The main measures for interview is established by good rapport, respect patient privacy, recognize face value, move to the patient's field of vision, SOLER as a reminder to sit directly, have an open posture, lean forward, make eye contact and relax, ask open-ended questions, one thing at a time, listen, culture matters, and avoid the medical terminology. This writer sets into view to interview an African-American gentleman with a two years history of chronic obstructive pulmonary disease (COPD). The aim of this interview is to explore the effect of medications on the patient’s health status, including the pharmacokinetics, pharmacodynamics, and patient’s knowledge and compliance of medications.
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Louis is 54 years old, high school graduate, working as a mechanic helper in a local workshop in New York. He brought to the Emergency Department (ED) by ambulance, due to coughing, wheezing, shortness of breath, chest tightness, and tachycardia for past four days. Patient was alert and oriented to place and person only. Medical diagnosis includes Asthma, GERD, and Diabetes Mellitus. Upon arrival in the ED, symptomatic treatment provided as per order. He notices shortness of breath on exertion while carrying things from grocery shops or while keeping garbage pail in the street two year ago. Finally he made an appointment with primary care physician (PCP) and diagnosed with COPD. The COPD diagnosed by chest x-ray and pulmonary function tests (PFT). Louis is a smoker for past 20 years with more encouragement he quit smoking for the past one month. He was prescribed albuterol inhaler while on exacerbation. Occasionally, he also took oral Prednisone for short periods during exacerbations but later he was non-compliant due to his depression and anxiety. He has complained of loss of appetite, weight loss and insomnia. His current medications include Metformin 500mg twice a day PO for Diabetes Mellitus, Type II, and Protonix 40 mg PO daily before breakfast for GERD, Albuterol inhaler two times a day, Prednisolone 5 mg PO on exacerbation and Lorazepam 0.5mg PO twice a day for anxiety. He currently weighs 154 lbs., although he lost 20 Lbs. since past one month. His past …show more content…
“Hence, the overall objective of treatment is centered on relieving symptoms, thwarting lung function decline, improving exertional tolerance, refining health status, averting exacerbations, and reducing mortality” (Dzierba, 2009). Education on the disease condition, and unalterable effects of smoking, restated. Education about quitting smoking and avoidance of secondhand smoke and places with dust, fumes, or other toxic substances is the most important stage to treat COPD. According to Maurer et al., (2008), “instruction on stress management and coping skills should be devised to reduce anxiety and lessen anxiolytic use”. Educate in the proper use of a bronchodilator, with the use of spacer with the MDI, to improve delivery of the inhaled medication. Don’t discontinue Lorazepam without doctor’s order. “Instruction should be provided about adverse effects, implications, and precautions of all medications (Takemura, et al., 2011)”. As stated by Rice, (2011), “emphasis should be placed on adhering to the medication regimen per physician instruction”. Eating small, more frequent meals; resting before eating; and taking vitamins or nutritional supplements are included. “Repeat spirometry should be ordered to check progress of disease conditions and evaluate efficacy of treatment” (Rice, et al., 2011). Referral to pulmonologist and pulmonary rehabilitation
Louis is 54 years old, high school graduate, working as a mechanic helper in a local workshop in New York. He brought to the Emergency Department (ED) by ambulance, due to coughing, wheezing, shortness of breath, chest tightness, and tachycardia for past four days. Patient was alert and oriented to place and person only. Medical diagnosis includes Asthma, GERD, and Diabetes Mellitus. Upon arrival in the ED, symptomatic treatment provided as per order. He notices shortness of breath on exertion while carrying things from grocery shops or while keeping garbage pail in the street two year ago. Finally he made an appointment with primary care physician (PCP) and diagnosed with COPD. The COPD diagnosed by chest x-ray and pulmonary function tests (PFT). Louis is a smoker for past 20 years with more encouragement he quit smoking for the past one month. He was prescribed albuterol inhaler while on exacerbation. Occasionally, he also took oral Prednisone for short periods during exacerbations but later he was non-compliant due to his depression and anxiety. He has complained of loss of appetite, weight loss and insomnia. His current medications include Metformin 500mg twice a day PO for Diabetes Mellitus, Type II, and Protonix 40 mg PO daily before breakfast for GERD, Albuterol inhaler two times a day, Prednisolone 5 mg PO on exacerbation and Lorazepam 0.5mg PO twice a day for anxiety. He currently weighs 154 lbs., although he lost 20 Lbs. since past one month. His past …show more content…
“Hence, the overall objective of treatment is centered on relieving symptoms, thwarting lung function decline, improving exertional tolerance, refining health status, averting exacerbations, and reducing mortality” (Dzierba, 2009). Education on the disease condition, and unalterable effects of smoking, restated. Education about quitting smoking and avoidance of secondhand smoke and places with dust, fumes, or other toxic substances is the most important stage to treat COPD. According to Maurer et al., (2008), “instruction on stress management and coping skills should be devised to reduce anxiety and lessen anxiolytic use”. Educate in the proper use of a bronchodilator, with the use of spacer with the MDI, to improve delivery of the inhaled medication. Don’t discontinue Lorazepam without doctor’s order. “Instruction should be provided about adverse effects, implications, and precautions of all medications (Takemura, et al., 2011)”. As stated by Rice, (2011), “emphasis should be placed on adhering to the medication regimen per physician instruction”. Eating small, more frequent meals; resting before eating; and taking vitamins or nutritional supplements are included. “Repeat spirometry should be ordered to check progress of disease conditions and evaluate efficacy of treatment” (Rice, et al., 2011). Referral to pulmonologist and pulmonary rehabilitation