Diseases & Drugs For Their Treatment

The medical condition in which irreversible brain damage occurs due interruption of the supply of blood to the brain due to rupture or blockage in the blood vessel. The risk factors are smoking, hypertension, diabetes, hyperlipidaemia, and aging (Sommers & Fannin, 2015). Audrey should be closely monitored with oxygen saturation and vital signs and neurological assessment because she is suffering from AF, diabetes, and hypertension and past history of left CVA (which is the reason of her right side weakness) (Sommers & Fannin, 2015).

Type- II Diabetes Mellitus

This is the non-insulin dependent diabetes. The condition in which pancreas gradually decrease insulin production and body become resistant to insulin which further leads to hyperglycaemia. Diabetes can further lead to cardiac impairment and neurological impairment. Therefore, it is important to monitor Audrey’s blood glucose level before and after meals. Postoperatively, surgical wound can be treated using aseptic technique, promote wound healing and medications can be administered as per doctor’s order (American Diabetes Association, 2014).

Gastro-Oesophageal Reflux Disease (GORD)

GORD is the medical condition in which the reflux of the gastric content or occasionally bile enters in the oesophagus due to the weakening of the sphincter of the oesophagus. Further, it leads to damage to oesophageal layer, ulcer, heartburn, and pain (Peate, 2016). It can be managed with the lifestyle modifications such as; avoid alcohol, fast and oily food. Post-operatively, a nurse should educate Audrey to avoid food which may produce acidity, refer to a dietician regarding the selection of food. The patient should sleep in reverse Trendelenburg’s position; raise the bedside to reduce the intra-abdominal pressure and providing comfort to the patient (Keung & Hebbard, 2015).

Osteoporosis

Osteoporosis is a metabolic bone disorder which can decrease the bone density and bones become weak and brittle which further leads to fractures due to any minor injury or fall. It is the common problem in women after menopause which can commonly lead to hip fracture due to fall. The patient should continue the intake of calcium and vitamin supplementation therapy (Peate, 2016). Post-operatively, a nurse can encourage her to ring the call bell to reduce the chances of fall in hospital. Encourage Audrey to wear hip protectors. Consult the physician, dietician and occupational therapist for the rehabilitation and ensure her safety (Qiu, 2013).

Total Hysterectomy

McKenzie & Porter (2015) stated that it is the surgical procedure using an abdominal approach to remove the uterus and cervix. It is the surgery recommended in case patient having cancer of the uterus, ovaries, vaginal prolapse and cervix. Audrey undergoes a total hysterectomy in 1995 which would not effect on her present condition. Because the past medical history is important to prevent any complications related to the present surgery (Papadopoulos, Tolikas & Miliaras, 2010).

Depression

It is a medical condition which negatively affects the mood, for instance, sadness, loss of interest in daily activities. Monitor the Audrey for the mood changes and behaviour with the help of psychological assessment. She has the history of depression (2011). Encourage Audrey to share her feelings with others and ventilate the reasons of sadness and reduce anxiety (Mckenzie & Porter, 2015).

Medication historyDigoxin

Digoxin belongs to the cardiac glycoside family which is used to treat Atrial Fibrillation, CCF and paroxysmal atrial tachycardia. In the case of Audrey, monitor her apical pulse for a minute, if it is lower than 60 than inform the consultant/physician. Monitor for early signs of digoxin toxicity such as; vomiting, nausea, dizziness and digoxin level (MIMS online, 2018).

Warfarin

It is an anticoagulant which prevents the formation of the clotting of blood by inhibiting the uptake of vitamin K which can further reduce any complication or risk of heart attack. Due to the history of AF and CVA Audrey is on warfarin therapy to prevent the formation of venous thrombosis. Monitor her for any signs and symptoms of bleeding or haemorrhage. The clotting factor INR and PT should be monitored regularly and warfarin should be stopped before the commencement of the surgery as per the doctor’s decision (MIMS online, 2018).

Coversyl (5mg OD)

This is the drug with antihypertensive properties used for the management of the high blood pressure by stopping the action of the ACE (angiotensin converting enzyme). In the case of Audrey, monitor the sodium and potassium levels and check for risk of hyperkalaemia. Check the blood pressure and if the systolic BP is below 100 then withhold the drug and inform the doctor. The patient should lie in supine position when there is hypotension (MIMS online, 2018).

Vitamin D (1,000 units OD)

This is the drug prescribed to Audrey to treat her osteoporosis by increasing the absorption of calcium and maintaining serum calcium in her body. Audrey is prescribed for taking Vitamin D 1000 units which would not effect on her surgery. Encourage her to take vitamin D rich supplements and diet. Audrey should be monitored and educated for the signs of toxicity (MIMS online, 2018).

Metformin (500mg BD)

This medication is used to control the blood sugar level in the body by increasing the uptake of glucose (oral hypoglycaemic agent). In Audrey’s case, she has type II diabetes mellitus. The drug should be administered with food. Monitor the blood sugar level of Audrey before and after meal regularly to prevent the risk of hypoglycaemia (MIMS online, 2018).

Esomeprazole (40mg OD)

It is a proton pump inhibitor which helps to reduce the secretion of gastric content. It is used to treat hyperacidity, ulcers, and reflux (GORD). In the case of Audrey, this drug is administered to treat the symptoms occurring with GORD (Keung & Hebbard, 2015). Administer the drug one hour before the meals. The drug would not effect on the present condition of the Audrey. Monitor the Audrey for the S/S of adversative CNS effects and also with simultaneous warfarin therapy monitor INR and PT levels of Audrey (MIMS online, 2018).