Chamberlain
College of Nursing NR291 Pharmacology I

Wanda McKay is 36 years old and
homeless, although she sleeps in a shelter nightly and has been going to a day
program for the past 5 weeks, where she showers, receives her mail, gets some
counseling, and has her meals. She is being treated daily for tuberculosis with
directly observed therapy (DOT) and has been receiving this treatment for the
last 6 months. She had a tubal ligation 5 years ago with no complications and
is not currently sexually active. She was last tested for HIV and hepatitis C 2
months ago and was negative. She has been vaccinated for hepatitis B. She
drinks, but does not use drugs, and has not been prescribed any psychiatric
medications. When she was admitted into the day treatment program, her hospital
records were sent indicating that she is sputum culture negative, so she is not
a risk to others in close quarters.

When her nurse comes to the day
program to administer her meds today, she notices that the sclera of her eyes
have a yellow tint to them. She is brought into the mobile center and examined
by the nurse practitioner. Data obtained from the nursing assessment include
the following:

• The
patient complains of abdominal pain, nausea.

• The
patient is tender to palpation of liver.

• Lung
sounds clear

• Chest
x-ray clear

• Vital
signs: temperature, 100.2°F; pulse, 88; respirations, 20; blood pressure,
130/80

The patient’s current medications
include: isoniazid, 300 mg q day; rifampin, 600mg q day; and ethambutol, 800 mg
q day.

Case Study Questions

1. Provide
the rationale for why Ms. McKay is prescribed this combination of drugs. (5 pts)

2. What
contraindications or precautions would eliminate the use of these drugs for Ms.
McKay? (5 pts)

3. What
patient variables are most important to consider for Ms. McKay when assessing
her drug therapy? (10 pts)

4. What
aspects of core drug knowledge (pharmacotherapeutics, pharmacokinetics, and
pharmacodynamics) are especially relevant to consider because they may interact
with the patient variables? (5 pts)

5. Which
of the findings from the nursing assessment demonstrate the effectiveness of
drug therapy? (5 pts)

6. Which
of the findings from the nursing assessment demonstrate possible adverse
effects from the drug therapy? (5
pts)

7. What
nursing actions are indicated to maximize therapeutic effects? (5 pts)

NR291
Case Study.Antituberculars.pdf
Created 7/5/2012 RC 1

Chamberlain
College of Nursing NR291 Pharmacology I

8. What
nursing actions are indicated to minimize adverse effects? (5 pts)

9. What
teaching is required for Ms. McKay regarding her drug therapy? Include list of
any additional data needed to determine appropriate teaching. (5 pts)

NR291
Case Study.Antituberculars.pdf
Created 7/5/2012 RC 2

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