Self-Care and Nonprescription Pharmacotherapy I (7405 ... Cases 0912… · Decrease Vicodin or d/c...
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Self-Care and Nonprescription Pharmacotherapy I (7405) Utilize the QuEST/SCHOLAR process to complete patient exam cases. Address all incomplete sections by incorporating the directions below. Point distribution is included with each section. Only answers written in the specified space will be assessed. DO NOT write in the section designated for instructor comments. Patient Initials: AL Age: 16 Gender: F Chief Complaint: “Do you have the morning after pill?” Qu Quickly and accurately assess the patient Symptoms Characteristics History Onset Location Aggravating factors Remitting factors Medications Allergies Coexisting conditions (past medical history) (SCHOLAR): My boyfriend said there was a rip in the condom last night. (MAC): Meds--Albuterol inhaler 2puffs Q4H prn, Flovent inhaler 110mcg/inhalation 2 puffs BID, Loratadine 10mg po daily Allergies--None Co-existing conditions--Asthma, Allergic Rhinitis Physical Observation: Looks distressed, mascara running down face E Establish if the patient is a candidate for self-care once you have identified the medical and drug- related problems Include any assumptions (additional facts) made when determining treatability – limit 2 Medical Problem: DRP: Circle one: No treatment Self-treatment Referral Assumptions: 6.0 5.25 4.5 3.0 0 2.0 1.75 1.5 1.0 0
Transcript of Self-Care and Nonprescription Pharmacotherapy I (7405 ... Cases 0912… · Decrease Vicodin or d/c...
Self-Care and Nonprescription Pharmacotherapy I (7405)
Utilize the QuEST/SCHOLAR process to complete patient exam cases. Address all incomplete sections by incorporating the directions below.
Point distribution is included with each section. Only answers written in the specified space will be assessed. DO NOT write in the section
designated for instructor comments.
Patient Initials: AL Age: 16 Gender: F
Chief Complaint: “Do you have the morning after pill?”
Qu Quickly and accurately assess the patient
Symptoms Characteristics History Onset Location Aggravating factors Remitting factors Medications Allergies Coexisting conditions (past medical history)
(SCHOLAR):
My boyfriend said there was a rip in the condom last night.
(MAC):
Meds--Albuterol inhaler 2puffs Q4H prn, Flovent inhaler 110mcg/inhalation 2 puffs BID, Loratadine 10mg po daily
Allergies--None
Co-existing conditions--Asthma, Allergic Rhinitis
Physical Observation: Looks distressed, mascara running down face
E Establish if the patient is a candidate for self-care once you have identified the medical and drug-related problems Include any assumptions (additional facts) made when determining treatability – limit 2
Medical Problem: DRP: Circle one: No treatment Self-treatment Referral Assumptions:
6.0 5.25 4.5 3.0 0
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405) S Suggest appropriate self-
care strategies based on desired therapeutic outcomes (if appropriate)
Include medication name, dose, frequency, duration of therapy, and nonpharmacologic general care
measures
Goals: Treatment:
4.0 3.5 3.0 2.0 0
10.0 8.75 7.5 5.0 0
Treatment justification:
2.0 1.5 1.0 0
T Teach the patient Include medication action, administration and adverse effects
6.0 5.25 4.5 3.0 0
Include what to expect and appropriate follow- up (monitoring)
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405)
Utilize the QuEST/SCHOLAR process to complete patient exam cases. Address all incomplete sections by incorporating the directions below.
Point distribution is included with each section. Only answers written in the specified space will be assessed. DO NOT write in the section
designated for instructor comments.
Patient Initials: BY Age: 72 Gender: F
Chief Complaint: “I haven’t been able to go to the bathroom in about 3 days”
Qu Quickly and accurately assess the patient
Symptoms Characteristics History Onset Location Aggravating factors Remitting factors Medications Allergies Coexisting conditions (past medical history)
S: Include bloating, gas, feeling full, stomach ache
C: Last bowel movement was hard and difficult to pass
H: Experience constipation a few years ago, however usually produces a stool every day after tea and toast in the morning.
