Module 5 Assignment
Write a 550-word APA reflection essay of your experience with the ShadowHealth© virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
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- Would you prescribe any medications at this point? Why or why not? If so, what?
- What would be the choice for second-line therapy?
- What are the parameters for monitoring success of the therapy?
- Discuss specific patient education based on the prescribed therapy.
- List one or two adverse reactions for the selected agent that would cause you to change therapy.
- What would be the choice for second-line therapy?
- What lifestyle changes would you recommend for this patient, in addition to medication?
- Describe one or two drug–drug or drug–food interactions for the selected agent.
Expert Answer and Explanation
Medications Necessary at this Point
The existing symptoms and past medical history of Ms. Henderson shows that she is suffering from Urinary Tract Infections. Specifically, having frequent urinations, burning sensations when urinating, smelling urine, and one that is dark cloudy in appearance is characteristic of the UTI, possibly caused by lack of hygiene or failure to have urination immediately after having sexual intercourse (Chu & Lowder, 2018). I would recommend that the patient is given Antibiotics such as Fosfomycin or Trimethoprim. These would help to kill all the bacteria that accumulated in her urinary tract.
The 2nd Line Therapy
The best second line therapy for urinary tract infections is drugs that have beta lactam agents. For this patient, I would prescribe amoxillin-clavulanate for 3-7 days, as the medication works well in stopping the growth of bacteria where other agents have failed (Bader et al., 2020).
The Parameters for Monitoring the Therapy Success
The main parameter in monitoring the therapy’s success is the disappearance of the burning sensation when urinating and also the resumption of the normal frequency of urinating (Arcangelo et al., 2017). If necessary, however, the patient would have to submit urine samples to do a qualitative assessment of the absence or presence of bacteria in the urine.
Specific Patient Education
The patient does not have much information regarding sexual hygiene and safe practices. As part of the specific patient education, I would tell them about the importance of urinating immediately after having intercourse. I would also advise them against the contraceptive she is using, Norgestimate-Ethinyl Estradiol, as it has multiple side effects including but not limited to fluid retention, weight changes, vaginal bleeding, and on the long term basis is a risk factor for cervical cancer (Eremenko et al., 2020).
Adverse Reactions that would Cause the Therapy Change
The therapy of ceftriaxone and trimethoprim would be changed if the client experiences the adverse effects of blood clots, excessive headaches, and diarrhea. Other adverse reactions could be loss in appetite that affects the eating patterns and too many itches and rashes (Smith et al., 2018). The side effects should always be expected as they are common with all patients, but if they exceed the limit that interferes with her daily life, she should consult a doctor on the same (Smith et al., 2018).
Lifestyle Changes I Would Recommend
The primary lifestyle change I would recommend for the patient is that she chooses natural birth control over hormone-related birth control. The natural methods of using withdrawal and observations of the menstrual cycle patterns would help to limit the interference of her reproductive health (De Cueto et al., 2017). Other lifestyle changes I would recommend include increased exercise and workout activity and taking healthy meals, drinking plenty of water especially now that her body loses a lot of fluid during the frequent urination (De Cueto et al., 2017). She should also avoid dangerous habits such as excessive alcohol consumption and having multiple male and female partners, which increases her risk for various sexually transmitted infections.
Drug-drug/Drug-food Interactions
Ceftriaxone is likely to react with food and drugs that contain calcium carbonate and calcium acetate, which include common drugs such as cholera vaccine, dalteparin, and argatoban (Smith et al., 2018). Trimethoprim, on the other hand, interacts with sulfamethoxazole to lead to numerous effects such as liver disease, renal dysfunction, colitis, and porphyria (De Cueto et al., 2017). Also since both drugs are taken orally and metabolism happens in the liver, the consumption of alcohol can significantly affect the bioavailability of the drug.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2017). Pharmacotherapeutics for Advanced Practice: A Practical Approach (4th ed.). Wolters Kluwer. IBSN: 9781496319968.
Bader, M. S., Loeb, M., Leto, D., & Brooks, A. A. (2020). Treatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents. Postgraduate medicine, 132(3), 234-250. https://doi.org/10.1080/00325481.2019.1680052
Chu, C. M., & Lowder, J. L. (2018). Diagnosis and treatment of urinary tract infections across age groups. American journal of obstetrics and gynecology, 219(1), 40-51. https://doi.org/10.1016/j.ajog.2017.12.231
De Cueto, M., Aliaga, L., Alós, J. I., Canut, A., Los-Arcos, I., Martínez, J. A., & Pigrau, C. (2017). Executive summary of the diagnosis and treatment of urinary tract infection: Guidelines of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC). Enfermedades infecciosas y microbiologia clinica, 35(5), 314-320. https://doi.org/10.1016/j.eimc.2016.11.005
Eremenko, R., Barmatz, S., Lumelsky, N., Colodner, R., Strauss, M., & Alkan, Y. (2020). Urinary Tract Infection in Outpatient Children and Adolescents: Risk Analysis of Antimicrobial Resistance. The Israel Medical Association journal: IMAJ, 22(4), 236-240. https://europepmc.org/article/med/32286027
Smith, A. L., Brown, J., Wyman, J. F., Berry, A., Newman, D. K., & Stapleton, A. E. (2018). Treatment and prevention of recurrent lower urinary tract infections in women: a rapid review with practice recommendations. The Journal of urology, 200(6), 1174-1191. https://doi.org/10.1016/j.juro.2018.04.088
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