ScenariosThis week the topic is gastrointestinal and hepatobiliary disorders. There is another assignment due by Day 7 of Week 4. Please make sure to look at the rubric before writing answers to the scenarios to make sure all required topics are addressed. I will post the scenarios in another announcement. Have a good week!Directions: For each of the scenarios, answer the questions using clinical practice guideline where applicable. Explain the problem and explain how you would address the problem. Write out a complete medication order just as you would if you were completing a prescription. Use at least 3 sources for each scenario and cite sources using APA format.
Sara is a 45-year-old female presenting for her annual exam. Her blood pressuretoday is 160/90 HR 84 RR 16. Her height is 64 inches and her weight is 195. Herlast visit to the clinic 3 months ago shows a BP of 156/92. She is currently takingibuprofen 600 mg tid for back pain. She has no known allergies. What is the goalfor her blood pressure? What medication would you prescribe to treat her bloodpressure? What education would you prescribe?Monty is a 52-year-old male following up on his labs that were drawn last week.He smokes 1 pack per day. He is currently on Lisinopril 20 mg po daily. He isallergic to penicillin. Fasting lipid profile shows total cholesterol 266, LDLcholesterol 180, HDL cholesterol 40, and Triglycerides 185. What treatment planwould you implement for Monty’s lipid profile? What is the goal Total Cholesterol(TC), HDL-C, and LDL-C level for Monty? How would you monitor theeffectiveness of your treatment plan? How many risk factors for coronary arterydisease does this patient have? Identify them specifically.Beatrice is a 17-year-old female diagnosed with mild persistent asthma since age7. During her visit today, she reports having to use her albuterol MDI 3 to 4 daysper week over the past 2 months. Over the past week she has been usingalbuterol at least once per day. She reports being awakened by a cough threenights during the last month. She is becoming shorter of breath with exercise.She also has a fluticasone MDI, which she uses “most days of the week.” Hercurrent medications include: Flovent HFA 44 mcg, two puffs BID, Proventil HFAtwo puffs Q 4–6 H PRN shortness of breath, Yaz one PO daily, Propranolol 80mg PO BID. What treatment plan would you implement for this patient? Whatmedication changes would you make? How would you monitor the effectivenessof this plan?Daute is a 56-year-old man seeking evaluation for increasing shortness ofbreath. He noticed difficulty catching his breath about 3 years ago. Physicalactivity increases his symptoms. He avoids activity as much as possible toprevent any SOB. His previous physician had placed him onsalmeterol/fluticasone (Advair Diskus) one inhalation twice daily 2 years ago. Hethinks his physician initiated the medication for the shortness of breath, but he isnot entirely sure. He did not refill the prescription and has not been taking it.Pertinent history – Chronic bronchitis X 8 years with one exacerbation in last 12months of treatment with oral antibiotics. He has a 40-pack-year smoking history.What treatment plan would you implement for this patient? What medication(s)would you prescribe? How would you monitor the effectiveness of this plan?