answer to each classmate. total of 4-5 sentence per classmate is fine.
class mate 1
Scenario 1: A 23 yr. old soccer player is taking lithium. He practices 4 days a week and perspires a lot, thus his nurse is concerned about lithium levels being consistent. What should the nurse be considering?
Lithium is a powerful antimanic medication with an unknown mechanism of action and a narrow therapeutic index. Lithium is a monovalent cation similar to sodium approved by the U.S. Food and Drug Administration (FDA) as a mood-stabilizing medication for treatment of mania in the 1970s.
Absorption and secretion of lithium and sodium are closely related. Lithium is reabsorbed with sodium in the proximal tubule (Keltner & Steele, 2019). Sodium and volume depletion due to conditions like excessive sweating, vomiting, diarrhea, fever, renal insufficiency, water restriction, low sodium diet, and congestive heart failure may enhance lithium reabsorption in the kidneys and result in lithium toxicity (Heyda et al., 2020).
The nurse should be observant of any sign of lithium toxicity. Symptoms of intoxication include nausea, vomiting, muscle weakness, seizures, coarse tremor, hyperreflexia, nystagmus, and ataxia among others. The nurse should instruct the patient to maintain usual dietary intake of sodium, and educate him on the signs and symptoms of hyponatremia the require prompt medical attention (Townsend & Morgan, 2018).
Jean Watson’s caritas #6 “Creatively problem-solving, solution-seeking through caring process, full use of self and artistry of caring-healing practices via use of all ways of knowing” (Watson, 2012) can be applied in the process of caring and educating this young athlete about finding a balance between his treatment for mania and his active lifestyle. The information should be presented in a way that highlights the seriousness of potential complication while acknowledging the activities that are important for the patient.
class mate #2
Dear Classmates and Professor.
I have decided to write on scenario three, if someone you know has been diagnosed with Alzheimer’s Disease, would it be a good idea for them to start taking a nonsteroidal anti-inflammatory drug?
Nonsteroidal anti-inflammatory drugs have many contraindications in the elderly due to decreased kidney function, many of them are on anti-coagulants, and other medication interactions. This poses the question of would an NSAIDs benefit or put someone at risk more with Alzheimer’s disease? Many studies have shown that there is no link of NSAID use helping memory impairment in the past, but more have been done recently showing that NSIADs preserve memory and protect neurons (Malkki, 2016). Benito-Leon et al., (2019) studied the use of NSAIDs in patients with Alzheimer’s disease and found decreased mortality with the use of NSAIDs. NSAIDs can be helpful with Alzheimer’s for pain but should be used cautiously due to the GI effects and the problems it can cause to kidneys.
Jean Watson’s Carita number eight is creating a healing environment. When choosing medications for patients, it is imperative to make sure we are doing what is best for the patient. Creating a healing environment allows the whole team to create the environment that is needed for patients to heal. Norman et al., (2016) studied the use of Watson’s Carita factors and found that its improved patient outcomes and created a healing environment for patients and staff. Health care providers must do what is necessary to create a healing environment and help patients through the hardship that they are going through.
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