Patient medication education scenario

Using the SMARTER goals: develop a patient medication education scenario(Pick 1 of the below scenerios) in which the SMARTER help support patient outcomes

1- Congestive Heart Failure: Beta Blocker, & ACE/ARB

2- Acute Myocardial Infarction – Antiplatelet, antithrombolytic,ASA, Beta Blocker, & ACE/ARB

3- Diabetes- Insulin

4- CVA/Stroke- Antiplatelet, antithrombolytic, Hypertension medication (Common)

Describe each condition, the medication(Medication class, Pharmacokinetics) needed to improve or manage condition, patient education (SMARTER Goals)

Be creative and have fun- This should highlight what you have learned so far and how you are keeping patients healthy in the community!

FIRST PERSON TO RESPOND TO ………………………….

Diabetes is a chronic disease that affects the normal balance of glucose and insulin in the blood. The levels of glucose are elevated in the blood. There are various risk factors for diabetes, such as family history, environmental factors, age, and obesity. Diabetes can lead to many complications if not managed well in time that can even damage the organs (Cole & Florez, 2020). Diabetes is diagnosed by the Fasting plasma glucose test, Oral glucose tolerance test, and Random glucose levels. Normal Fasting glucose level is 80-180 mg/dL, and Random glucose level should be less than 180 mg/dL. If the levels are out of normal range, then the patient is suffering from diabetes. Type of diabetes depends upon the etiology of the disease. The SMART goal can help following the medication regimen and improve the health status. In this case, it will be “the reduction of blood glucose levels to the normal range with stability through insulin administration in a period of three months”

Medication

Lantus is the long-acting human insulin analog and belongs to the class hormones (Naafs, 2020). It is indicated for diabetes type 1 and diabetes type 2. It is available as 100 units per mL in two forms: multiple-dose vial 10mL and single-use vial 3mL. It is administered through a subcutaneous route.

Pharmacokinetics

Absorption is slow, prolonged, and takes 24 hours to achieve constant concentration/time. The metabolism of insulin glargine yields two active metabolites, which are similar to human insulin.

Patient Education about medication

LANTUS should not be given intravenously.

Insulin glargine’s long-lasting activity is based on its infusion into subcutaneous tissue.

LANTUS should never be mixed or diluted with another insulin or solution.

The dose of the medicine is prescribed by the physician according to the severity of the disease. Make sure you know how much LANTUS you’re using. If your healthcare practitioner instructs you to, don’t adjust the amount of LANTUS you’re taking. Make sure you’re using the right insulin by checking the label each time you give an injection.

Follow these guidelines to keep the insulin in a good state for use and right administration; (i) the insulin should be injected at a distant place than the previous site, (ii) avoid the use if it has clumps or show different texture, (iii) mix and roll the vial in your palms before use, (iv) place and store at a cool place (Diabetes Canada, 2018).

SECOND PERSON TO RESPOND TO ……………..

A. Congestive Heart Failure: Beta Blockers, & ACE/ARB

· Heart failure is a complex clinical syndrome in which the heart is unable to pump enough blood to meet the requirements of the body. It results from any disorder that impairs ventricular filling or ejection of blood to the systemic circulation. Patients usually present with fatigue and dyspnea, reduced exercise tolerance, and fluid retention (pulmonary and peripheral edema). (Malik, 2021) A patient suffering from CHF heart is unable to maintain adequate cardiac output to meet the metabolic needs of the body. The diminished cardiac output results in adequate peripheral tissues perfusion. Congestion of the lungs and periphery may occur, and the client may develop acute pulmonary edema.

B. Types of heart failure:

· right and left heart failure

· forward failure and backward failure

· systolic failure and diastolic failure

C. Signs and symptoms:

· Shortness of breath with activity or when lying down

· Fatigue and weakness

· Swelling in the legs, ankles, and feet

· Rapid or irregular heartbeat (tachycardia)

· Reduced ability to exercise

· Persistent cough or wheezing with white or pink blood-tinged mucus

· Swelling of the belly area (abdomen)

· Very rapid weight gain from fluid buildup

· Nausea and lack of appetite

· Difficulty concentrating or decreased alertness

· Chest pain if heart failure is caused by a heart attack

· Nasal faring

· Cyanosis

· Pallor

D. Immediate management:

· Place the client in a high Fowler’s position

· Administer oxygen

· Monitor lung sounds

· Ensure an intravenous fluid

E. Interventions:

· Encourage the client to verbalize feelings

· Advise the client to notify the HCP if any side effects of medications occur

· Advise the client to avoid over the counter medications

F. Medication management:

• Beta-blockers, also known as beta-adrenergic blockers, inhibit the response to beta-adrenergic stimulation, lowering cardiac output and lowering blood pressure. They block the release of catecholamines, epinephrine, and norepinephrine, lowering cardiac output and lowering blood pressure. Beta-blockers have a half-life of 1 to 2 hours. (Vallerand, Sanoski, 2021)
• Metoprolol (Lopressor)
• Bisoprolol (Zebeta)
• Propranolol (Inderal) and other beta-blocker have side effects such as bradycardia, bronchospasm, hypertension, tiredness, vomiting, hyperglycemia, and depression.
• ACE inhibitors prevent peripheral vasoconstriction by inhibiting angiotensin I and II conversion and ARB prevent aldosterone vasoconstriction and block all binding to type I all receptors. ACE/ ARB is used to treat hypertension and heart failure. (Vallerand, Sanoski, 2021)

Sample Solution