Case study on Nursing 2022

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

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Part 1:
a. Based on the review of the case study of Mr. Mathewson, the two goals/objective and
outcomes desired for the patient are:
 To reduce the exacerbating effects of illnesses like COPD, asthma, rheumatoid
arthritis and hypertension.
 to support Mr. Mathewson to provide relief to patient from inflammation, severe
allergies and increased bronchial obstruction
b. The following evaluation criteria will be important to evaluate patient’s compliance with
his medication:
 The first criteria is to evaluate patient’s knowledge of inhalation technique for prescribed
inhalers as improper inhalation technique are the major reason for decrease efficacy of
the medications (Price et al., 2013). Hence, patient’s understanding about ways to use the
device is important to ensure that medications are used optimally. This may help to
implement educational interventions to reduce inhaler technique related errors.
 To ensure compliance with the prescribed medication, it will also be important to assess
whether Mr. Mathewson is able to return demonstrate the inhalation technique that he has
been taught by medical staffs or not. Patient’s demonstration of inhaler technique can be
measured via a validated checklist that can give idea about skills related to the use of
devices like metered dose inhaler and the Diskus device inhaler. This evaluation criteria
can have a significant impact on patient outcome and return demonstration of appropriate
technique (De Tratto et al., 2014).
 Patient’s self-perception related to the use and importance of each medication must also
be evaluated as their understanding about the medication regimen can have a major

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impact on improving adherence to treatment guidelines and improving symptoms of
patient.
Part 2:
The medication information for each medication prescribed to Mr. Mathewson are as
follows:
1. Lisiniprol and hydrochlorothiazide:
Purpose and benefit of the medication: Lisiniprol is an ACE inhibitor and hydrochlorothiazide is
a thiazide diuretic used to treat hypertension.
How to take the medication:
The two medications are taken orally with or without food. The directions on the prescription
label need to be followed carefully.
Special precautions for the medication: Patients must inform physicians if they are allergic to
ACE inhibitor or taking Valsartan and sacubitril. They must also inform them about other
medications and nutritional supplements that they are taking. Monitoring for side effects like
dizziness, cough, headache, stomach pain and swelling of the face is important.
2. Carvedilol (Coreg)
Purpose and benefit of the medication: It is a beta blocker or alpha/beta-adrenergic blocking
agent used to treat patients with mild to severe heart failure, hypertension and patient with left
ventricular dysfunction.

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How to take the medication: The dose will differ for patient with either of the three problems
presented above. However, for all patients it should be taken with flow to reduce rate of
absorption.
Special precautions for the medication: The medication should be protected from moisture and
dispensed in a light-resistant container. It is necessary for patient with coronary artery disease
not to abruptly discontinue the therapy. Diuretics should be increased for patient with worsening
heart failure (Bhatt et al., 2017).
3. Digoxin (250mcg po daily)
Purpose and benefit of the medication: It is a cardiac glycoside that is used to treat heart failure
and reduce risk of heart attack. It functions by influencing certain minerals like sodium and
potassium inside the heart cells.
How to take the medication: It is taken orally with or without food.
Special precautions for the medication: Information about any allergy must be provided before
taking this medication. Doctors must also be informed if patient takes any diuretics.
4. Albuterol Inhaler
Purpose and benefit of the medication: It is a type of bronchodilator that is mainly used to treat
symptom of breathing difficult, cough and shortness of breath. It acts to ease breathing by
relaxing and opening airway passage towards the lungs.
How to take the medication: 2 puffs of inhaler is taken by holding breath for 10 seconds or by
using a nebulizer.

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Special precautions for the medication: Patient must provide information about any allergy to
this medication and use of other medication and supplements (Yusuff, 2018).
5. Prednisone (60mg po daily)
Purpose and benefit of the medication: Prednisone is a medication used to treat inflammatory
conditions in patient with severe allergies, breathing problem and skin disease. It work by
reducing the response of the immune system to various diseases.
How to take the medication: The medication can be taken orally with food or milk.
Special precautions for the medication: The patient must inform if they are allergic to the
medication or if they are using corticosteroid for a long time.
Part 3:
A discharge planning tool that will be useful for patient to be used at home includes a tablet
based multimedia which can have several links to guide Mr. Mathewson to understand his
medication regimen and ways to use inhaler. The structure of the tool will be as follows:

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Discharge planning instruction and daily care plan:
Post discharge to home, it is necessary that Mr. Mathewson comply with his
medication regimen. Given are important links from where the patient can get guidance
regarding daily dose of his medications:
Daily medication dose
Precautions to be taken during
the use of medication
Video based link for correct
use of inhalers

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References:
Bhatt, A. S., DeVore, A. D., DeWald, T. A., Swedberg, K., & Mentz, R. J. (2017). Achieving a
maximally tolerated β-blocker dose in heart failure patients: is there room for
improvement?. Journal of the American College of Cardiology, 69(20), 2542-2550.
Costa, E., Giardini, A., Savin, M., Menditto, E., Lehane, E., Laosa, O., ... & Marengoni, A.
(2015). Interventional tools to improve medication adherence: review of
literature. Patient preference and adherence, 9, 1303.
De Tratto, K., Gomez, C., Ryan, C. J., Bracken, N., Steffen, A., & Corbridge, S. J. (2014).
Nurses’ knowledge of inhaler technique in the inpatient hospital setting. Clinical Nurse
Specialist, 28(3), 156-160.
Price, D., Bosnic-Anticevich, S., Briggs, A., Chrystyn, H., Rand, C., Scheuch, G., ... & Inhaler
Error Steering Committee. (2013). Inhaler competence in asthma: common errors,
barriers to use and recommended solutions. Respiratory medicine, 107(1), 37-46.
Yusuff, K. B. (2018). Inhaled antiasthmatic medications, self‐management and optimal outcome
in ambulatory asthma: content analysis of patients’ knowledge and practice. Journal of
Pharmaceutical Health Services Research, 9(2), 133-139.