O: 3 days ago
L:
A: nothing making worse
R: ExLax in cabinet was expired so did not take. Tried drinking more coffee. Pt doesn’t really like water
M:
Vicodin 5mg /325mg po prn x 5 days for recent fall resulting in minor injury
HCTZ 25mg po QAM
Lisinopril 20mg po QAM
Amlodipine 5mg PO QAM
Spiriva inhalation once a day
Albuterol HFA prn
A: sulfa
C: HTN, COPD
Physical observation: Pt looks uncomfortable, limping due to recent injury
Self-Care and Nonprescription Pharmacotherapy I (7405) E Establish if the patient is a
candidate for self-care once you have identified the medical and drug-related problems Include any assumptions (additional facts) made when determining treatability – limit 2
Medical Problem: DRP: Circle one: No treatment Self-treatment Referral Assumptions:
6.0 5.25 4.5 3.0 0
2.0 1.75 1.5 1.0 0
S Suggest appropriate self-care strategies based on desired therapeutic outcomes (if appropriate)
Include medication name, dose, frequency, duration of therapy, and nonpharmacologic general care
measures
Goals: Treatment: (nondrug): Increase water/fluid to 6-8 8oz glasses per day, increase fiber in diet, increase activity is not
appropriate at this time due to the recent injury limiting
Decrease Vicodin or d/c if possible. If patient states that she still needs Vicodin for current pain
management, then recommend bisacodyl
4.0 3.5 3.0 2.0 0
10.0 8.75 7.5 5.0 0
Treatment justification:
2.0 1.5 1.0 0
T Teach the patient Include medication action, administration and adverse effects
6.0 5.25 4.5 3.0 0
Include what to expect and appropriate follow- up (monitoring)
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405)
Utilize the QuEST/SCHOLAR process to complete patient exam cases. Address all incomplete sections by incorporating the directions below.
Point distribution is included with each section. Only answers written in the specified space will be assessed. DO NOT write in the section
designated for instructor comments.
Patient Initials: FT Age: 14 Gender: F
Chief Complaint: “I am having some discomfort and pain. Where is the Midol?”
Qu Quickly and accurately assess the patient
Symptoms Characteristics History Onset Location Aggravating factors Remitting factors Medications Allergies Coexisting conditions (past medical history)
S: abdominal pain
C: cramping, bloating, sister also has symptoms
H: last 2 months
O: 1 hour prior to the start of menstruation (last night)
L: abdomen
A:
R: after menstruation ends
M: Doryx
A: NKDA
C: Acne, not pregnant
Physical Observation:
E Establish if the patient is a candidate for self-care once you have identified the medical and drug-related problems Include any assumptions (additional facts) made when determining treatability – limit 2
Medical Problem: DRP: Circle one: No treatment Self-treatment Referral Assumptions:
6.0 5.25 4.5 3.0 0
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405) S Suggest appropriate self-
care strategies based on desired therapeutic outcomes (if appropriate)
Include medication name, dose, frequency, duration of therapy, and nonpharmacologic general care
measures
Goals: Treatment: (nondrug): heating pad, exercise, water, avoid Na+,
Drug: Use NSAID (not ASA) such as: ibuprofen tabs 200mg po 4-6 hrs prn with max of 6 tabs or
1200mg per day or naproxen 220 mg po q 12 hrs prn (do not recommend APAP as it is less
effective)
4.0 3.5 3.0 2.0 0
10.0 8.75 7.5 5.0 0
Treatment justification:
2.0 1.5 1.0 0
T Teach the patient Include medication action, administration and adverse effects
Take NSAID prior to the start of menstruation, take round the clock, take with food to decrease GI upset
6.0 5.25 4.5 3.0 0
Include what to expect and appropriate follow- up (monitoring)
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405)
Utilize the QuEST/SCHOLAR process to complete patient exam cases. Address all incomplete sections by incorporating the directions below.
