Online Case Studies Learning Activity #2: Antimicrobials Case Study Assignment
Assignment Outline
This assignment will give you the opportunity to apply your knowledge related to antimicrobials. You will be asked to complete preparation work prior to reviewing a written case study. As you work through the related knowledge application questions, additional information about this case will be provided. To complete this activity, please download this worksheet and complete the fillable spaces, working through the document in the order that the questions appear. Please submit your completed document to Dropbox by midnight Friday March 31st, 2023. You will be evaluated based on your responses on the worksheet. This assignment is worth 5% of your overall theory mark.
Patient Information
Robert is a 54-year-old male who has come into the clinic with a chief complaint of heartburn. Robert states that lately he has been experiencing more frequent heartburn, and that it is keeping him awake at night. He has been managing by using Maalox tablets as needed, but states that they only seem to help for a short while.
Upon further discussion, Robert reveals that he has dealt with occasional heartburn once or twice a week for “a few years” but has noticed increased frequency in the past couple months. He states he experiences heartburn almost daily now. Robert states the pain he feels is a burning sensation, in his sternal area. He said the pain is worse when he goes to bed and has been having trouble sleeping as a result. Robert states that “drinking a glass of milk usually helps” or that he takes Maalox. He does not complain of nausea or vomiting.
Physical examination does not reveal any abnormal findings. Robert’s abdomen is soft, non-tender with appropriate bowel sounds. Robert’s vital signs are 36.7-74-16-122/74. Robert’s height is 6’ and his weight is 125 kg.
Case Study Preparatory Work- Mini Drug Cards (1.5 marks)
| Calcium carbonate and simethicone (Maalox) | Classification: Antacids |
| Indication: low serum calcium conditions (ie. Osteoporosis, osteomalacia, hypothyrodoism, hypoparathyrodism, pregnancy, nursing mothers), hearetburn caused by gerd | |
| Assessment required: allergies, pregnancy, hypercalcemia, kidney disease, dehydration, intestinal blockage | |
| Contraindication: hypersensitivity, renal calculus, high urine calcium levels, elevated serum calcium, low serum phosphate, achlorhydria, suspected digoxin toxicity | |
| Omeprazole (Losec) | Classification: Proton pump inhibitor (PPI) |
| Indication: reflux oesophagitis, duodenal ulcer, gastric ulcer, symptoms of acid related dyspepsia, zollinger-ellison syndrome | |
| Assessment required: vital signs, neuro statu, respiratory status and gastrointestinal symptoms | |
| Contraindication: history of hypersensitivity to drug, ripilverine |
Learning Resources
Please review the following resources to assist you in completing the assignment:
Sealock, K., Seneviratne, C. (2020). Lilley’s pharmacology for Canadian health care practice (4th edition). Elsevier. Chapter 39.
Canadian Digestive Health Foundation. (2021). GERD. Canadian Digestive Health Foundation. https://cdhf.ca/digestive-disorders/gerd/
You are encouraged to procure any additional resources that you find useful for completing the worksheet.
Assignment Questions (16 marks total)
- As you complete your assessment of Robert, what other pertinent history would you want to gather from Robert?
(3 marks)
Family history, nutrion and lifestyle, additional medication intake
The health care provider concludes their assessment and tells Robert that he likely has gastroesophageal reflux disease, or GERD. The HCP provides Robert with a prescription for omeprazole (Losec).
- What is GERD? (1 marks)
Gastroesouphageal reflux disease occurs when stomach acid repeatedly flows back into the esophagus
- What are predisposing factors for GERD? (2 marks)
Smoking, obesity, alcohol or coffee, fatty or fried foods, medications (ie. aspirin)
- Which key assessment findings from the initial examination suggest that Robert has GERD? (1 mark)
Frequent heartburn experience that is worse at night.
- How does omeprazole treat GERD? (1 mark)
Decreases amount of scid made by the stomach.
- Why is Robert only experiencing temporary relief from his heartburn when using calcium carbonate (Maalox) tablets? What is the risk of prolonged use of antacids to treat heartburn? (2 marks)
Maalox deals ony with existing acid. Maalox is an antacid amd therefore contains high levels of calcium that could lead to nausea and since it does not prevent acid production it will only provide temporary relief meaning that it would need to be used multiple times which could lead to an overdose.
- You are teaching Robert about lifestyle modifications to help reduce the severity of his GERD. What information will you include? (2 marks)
Staying up for at 30min after a meal, maintainace of healthy balance and physical activity.
- Robert asks for more information about this new medication. Which key teaching points will you provide him about omeprazole? (4 marks)
Medication should be taken as directed no more or less. It can be taken with food or on empty stomach. Store in close container at room temp way from moisture, light and heat. If a dose is missed take as soon as possible but if it is almost time for next dose skip it altogether.
Reflection and Application of Learning (4 marks total)
- Did the mini drug card preparation assist you in critically thinking through pertinent education related to omeprazole for this patient? Why or why not? If not, how could you better prepare yourself for medication administration? (2 mark)
Yes, it helped. Preparing the mini drug card helped me to better prepare to be able to explain the drug and its effects, helping me to know what is best for the patient
- What are two pieces of learning that you will take away from this case study? (2 marks)
Treatment for GERD and the differences between maaloc and losec medication
References
Please include your APA formatted references here if you have incorporated additional references into your learning.
Calcium carbonate; simethicone soft chews and chewable tablets. Cleveland Clinic. (n.d.). Retrieved February 23, 2023, from https://my.clevelandclinic.org/health/drugs/23615-calcium-carbonate-simethicone-chewable-tablets-or-soft-chews#:~:text=It%20belongs%20to%20a%20group,pharmacist%20if%20you%20have%20questions
Mayo Foundation for Medical Education and Research. (2023, January 4). Gastroesophageal reflux disease (GERD). Mayo Clinic. Retrieved February 23, 2023, from https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940#:~:text=Gastroesophageal%20reflux%20disease%20(GERD)%20occurs,the%20lining%20of%20your%20esophagus
NEW ZEALAND DATA SHEET. (n.d.). New Zealand Data sheet 1. product name – medsafe. NEW ZEALAND DATA SHEET. Retrieved February 24, 2023, from https://www.medsafe.govt.nz/Profs/Datasheet/l/Loseccap.pdf
NIH. (n.d.). Calcium carbonate – statpearls – NCBI bookshelf. NIH. Retrieved February 24, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK562303/
NIH. (n.d.). Omeprazole – StatPearls – NCBI Bookshelf. NIH. Retrieved February 24, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK539786/
Node view. Calcium Carbonate/Simethicone Chewable – Oral | HealthLink BC. (n.d.). Retrieved February 23, 2023, from https://www.healthlinkbc.ca/medications/calcium-carbonatesimethicone-chewable-oral
Osmosis. (n.d.). Proton Pump Inhibitors (PPIS): Nursing Pharmacology | Osmosis. Osmosis. Retrieved February 24, 2023, from https://www.osmosis.org/learn/Proton_pump_inhibitors_(PPIs):_Nursing_Pharmacology