Administer medication safely. monitor, and evaluate the outcomes of the medication, both positive and negative
The assignment consists of 3 parts.. part one contain 3 questions to answer, part 2 is a case study reading and answer the questions, part 3 is the case study as well and answer questions
Case Studies
Your role as a Developmental Service Worker is to administer medications safely. Another significant role is to monitor, and evaluate the outcomes of the medication, both positive and negative.
Review the following case studies and answer the questions.
The challenge is “putting it all together” in a way that demonstrates your understanding of various types of medication as well as the various diagnoses. In order to answer the questions, you must research each of the medications, and also have some knowledge of the various diagnoses. Some of your answers will require your creative problem solving, as you may not find the answer in a text. If you can recall some of the classroom discussions, it might be helpful.
To gather information, you will be using the course text, Essentials of Pharmacology for Health Professions, Guide to Drugs in Canada, class notes and power point presentation (week 8); you may also access reliable web sites: Canoe Health, WebMD., Epilepsy Canada, CAMH, (Wikipedia is NOT considered a reliable website.)
Part 1
1. Explain the following terms and give examples of each;
a) Psychotropic medication
b) Typical and Atypical medication c) Delusion
d) Hallucination
2. Give a brief description of;
a. Drug tolerance
b. Drug dependence
3. As a DSW, briefly describe in one – two paragraphs how you would ensure an individual with an intellectual disability has consistent support while transitioning onto a new medication. i.e. teaching, protocols
Part 2
4. Rob sustained a brain injury due to trauma at age 18 months and is now 25 years old. Rob has a moderate (to severe) developmental disability and he has complex partial seizures.
• Rob also has behavioural problems in that he can be aggressive at times. Rob becomes very frustrated when he is told “no” or that he cannot do something that he believes that he can, such as taking the train by himself to Montreal to look after his elderly grandmother.
• In the last month, Rob’s aggression of yelling profanities at staff and threatening them has increased significantly. Rob also has an older sibling who has been diagnosed with a bipolar disorder but does not have a developmental disability.
• Rob was assessed by his neurologist 2 months ago. Due to being seizure-free for 2 years, the neurologist decreased the Depakote (Divalproex Sodium) by 250 mg/day. Rob is due to return to the neurologist for a 6-month follow-up in 4 months’ time.
• Rob eats regular diet, but the foods must be chopped into bite-sized pieces or smaller.
Rob’s Medications include:
Depakote (Divalproex Sodium): 250mg in the morning and 500mg at night.
Ferrous gluconate: 300mg once daily.
Answer the following questions:
a) Identify the drug classification for each medication and suggest the reason why they were prescribed. Is it possible that one medication may have been playing a dual role?
b) Depakote (Divalproex Sodium) is ‘enteric coated’. Explain what that means.
c) Write directions for your co-workers as to the best way to administer both of his medications. What times for medication administration would you suggest? Explain how you would use Rob’s input.
d) You are accompanying Rob to a routine 3-month follow-up with his primary physician. What information would you help Rob to share with the physician? Explain why.
e) What tests do you think the physician should be ordering? Explain why.
f) How would you explain the type of seizures that Rob has to a new co-worker. Explain the rationale for not restraining Rob during a seizure.
Part 3
5. Paul is 30 years old and has a severe developmental disability of unknown origin. Paul’s living arrangements includes 24-hour support in a group living situation. He has been taking Haldol 1 mg twice daily plus Benztropine 2 mg twice daily for over 10 years.
• Paul exhibits aggression that consists mostly of pinching staff. Staff interprets the pinching to be his way of communicating things he considers urgent. The pinching seems to mean a variety of things such as “you are in my chair”, “I need to go to the bathroom”, “I am ready for dinner”, “I don’t feel well”, “it hurts when I void (pee)”, and it’s really hot in this house”.
• Recently the aggression has increased up in frequency from, once a month to 3 – 4 daily.
• The psychiatrist has decided that due to long term use of Haldol and its apparent ineffectiveness, she has prescribed Celexa 10 mg twice daily to start slowly.
• If effective the Haldol will be slowly decreased and stopped.
• Paul has gained 10 lbs. over the past year and burps frequently during the day, after which he makes a sour face. Why do you think that is happening?
• Paul eats a regular diet, and the residential direct care staff has been known to offer food to temporarily appease him.
Answer the following questions;
a) Identify the drug classification for each medication and suggest the reason why they were prescribed.
b) Explain the meaning of the term ‘dual diagnoses.
c) What format of the medication would best be suited for Paul? Write directions for your co- workers as to the best way to administer his medication. What times for medication administration would you suggest?
d) Explain the rationale for slowly decreasing the Haldol, rather that stopping it abruptly.
e) You are accompanying Paul to a routine 3-month follow-up with his primary physician. What information would you help Paul to share with the physician? Explain why.
f) What non-medication actions could you use to help Paul to reduce his weight? The weight gain could aggravate his hiatus hernia or a gastro-esophageal reflux which in turn may require management with additional medication.
g) Devise a way of monitoring the effectiveness of the new medication.
h) What information would you assist Paul to share with the psychiatrist?
i) What are Paul’s rights when the physician prescribes psychotropic medication?
j) What is the term for the person who could legally assist Paul to make medical decisions?
k) Does Paul have the right to refuse to take medication? What action might you take if Paul did refuse to take his medication?
l) While you were preparing Paul’s medication, you accidentally dropped a Celexa tablet onto the floor. What actions would you take? (Include how you would dispose of the medication.
m) How would you store each of these medications?
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