Case Study #1:M.H., a 70-year-old woman with postoperative acute glaucoma, is prescribed one drop of latanoprost 0.005% ophthalmic solution each evening and one drop of timolol 0.25% ophthalmic solution each morning and evening.1. What is the purpose of giving two different medications to manage M.H.’s glaucoma?2. What special concerns related to medication timing are important for M.H. to consider when administering the evening dose of these medications?3. Although systemic absorption of ophthalmic beta-adrenergic antagonists is usually small, it may potentially create problems for patients with certain conditions. Which conditions create a risk, and how will the nurse monitor for complications?4. After a few months on these medications, M.H. notices changes in the appearance of her eyes. Describe the changes that M.H. is likely experiencing, and explain which ophthalmic drug is responsible. Case Study #2:M.G., a 15-year-old patient, complains about blackheads and large, raised acne with surrounding erythema on her face. She seeks help from a health care provider.1. To assist in identifying her skin problem, what should the health history and assessment include?2. Which nonpharmacologic measures might the nurse discuss with M.G. in caring for her skin condition?M.G.’s skin disorder does not improve. Her health care provider says she has acne vulgaris and has prescribed benzoyl peroxide and oral tetracycline.3. M.G. asks the nurse how to use benzoyl peroxide. What should the explanation of the method and frequency for use of benzoyl peroxide include?4. What should be included in the patient teaching related to the use of oral tetracycline?5. What other drugs for acne might M.G. use? Explain their uses and side effects.6. M.G. asks if she will have to remain on benzoyl peroxide and oral tetracycline for the rest of her life. What is the nurse’s best response or course of action? Explain your answer.  Case Study #3:T.C., a 32-year-old patient, was diagnosed with diabetes mellitus after the birth of her first child; her blood glucose level was 180 mg/dL. Her serum glucose level has been maintained within the normal range with metformin 500 mg/day.1. Why was T.C., at 32 years of age, taking an oral antidiabetic drug instead of insulin?2. Metformin is indicated for what type of diabetes mellitus? When should metformin not be taken?3. Why should T.C. monitor her blood glucose using a home glucometer? Two years later, T.C. became pregnant again. Metformin was discontinued, and NPH insulin 25 units was prescribed. Since the birth of her second child, she has remained on NPH 25 units/day.4. Give a possible reason why the health care provider changed the antidiabetic drug to insulin when T.C. became pregnant.5. What are examples of human insulin and what are its advantages?6. How should insulin be administered?7. What is NPH and what are the pros and cons for T.C. to receive NPH 70/regular 30 insulin?8. What are the signs and symptoms of hypoglycemic reaction?9. What should be included in patient teaching? Case Study #4:M.P., a 68-year-old woman, had a severe allergic reaction to shellfish and was taken to the emergency department. She presented with angioedema and anaphylactic shock. A single dose of dexamethasone 100 mg IV (direct IV over 30 seconds) was ordered. M.P. weighs 65 kg.1. Why is M.P. receiving dexamethasone intravenously? Is the dosage of dexamethasone within the safe therapeutic range? Explain your answer.2. Describe the various ways dexamethasone can be given intravenously. Which IV fluid is compatible with dexamethasone? Describe other routes by which dexamethasone can be administered.3. What additional health information and assessment may aid the health care provider in treating M.P.’s condition? Twenty-one tablets of prednisone, 5 mg each, were prescribed to be taken over 5 days, with tapering daily doses. The dosage is as follows: Day 1, take 10 mg four times a day; day 2, take 10 mg three times a day; day 3, take 10 mg twice a day; day 4, take 10 mg once a day; and day 5, take 5 mg once a day.4. Why was prednisone ordered for M.P. and not oral dexamethasone? Explain your answer.5. What is the purpose for tapering prednisone doses?6. Is the drug dose within the safe therapeutic range? Explain your answer.7. Should M.P. have side effects such as peripheral edema caused by water and sodium retention as a result of tapered prednisone doses? Explain your answer.8. What is the difference between prednisone and prednisolone?9. What are the adverse reactions from prolonged use of prednisone?10. What are the nursing interventions and patient teaching for M.P. and for patients who take prednisone? Please include reference.Health ScienceScienceNursing NUR 2407

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