Showing Page:
1/5
Pharmacology
The patient, in this case, has been diagnosed with a fractured left wrist. There are diverse pain
management options that are available; however, it is important to determine the specific needs of
a patient before considering any pain relief option. The initial pharmacological management plan
for this patient would include an effective analgesia or anti-inflammatory pain relieving
medication. This would include non-steroidal anti-inflammatory drugs (NSAIDs) for minimizing
inflammation and pain associated with the fracture. The main rationale for this pharmacological
treatment is to alleviate the pain associated with her wrist injury and to provide quality care and
treatment. However, the health care provider might need to switch to an opioid medication for pain
relief as long term use of NSAIDs might reduce the healing process of bone (National Clinical
Guideline Centre UK, 2016).
The first step in the nursing process is data collection. Thus, the patient should be first assessed in
which her vital signs should be obtained and her level of pain should be determined. The
assessment of vital signs of the patient is the primary function which helps in identifying the status
of the patient. Additionally, pain of the patient should be addressed and an appropriate
pharmacological treatment should be initiated in order to enhance comfort of the patient. The
previous medical and health history of the patient should also be obtained during patient
assessment to identify any possible risk of complication or contradiction related to prescribed
medications.
Showing Page:
2/5
The main goals and appropriate treatment for this condition is to provide pain relief and prevent
any further injury. This can be accomplished by giving an NSAID (National Clinical Guideline
Centre UK, 2016) and by ensuring that the wrist of the patient is stabilized by keeping it on the
exact position. Pain relief for the patient is essential to provide comfort and securing the splint is
important to prevent any further damage to the wrist of the patient. The pharmacological therapy
is considered if there are any signs of inflammation and pain in the affected area. Thus, it is
important to assess the wrist of the patient for any swelling or any other complication that might
disrupt the process of healing (Mears & Kates, 2015).
There are some essential components that must be considered when pharmacological therapy is
selected for treatment of the patient. This includes the previous medical history as well as present
health problems. The safety of the patient needs to be ensures while prescribing a drug. The
primary purpose of prescribing any medication to the patient is to ensure that her current health
issues are resolved; however, it is also important that the adverse effects associated with the
prescribed medication should also be considered to ensure that no further health problem occurs
to the patient. In this case, NSAID is to be prescribed but prior to that it would be important that
previous health issues of the patient such as any sort of allergies or other medication should be
identified in order to prevent any contradictions from the medication.
The mechanism of action for NSAIDs is that they inhibit the activity of cyclooxygenase enzymes
(COX-1 or COX-2) which are involved in the synthesis of prostaglandins; thus, they inhibit the
production of prostaglandins resulting in reduced inflammation (Steinmeyer, 2000). This
Showing Page:
3/5
medication can be prescribed after assessing the physiologic condition of patient’s liver and
kidneys as these organs are vital in metabolism and excretion of medications respectively.
Once, the patient starts with the pharmacological therapy with NSAID, the next step is to determine
if the medication is working, that is, to identify the efficacy of medication. This can be done by
assessing the patient for complains of pain in her injured area. Additionally, an assessment of the
swelling and inflammation at the injury site should be performed to determine the efficacy of the
medication (Ong, Lirk, Tan & Seymour, 2007). Pain assessment is a type of subjective assessment
which, in this case, is a vital measurement tool for the efficacy of the prescribed medication. The
observation of the injured site for the presence of swelling would ensure if the medication is
actually effective.
There are some adverse effects of the medication for which the patient should be regularly
monitored. These includes dizziness, effects on blood pressure, hepatic injury, inhibition of platelet
(increasing the risk of bleeding), gastrointestinal effects, cardiovascular effects, and alterations in
renal function (Ong, Lirk, Tan & Seymour, 2007). This medication could cause problems in patient
with gastrointestinal problems. Thus, specific patient education is also needed to minimize the
risks of these adverse effects. Some of the patient educations that should be provided are as
follows:
Advise the patient to take the medication with meal in order to avoid any stomach
problems. Taking the medication on an empty stomach can increase the risk of stomach
ulcers (Ong, Lirk, Tan, & Seymour, 2007).
Showing Page:
4/5
Teach the patient about the importance of reporting any sort of adverse effects immediately
to the health care provider to minimize any other health complication.
Provide education about the taking care of the splint area to minimize the risk of any
infection.