Point distribution is included with each section. Only answers written in the specified space will be assessed. DO NOT write in the section
designated for instructor comments.
Patient Initials: SE Age: 17 Gender: F
Chief Complaint:
Qu Quickly and accurately assess the patient
Symptoms Characteristics History Onset Location Aggravating factors Remitting factors Medications Allergies Coexisting conditions (past medical history)
S: cramping, abdominal pain, lower back pain
C: cramping that limits activities when it occurs
H: last 4-5 months, describes as intermittent, some months are worse than others
O: 1-2 days prior to the start of menstruation
L:
A: None
R: heating pad, tried midol-teen but it did not work
M:
A: PCN
C: Migraine headaches, not pregnant
Physical Observation: holding abdomen (may also present wearing a ThermaCare patch)
E Establish if the patient is a candidate for self-care once you have identified the medical and drug-related problems Include any assumptions (additional facts) made when determining treatability – limit 2
Medical Problem: DRP: Circle one: No treatment Self-treatment Referral Assumptions:
6.0 5.25 4.5 3.0 0
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405) S Suggest appropriate self-
care strategies based on desired therapeutic outcomes (if appropriate)
Include medication name, dose, frequency, duration of therapy, and nonpharmacologic general care
measures
Goals: Treatment: (nondrug): avoid salty foods, remain hydrated, exercise, continue to use heating pad
Drug: Use NSAID like ibuprofen tabs 400mg po TID prn with max of 6 tabs or 1200mg per day or
naproxen 220 mg po BID prn
For this episode, take as needed. Next month, begin taking 1 day before menstruation
4.0 3.5 3.0 2.0 0
10.0 8.75 7.5 5.0 0
Treatment justification:
2.0 1.5 1.0 0
T Teach the patient Include medication action, administration and adverse effects
6.0 5.25 4.5 3.0 0
Include what to expect and appropriate follow- up (monitoring)
If symptoms do not resolve or get worse, follow-up with PCP
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405)
Utilize the QuEST/SCHOLAR process to complete patient exam cases. Address all incomplete sections by incorporating the directions below.
Point distribution is included with each section. Only answers written in the specified space will be assessed. DO NOT write in the section
designated for instructor comments.
Patient Initials: ES Age: 25 Gender: F
Chief Complaint: “I have this rash on my hands that really itches”
Qu Quickly and accurately assess the patient
Symptoms Characteristics History Onset Location Aggravating factors Remitting factors Medications Allergies Coexisting conditions (past medical history)
S: Interdigital linear rashes
C:
H: Itches more at night. Hands are dry from washing and use of latex free gloves. Patient works at a long term care facility.
O: 1 week ago
L: Both hands
A: Worse at night
R: Nothing has helped. Tried Vaseline Intensive care and cortisone cream.
M: Takes no meds
A: PCN
C: might be pregnant
Physical Observation: red linear rash interdigitally, slight excoriation from scratching
E Establish if the patient is a candidate for self-care once you have identified the medical and drug-related problems Include any assumptions (additional facts) made when determining treatability – limit 2
Medical Problem: Scabies DRP: Circle one: No treatment Self-treatment Referral Assumptions:
6.0 5.25 4.5 3.0 0
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405) S Suggest appropriate self-
care strategies based on desired therapeutic outcomes (if appropriate)
Include medication name, dose, frequency, duration of therapy, and nonpharmacologic general care
measures
Goals: Treatment: (nondrug):
4.0 3.5 3.0 2.0 0
10.0 8.75 7.5 5.0 0
Treatment justification:
2.0 1.5 1.0 0
T Teach the patient Include medication action, administration and adverse effects
6.0 5.25 4.5 3.0 0
Include what to expect and appropriate follow- up (monitoring)
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405)
Utilize the QuEST/SCHOLAR process to complete patient exam cases. Address all incomplete sections by incorporating the directions below.
Point distribution is included with each section. Only answers written in the specified space will be assessed. DO NOT write in the section
designated for instructor comments.
