Discuss on Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders To Prepare • Review the resources for this module and reflect on the different health needs and body systems presented. • Review your peers case studies from Week 9. • Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected. Week 9 Discussion COLLAPSE Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders History and Physical Community-acquired pneumonia (CAP) is mainly due to S. pneumoniae, Mycoplasma spp., H.influenzae, and Staphylococcus aureus (Rosenthal & Burchum, 2019, p.655). HH needs to understand the main cause of the condition. As a result of potential allergies, the use of penicillin antibiotics is off the table. The use of the current course is appropriate due to infective agents andthe weight of the patient. It is appropriate for the APRN to get a susceptibility panel for the identification of the organisms. Nausea and anorexia are the main side effects when using these medications. Health Needs Other than the CAP therapy, HH suffers from COPD that can worsen due to repeated respiratory infections like CAP (Mayo, 2020). The APRN must be mindful and make sure that he baseline needs are met through common COPD medications and oxygen needs to ensure that the underlying COPD is controlled. There are also indications of clinical improvement although plagued by nausea and loss of appetite. HH requires less oxygen needs hence showing how the current treatment is effective. The APRN must treat the side effects of the antibiotics Drug Therapy Regimen Before starting a treatment plan, a thorough medication reconciliation should be done to verify potential drug interactions. In addition to this, the APRN should get a susceptibility panel to identify the specific organisms. This will help to ensure that the minimal use of antibiotics occurs while still achieving results. The APRN should be a good steward combating antibiotic resistance (Rosenthal & Burchum, 2019). The next step is to consider de-escalation of the patient’s antibiotic regimen. According to Aoki, et al, (2021), there exists no difference between ceftriaxone + azithromycin and ceftriaxone monotherapy for the empiric treatment of CAP. There is a high likelihood of vomiting, nausea, and diarrhea due to antibiotics, the use of azithromycin can help in alleviating the undesirable symptoms. It is also necessary to supplement the course of the patient with probiotics. There are specific probiotics that assist in reducing the abdominal pain duration and the intensity of diarrhea. The use of antiemetic medication like ondansetron is appropriate in the control of nausea. Its usage is safer than using promethazine that leads to respiratory depression. Drug therapy justifications Due to symptoms like vomiting and anorexia, I decide to take away azithromycin as a de-escalation strategy. For patients who have community-acquired pneumonia, de-escalation is asafer strategy (Yamana et al., 2016). The second step was to offer supportive care that has a safeantiemetic. The reason is to help in the short term and offer probiotic supplements as it eases negative side effects related to antibiotic therapy. The issue will see an improvement in CAP and return on the appetite. Patient Education Due to the COPD status of the patient, it is possible to have a respiratory infection. Such recurring infections can worsen the COPD condition of the patient (Mayo, 2020). The APRN must make sure that the patient is discharged with PO medication and finishes the prescription. The issue helps in preventing the recurring of the condition (Rosenthal & Burchum, 2019, p.667). The APRN also needs to discuss the potential lifestyle habits. Reference Rosenthal, L. D., & Burchum, J. R. (2019). Lehne’s pharmacotherapeutics for advancedpractice providers. St. Louis, MO: ElsevierYamana, H., Matsui, H., Tagami, T., Hirashima, J., Fushimi, K., & Yasunaga, H. (2016). De-escalation versus continuation of empirical antimicrobial therapy in community-acquiredpneumonia. Journalof Infection, 73(4), 314–325. https://doi- org.ezp.waldenulibrary.org/10.1016/j.jinf.2016.07.001 Mayo Clinic: COPD (2020). Retrieved from https://www.mayoclinic.org/diseases-conditions/COPD/symptoms-causes/syc-20353679#: ~:text=Chronic%20obstructive%20pulmonary%20disease%20(COPD,(sputum)%20production%20and%20wheezing.Aoki, T., Mizushima, D., Takano, M., Ando, N., Uemura, H., Yanagawa, Y., … & Oka, S.(2021). Efficacy of 1g ceftriaxone monotherapy compared to dual therapy withazithromycin or doxycycline for treating extragenital gonorrhea among men who have sex with men. Clinical Infectious Diseases. Resources for the case study: Lunenfeld, B., Mskhalaya, G., Zitzmann, M., Arver, S., Kalinchenko, S., Tishova, Y., & Morgentaler, A. (2015). Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male, 18(1), 5–15. doi:10.3109/13685538.2015.1004049 Montaner, J. S. G., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., … Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS ONE, 9(2), e87872. Retrieved from https://doi.org/10.1371/journal.pone.0087872 This study examines HAART therapy and its sustainability and profound population-level decrease in morbidity, mortality, and HIV transmission. Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53–58. .https://doi.org/10.1016/j.maturitas.2016.01.007 Agency for Healthcare Research and Quality. (2014). Guide to clinical preventive services, 2014: Section 2. Recommendations for adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, and counseling.