Provide education about monitoring vital signs such as temperature, blood pressure, pulse,
and respiratory rate. Temperature variations are indicative of infection or inflammation and
must be frequently monitored.
The patient should be monitored for her kidney and liver function test to minimize the risk of
toxicity from the NSAIDs. Appropriate advice regarding the course of treatment should be
discussed with the patient to enhance her compliance and medication adherence. A regular x-ray
of the fractured wrist needed to be done to monitor the progress of bone healing (van Gervan et
al., 2018).
There are no cultural or religious issues related with the treatment plan for this patient. However,
there are formulary considerations that are important because the brand and cost of the drug
influence its efficacy. Thus, the patient should be evaluated for her financial status prior to
prescribing a brand of medication. Additionally, the weight of the patient is also important in
determining appropriate dosage of the medication. The follow-up of the patient would involve an
assessment of her laboratory report in addition to her x-ray reports of the fractured wrist.
Showing Page:
5/5
References:
1. National Clinical Guideline Centre (UK. (2016, February). Initial pain management. Retrieved
from Nih.gov website: https://www.ncbi.nlm.nih.gov/books/NBK368141/
2. Mears, S. C., & Kates, S. L. (2015). A Guide to Improving the Care of Patients with Fragility
Fractures, Edition 2. Geriatric Orthopaedic Surgery & Rehabilitation, 6(2), 58120.
https://doi.org/10.1177/2151458515572697
3. Steinmeyer, J. (2000). Arthritis Research, 2(5), 379. https://doi.org/10.1186/ar116
4. Ong, C. K. S., Lirk, P., Tan, C. H., & Seymour, R. A. (2007). An Evidence-Based Update on
Nonsteroidal Anti-Inflammatory Drugs. Clinical Medicine & Research, 5(1), 1934.
https://doi.org/10.3121/cmr.2007.698
5. van Gerven, P., Rubinstein, S. M., Nederpelt, C., Termaat, M. F., Krijnen, P., van Tulder, M.
W., & Schipper, I. B. (2018). The value of radiography in the follow-up of extremity fractures: a
systematic review. Archives of Orthopaedic and Trauma Surgery, 138(12), 16591669.
https://doi.org/10.1007/s00402-018-3021-y

Unformatted Attachment Preview

Pharmacology The patient, in this case, has been diagnosed with a fractured left wrist. There are diverse pain management options that are available; however, it is important to determine the specific needs of a patient before considering any pain relief option. The initial pharmacological management plan for this patient would include an effective analgesia or anti-inflammatory pain relieving medication. This would include non-steroidal anti-inflammatory drugs (NSAIDs) for minimizing inflammation and pain associated with the fracture. The main rationale for this pharmacological treatment is to alleviate the pain associated with her wrist injury and to provide quality care and treatment. However, the health care provider might need to switch to an opioid medication for pain relief as long term use of NSAIDs might reduce the healing process of bone (National Clinical Guideline Centre UK, 2016). The first step in the nursing process is data collection. Thus, the patient should be first assessed in which her vital signs should be obtained and her level of pain should be determined. The assessment of vital signs of the patient is the primary function which helps in identifying the status of the patient. Additionally, pain of the patient should be addressed and an appropriate pharmacological treatment should be initiated in order to enhance comfort of the patient. The previous medical and health history of the patient should also be obtained during patient assessment to identify any possible risk of complication or contradiction related to prescribed medications. The main goals and appropriate treatment for this condition is to provide pain relief and prevent any further injury. This can be accomplished by giving an NSAID (National Clinical Guideline Centre UK, 2016) and by ensuring that the wrist of the patient is stabilized by keeping it on the exact position. Pain relief for the patient is essential to provide comfort and securing the splint is important to prevent any further damage to the wrist of the patient. The pharmacological therapy is considered if there are any signs of inflammation and pain in the affected area. Thus, it is important to assess the wrist of the patient for any swelling or any other complication that might disrupt the process of healing (Mears & Kates, 2015). There are some essential components that must be considered when pharmacological therapy is selected for treatment of the patient. This includes the previous medical history as well as present health problems. The safety of the patient needs to be ensures while prescribing a drug. The primary purpose of prescribing any medication to the patient is to ensure that her current health issues are resolved; however, it is also important that the adverse effects