Nursing Pharmacological Case Scenarios

Nursing Pharmacological Case Scenarios

SCENARIO 1 

What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication classification? What is the mechanism of action (MOA)? Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

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• methylphenidate 5 mg po BID before breakfast and lunch #60 1 refill

• zolpidem 10 mg po qhs #30 6 refills

• alprazolam (Valium) 0.5 mg po TID #90 1 refill

• pregabalin 75 mg po BID #60 6 refills

• infliximab (Humira) 40 mg SQ inject every other week #2 1 RF

SCENARIO 2 

Nicotine stimulates nicotinic acetylcholine receptors in the brain, leading to increased release of dopamine, norepinephrine, serotonin, acetylcholine, and glutamate. These neurochemical effects can temporarily enhance mood, concentration, and alertness—making nicotine use feel relaxing or mentally focusing. Many individuals with ADHD, anxiety, or depression use tobacco products as a form of self-medication. Identify a single prescription medication that can address depression, ADHD symptoms, and assist with smoking cessation. Write a complete medication order for this drug, and include monitoring and patient counseling. Should the patient quit smoking before beginning the medication?

Nursing Pharmacological Case Scenarios

SCENARIO 3 

Tramadol has a half-life of 6 hours. If a patient takes 50 mg at 21:00, what will the blood level be at 09:00 the next morning? Name 3 antidepressants that can be prescribed for pain-related conditions (eg fibromyalgia, neuropathic pain, or chronic musculoskeletal pain). Include complete medication orders, MOA and common side effects for each of the 3 medications.

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SCENARIO 4 

PL is a 42-year-old female presenting for medication refills. She has no recent lab work, but reports fatigue and occasional dizziness. Current meds: metformin 1000 mg PO daily, Invokamet 50/500 mg BID with meals, eszopiclone 2 mg po qHS, atomoxetine 40 mg po daily, and gabapentin 300 mg PO TID. How would you assess and improve her regimen? What monitoring is needed? List 5 possible disease states based on her medications.

Nursing Pharmacological Case Scenarios

Rubric

Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

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References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

APA.