Patient Initials: CP Age: 44 Gender: F
Chief Complaint: “I have this growth on my finger for the last few weeks and I don’t know what to do about it.”
Qu Quickly and accurately assess the patient
Symptoms Characteristics History Onset Location Aggravating factors Remitting factors Medications Allergies Coexisting conditions (past medical history)
S & C: not bleeding, slightly irritated, rough, not changing, left index finger (lateral side)
H: 3 weeks ago
O: not better/or worse but irritated when holding scissors
L: left index finger (lateral)
A: holding scissors
R: nothing (hasn’t tried anything)
M: Lexapro
A: aspirin (upset stomach)
C: depression and pre-menopausal
Physical Observation: ran finger over growth, noticeable flesh colored papule
E Establish if the patient is a candidate for self-care once you have identified the medical and drug-related problems Include any assumptions (additional facts) made when determining treatability – limit 2
Medical Problem: DRP: Circle one: No treatment Self-treatment Referral Assumptions:
6.0 5.25 4.5 3.0 0
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405) S Suggest appropriate self-
care strategies based on desired therapeutic outcomes (if appropriate)
Include medication name, dose, frequency, duration of therapy, and nonpharmacologic general care
measures
Goals: Treatment: (nondrug): file w/ an emery board, cover with duct tape (patient preference)
Drug: Compound W Gel or Freeze Off
Need to pursue more information regarding the ASA allergy to determine if a salicylic acid
product can be used
4.0 3.5 3.0 2.0 0
10.0 8.75 7.5 5.0 0
Treatment justification:
2.0 1.5 1.0 0
T Teach the patient Include medication action, administration and adverse effects
If using emery board, do not use on nails to avoid spread of virus 6.0 5.25 4.5 3.0 0
Include what to expect and appropriate follow- up (monitoring)
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405)
Utilize the QuEST/SCHOLAR process to complete patient exam cases. Address all incomplete sections by incorporating the directions below.
Point distribution is included with each section. Only answers written in the specified space will be assessed. DO NOT write in the section
designated for instructor comments.
Patient Initials: TS Age: 45 Gender: M
Chief Complaint: “I feel lightheaded and shaky”
Qu Quickly and accurately assess the patient
Symptoms Characteristics History Onset Location Aggravating factors Remitting factors Medications Allergies Coexisting conditions (past medical history)
S and C: in addition to complaints above, sweaty palms and slight nausea, does not feel feverish
H: patient has been busy and has not eaten since last night. These feelings occur on occasion and when working long hours.
Occurring more frequently of late. Blood glucose was checked in the pharmacy and is 62 mg/dL).
O: within the last hour
L: all over
A: skipping meals, rigorous exercise
R: if work-out or work day not too long
M: none
A: PCN
C:
Physical Observation: pale and sweating profusely, patient is obese
E Establish if the patient is a candidate for self-care once you have identified the medical and drug-related problems Include any assumptions (additional facts) made when determining treatability – limit 2
Medical Problem: DRP: Circle one: No treatment Self-treatment Referral Assumptions:
6.0 5.25 4.5 3.0 0
2.0 1.75 1.5 1.0 0
Self-Care and Nonprescription Pharmacotherapy I (7405) S Suggest appropriate self-
care strategies based on desired therapeutic outcomes (if appropriate)
Include medication name, dose, frequency, duration of therapy, and nonpharmacologic general care
measures
Goals: Treatment: (nondrug): eat three meals daily, begin checking BG
(drug): glucose tabs
4.0 3.5 3.0 2.0 0
10.0 8.75 7.5 5.0 0
Treatment justification:
2.0 1.5 1.0 0
T Teach the patient Include medication action, administration and adverse effects
Instruct on appropriate meter use 6.0 5.25 4.5 3.0 0
Include what to expect and appropriate follow- up (monitoring)
Repeat glucose check in 15 minutes (before leaving the pharmacy) May need to follow-up with PCP
2.0 1.75 1.5 1.0 0