associated with the prescribed medication should also be considered to ensure that no further health problem occurs to the patient. In this case, NSAID is to be prescribed but prior to that it would be important that previous health issues of the patient such as any sort of allergies or other medication should be identified in order to prevent any contradictions from the medication. The mechanism of action for NSAIDs is that they inhibit the activity of cyclooxygenase enzymes (COX-1 or COX-2) which are involved in the synthesis of prostaglandins; thus, they inhibit the production of prostaglandins resulting in reduced inflammation (Steinmeyer, 2000). This medication can be prescribed after assessing the physiologic condition of patient’s liver and kidneys as these organs are vital in metabolism and excretion of medications respectively. Once, the patient starts with the pharmacological therapy with NSAID, the next step is to determine if the medication is working, that is, to identify the efficacy of medication. This can be done by assessing the patient for complains of pain in her injured area. Additionally, an assessment of the swelling and inflammation at the injury site should be performed to determine the efficacy of the medication (Ong, Lirk, Tan & Seymour, 2007). Pain assessment is a type of subjective assessment which, in this case, is a vital measurement tool for the efficacy of the prescribed medication. The observation of the injured site for the presence of swelling would ensure if the medication is actually effective. There are some adverse effects of the medication for which the patient should be regularly monitored. These includes dizziness, effects on blood pressure, hepatic injury, inhibition of platelet (increasing the risk of bleeding), gastrointestinal effects, cardiovascular effects, and alterations in renal function (Ong, Lirk, Tan & Seymour, 2007). This medication could cause problems in patient with gastrointestinal problems. Thus, specific patient education is also needed to minimize the risks of these adverse effects. Some of the patient educations that should be provided are as follows: • Advise the patient to take the medication with meal in order to avoid any stomach problems. Taking the medication on an empty stomach can increase the risk of stomach ulcers (Ong, Lirk, Tan, & Seymour, 2007). • Teach the patient about the importance of reporting any sort of adverse effects immediately to the health care provider to minimize any other health complication. • Provide education about the taking care of the splint area to minimize the risk of any infection. • Provide education about monitoring vital signs such as temperature, blood pressure, pulse, and respiratory rate. Temperature variations are indicative of infection or inflammation and must be frequently monitored. The patient should be monitored for her kidney and liver function test to minimize the risk of toxicity from the NSAIDs. Appropriate advice regarding the course of treatment should be discussed with the patient to enhance her compliance and medication adherence. A regular x-ray of the fractured wrist needed to be done to monitor the progress of bone healing (van Gervan et al., 2018). There are no cultural or religious issues related with the treatment plan for this patient. However, there are formulary considerations that are important because the brand and cost of the drug influence its efficacy. Thus, the patient should be evaluated for her financial status prior to prescribing a brand of medication. Additionally, the weight of the patient is also important in determining appropriate dosage of the medication. The follow-up of the patient would involve an assessment of her laboratory report in addition to her x-ray reports of the fractured wrist. References: 1. National Clinical Guideline Centre (UK. (2016, February). Initial pain management. Retrieved from Nih.gov website: https://www.ncbi.nlm.nih.gov/books/NBK368141/ 2. Mears, S. C., & Kates, S. L. (2015). A Guide to Improving the Care of Patients with Fragility Fractures, Edition 2. Geriatric Orthopaedic Surgery & Rehabilitation, 6(2), 58–120. https://doi.org/10.1177/2151458515572697 3. Steinmeyer, J. (2000). Arthritis Research, 2(5), 379. https://doi.org/10.1186/ar116 4. Ong, C. K. S., Lirk, P., Tan, C. H., & Seymour, R. A. (2007). An Evidence-Based Update on Nonsteroidal Anti-Inflammatory Drugs. Clinical Medicine & Research, 5(1), 19–34. https://doi.org/10.3121/cmr.2007.698 5. van Gerven, P., Rubinstein, S. M., Nederpelt, C., Termaat, M. F., Krijnen, P., van Tulder, M. W., & Schipper, I. B. (2018). The value of radiography in the follow-up of extremity fractures: a systematic review. Archives of Orthopaedic and Trauma Surgery, 138(12), 1659–1669. https://doi.org/10.1007/s00402-018-3021-y Name: Description: ...
User generated content is uploaded by users for the purposes of learning and should be used following Studypool's honor code & terms of service.
Studypool
4.7
Trustpilot
4.5
Sitejabber
4.4