANT and must be NOTICED as clinically significant by
the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Past medical history of DM type II. Clients living with DM must monitor their BGLs and insulin levels
closely to ensure they are not becoming hypo- or hyperglycemic.
As the nurse responsible for this patient, you promptly review the medical
history and note that she has NKDA. This is her PMH, and current home
medications documented in the employee’s medical record:
, 1. What is the RELATIONSHIP of the past medical history and current medications? Why is your
patient receiving these medications?
Medical History (PMH): Home Medications:
Hypertension ASA 81 mg PO daily
GERD Lisinopril 40 mg PO daily
Type II diabetes mellitus HCTZ 25 mg PO am
Metformin 875 mg PO BID
Omeprazole 20 mg PO daily
Applying your knowledge of pharmacology, to provide safe
patient care, answer the following essential information:
2. List each home medication from the scenario and answer the following: (NCLEX Pharmacologic and
Parenteral Therapies)
Home Pharm. Indication(s): Mechanism of Action Body Common Nursing
Medication: Class: In OWN WORDS: System Side Effects Assessments:
Impacted
ASA 81mg NSAID Pain, fever, Prevents platelet coagulation. Cardiac Bronchospasm, Cardiac, resp.,
acute coronary edema, tinnitus, neuro
syndrome urticaria
Lisinopril 40 ACE Acute MI, Vasodilation of blood vessels cardiac Dizziness, Cardiac, pain
mg inhibitor hypertension, reducing the workload on the hypotension,
Heart failur heart chest pain
HCTZ 25 mg Diuretic Edema, fluid Inhibits the reabsorption of renal Anaphylaxis, Renal, I/O,
retention sodium, resulting in water anorexia, electrolytes
excretion confusion
Metformin 875 Antidiabetic DM diagnosis Decreases glucose absorption Endocrine, N/V/D, abd Renal, BGLs,
mg s renal pain, dizziness, CNS
HA
Omeprazole Proton pump Duodenal ulcer, Inhibits proton pump endocrine HA, abd pain, Cardiac
20 mg inhibitor H. pylori N/V/D, function
infection, flatulence.
gastric ulcer
3. Based on this patient’s home medication list, does the nurse need to address the clinical concern
of polypharmacy with the primary care provider?
Yes. The combination of medication, especially considering the diuretic she is prescribed, can alter the
absorption rate and concentration of bioavailable drugs in the body changing the intended side effects
and potentially leading to toxicity.
4. Based on this patient’s home medication list, are there any concerning medication interactions that
Study
Susan Jones, 42-year-old female
Initial Presentation:
Susan Jones is a 42-year-old African American female with a past medical history of diabetes mellitus type II.
She works in a manufacturing plant in her hometown. While at work, she feels faint and must sit down. The
occupational nurse is contacted to assess her.
Susan Jones is married and a mother of two elementary age children. She has been employed in her current
position for two years.
1. What data from the present problem are RELEVANT and must be NOTICED as clinically significant by
the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Past medical history of DM type II. Clients living with DM must monitor their BGLs and insulin levels
closely to ensure they are not becoming hypo- or hyperglycemic.
As the nurse responsible for this patient, you promptly review the medical
history and note that she has NKDA. This is her PMH, and current home
medications documented in the employee’s medical record:
, 1. What is the RELATIONSHIP of the past medical history and current medications? Why is your
patient receiving these medications?
Medical History (PMH): Home Medications:
Hypertension ASA 81 mg PO daily
GERD Lisinopril 40 mg PO daily
Type II diabetes mellitus HCTZ 25 mg PO am
Metformin 875 mg PO BID
Omeprazole 20 mg PO daily
Applying your knowledge of pharmacology, to provide safe
patient care, answer the following essential information:
2. List each home medication from the scenario and answer the following: (NCLEX Pharmacologic and
Parenteral Therapies)
Home Pharm. Indication(s): Mechanism of Action Body Common Nursing
Medication: Class: In OWN WORDS: System Side Effects Assessments:
Impacted
ASA 81mg NSAID Pain, fever, Prevents platelet coagulation. Cardiac Bronchospasm, Cardiac, resp.,
acute coronary edema, tinnitus, neuro
syndrome urticaria
Lisinopril 40 ACE Acute MI, Vasodilation of blood vessels cardiac Dizziness, Cardiac, pain
mg inhibitor hypertension, reducing the workload on the hypotension,
Heart failur heart chest pain
HCTZ 25 mg Diuretic Edema, fluid Inhibits the reabsorption of renal Anaphylaxis, Renal, I/O,
retention sodium, resulting in water anorexia, electrolytes
excretion confusion
Metformin 875 Antidiabetic DM diagnosis Decreases glucose absorption Endocrine, N/V/D, abd Renal, BGLs,
mg s renal pain, dizziness, CNS
HA
Omeprazole Proton pump Duodenal ulcer, Inhibits proton pump endocrine HA, abd pain, Cardiac
20 mg inhibitor H. pylori N/V/D, function
infection, flatulence.
gastric ulcer
3. Based on this patient’s home medication list, does the nurse need to address the clinical concern
of polypharmacy with the primary care provider?
Yes. The combination of medication, especially considering the diuretic she is prescribed, can alter the
absorption rate and concentration of bioavailable drugs in the body changing the intended side effects
and potentially leading to toxicity.
4. Based on this patient’s home medication list, are there any concerning medication interactions that
