Would you make any changes to Ms. BD’s blood pressure and GERD medications? Explain. If yes, what would you prescribe?
Make a comment Participation Responses: No later than the end of the week, review and comment on the discussion questions responses posted by at least two of your peers. Guidelines: Support your responses with scholarly academic references using APA style format. Assigned course reading and online library resources are preferred. Weekly lecture notes are designed as overviews to the topic for the respective week and should not serve as a citation or reference. In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and examples; demonstrates a clear connection to the readings In your participation responses to your peers, comments must demonstrate thorough analysis of postings and extend meaningful discussion by building on previous postings. Note: Review South University’s Substantive Participation Policy Criteria, Helpful Tips, and Late Policy available by clicking on the South University Policy and Guidelines navigation tab. The late policy applies to late discussion question responses. Discussion Question 1 For these questions, please read the following case study and then respond to the questions noted below. Ms. BD is a 33-year-old G2P1 African-American female who presents to your clinic today complaining of unusual fatigue, nausea, and vomiting for the last five days. She has a medical history of chronic hypertension (HTN) that was diagnosed shortly after her first pregnancy two years ago and GERD. MS. BD’s blood pressure is controlled on Lisinopril-Hydrochlorothiazide 20/12.5mg by mouth twice a day, and GERD controlled on Bismuth Subsalicylate 262mg by mouth every 6 hours as needed. During the interview, you learn that she is single, sexually active, has one partner and that her menses is ten days late. She performed a home pregnancy the three days after missing her menstrual cycle, and the results were inconclusive. She states she feels terrible and needs relief. She has no other medical problems, symptoms, or concerns. Assessment: Physical examination is unremarkable. BP128/68, HR is 74, Urine human chorionic gonadotropin (HCG) positive, beta HCG sent, potassium 4.2, blood urea nitrogen (BUN) 14, creatinine is 0.6, Alanine aminotransferase (ALT) 29, White blood cells (WBCs) 6.5, hemoglobin (Hgb) 12.8, hematocrit (Hct) 39, and platelets 330,000. List the additional questions you would need to ask this patient. Explain. What is the safety profile of Lisinopril-hydrochlorothiazide and bismuth subsalicylate in pregnant women? What are the possible complications to the pregnant woman and her fetus? What is the importance of assessing laboratory values when prescribing medications? How might the laboratory values, in this case, impact your treatment plan? Would you make any changes to Ms. BD’s blood pressure and GERD medications? Explain. If yes, what would you prescribe? Discuss the medications safety in pregnancy, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings. How does ethnopharmacology apply to this patient if she were NOT pregnant? Explain. What health maintenance or preventive education do you provide in this client case based on your choice of medications/treatment? Would you treat this patient or refer her? Explain. If you refer, where would you refer this patient? Rubrics: Quality of Initial Posting- The information provided is accurate, providing an in-depth, well thought-out understanding of the topic(s) covered. An in-depth understanding provides an analysis of the information, synthesizing what is learned from the course/assigned readings. Writing mechanics- Minor to no errors exist in grammar, mechanics, or spelling in both the initial post and comments to others. Formatting of citations and references is correct. If required for the assignment, utilizes sources to support work for both the initial post and the comments to other students. Sources include course and text readings as well as outside sources (when relevant) that are academic and authoritative (e.g., journal articles, other text books, .gov Web sites, professional organization Web sites, cases, statutes, or administrative rules)
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