15 FUNDAMENTALS COURSE PROJECT (GROUP) Introduction Client name Mr. Brown Client age: 72yrs Gender: Male Religion: Jewish Ethnic: African American Illness: T3 burst fracture Family History: Mr. Brown is from a family of six. He’s the only male child in the family with five siblings. He lost both his parent to high blood pressure when he was at the age of 35. Currently, Mr. Brown has been battling this condition for the past six years. During my assessment, his blood pressure was 165/90 which indicates that he is also experiencing high blood pressure, which is family heredity. Our focus for this project is the disease Mr. Brown is experiencing the T3 disease Question One Drug Name Trade & generic name, dose, route & frequency Pharmacological & therapeutic drug class & Expected action in the body What medical diagnosis is your patient taking this drug for? How will it help them? Side Effects & Adverse Reactions/ Complications/Top drug interactions Nursing Administration Special Instructions and Assessments Client Education Evaluation of Medication Effectiveness (e.g. Pain Scale) - Dosage: 5mg - route: rectally -frequency: 3 days daily - generic: Bisacodyl -Trade: Dulcolax (Gunnström et al., 2022). - Therapeutic: Fluid is altered that results in colon. fluid buildup - T3 burst Fracture: -the patient has agonized injury in the spinal cord, this will assist in colon clearing. - also the patient has a problem in his bladder and bowel . This medication aids in making the bowel soft when he is constipating. -Anxiety, memory loss, blurred vision, insomnia, depression, fatigue, dizziness, - interactions: no applicable drug interactions (Vallerand, 2021). - Assess for abdominal distention and bowel function - evaluate intake and output ratios in the body. - Do not take the dose twice or skip the dose as prescribed. - if a dose is skipped it ought to be taken immediately and given a duration of 6 hours before the next dosage (Gunnström et al., 2022). Trade: Gablofen, - route: Orally. - dose: 5mg -frequency: Daily4 times - generic: baclofen - Therapeutic: Muscle skeletal relaxant - contains impulses at the spine. Therapeutic effects: bladder and bowel purpose may also be enhanced (Gunnström et al., 2022). The patient has a problem in his bowel and Bladder hence the medication may help mend his bowel and bladder function (Vallerand , 2020). Side effects nasal congestion, insomnia, headache, hypotension, pruritus, and fatigue, - interactions: Hypnotics, Analgesics, and alcohol (Vallerand, 2020). - Assess - Monitor patient closely during test dose. -preventive apparatus ought to be present for unendurable effects in the body (Gunnström et al., 2022). - Advice the patient to take medication as prescribed. - instruct the patient to avoid continuous usage of alcohol while undergoing medication. (Vallerand, 2020). Trade: Sertraline Dose: 100mg Frequency: Daily Generic: Zoloft - Therapeutic: pharma ...

1. 15
FUNDAMENTALS COURSE PROJECT (GROUP)
Introduction
Client name Mr. Brown
Client age: 72yrs
Gender: Male
Religion: Jewish
Ethnic: African American
Illness: T3 burst fracture
Family History: Mr. Brown is from a family of six. He’s
the only male child in the family with five siblings. He lost both
his parent to high blood pressure when he was at the age of 35.
Currently, Mr. Brown has been battling this condition for the
past six years. During my assessment, his blood pressure was
165/90 which indicates that he is also experiencing high blood
pressure, which is family heredity. Our focus for this project is
the disease Mr. Brown is experiencing the T3 disease

2. Question One
Drug Name Trade & generic name, dose, route & frequency
Pharmacological & therapeutic drug class & Expected action in
the body
What medical diagnosis is your patient taking this drug for?
How will it help them?
Side Effects & Adverse Reactions/ Complications/Top drug
interactions
Nursing Administration Special Instructions and Assessments
Client Education Evaluation of Medication Effectiveness (e.g.
Pain Scale)
- Dosage:
5mg
- route:
rectally
-frequency:
3 days daily
- generic:
Bisacodyl
-Trade:
Dulcolax
(Gunnström et al., 2022).
- Therapeutic:
Fluid is altered
that results in colon.
fluid buildup
- T3 burst
Fracture:
-the patient has
agonized injury in the spinal

3. cord, this
will assist in colon
clearing.
- also the patient has a problem in his
bladder and bowel . This medication
aids in making the bowel soft when he is constipating.
-Anxiety, memory loss, blurred vision, insomnia, depression,
fatigue, dizziness,
- interactions:
no
applicable drug
interactions
(Vallerand, 2021).
- Assess for abdominal distention and bowel function
- evaluate
intake and
output ratios in the body.
- Do not take the dose twice or skip the dose as prescribed.
- if a dose is
skipped it
ought to be taken immediately and given a duration of 6 hours
before the next dosage
(Gunnström et al., 2022).
Trade:
Gablofen,
- route:

4. Orally.
- dose:
5mg
-frequency:
Daily4 times
- generic:
baclofen
- Therapeutic:
Muscle
skeletal
relaxant
- contains
impulses at the
spine.
Therapeutic
effects:
bladder and bowel purpose may
also be enhanced
(Gunnström et al., 2022).
The patient has a problem in his bowel and
Bladder hence the medication may
help mend his
bowel and bladder
function

5. (Vallerand , 2020).
Side effects
nasal congestion, insomnia, headache, hypotension,
pruritus, and fatigue,
- interactions:
Hypnotics,
Analgesics, and alcohol
(Vallerand, 2020).
- Assess
- Monitor
patient closely
during test
dose.
-preventive
apparatus
ought to be
present for
unendurable
effects in the body
(Gunnström et al., 2022).
- Advice the patient to take medication as prescribed.
- instruct the patient to avoid continuous usage of alcohol while
undergoing medication.
(Vallerand, 2020).
Trade:
Sertraline
Dose: 100mg

6. Frequency: Daily
Generic: Zoloft
- Therapeutic:
pharmacologic:
discerning
serotonin
reuptake
inhibitors
-Contains
serotonin in the
CNS hence
Helping Serotonin activities.
Therapeutic
effects:
decreased
incidence of
Panic attacks and Antidepressant
Action
(Vallerand, 2020).
-Patient lives alone and does not have close family members.
-He has
persistent
painful damage which has made him
became paralyzed
from the abdomen
downwards. Sertraline
can assist him in lessening
his depression
and anxiety
(Vallerand, 2020).
Side effects:
nervousness,
Suicidal

7. thoughts, diabetes and agitation
Interactions:
Simultaneous use
of alcohol is
prohibited
- Monitor
appetite and
nutritional
intake.
- evaluate for
serotonin
syndrome,
particularly in
patients
taking other
serotonergic
drugs
- Evaluate for
suicidal
trends,
specifically
during therapy
(Gunnström et al., 2022).
- Instruct client
to take
medication
regularly
without
missing a dose.
- Advise

8. patient to
consult the doctor if side effects persist.
- emphasize on alcohol avoidance during therapy sections
(Vallerand ,
2020).
Route: orally
Frequency: after every six hours
Dosage:
5/325
-generic: hydrocodone
-Trade:
Anexsia Norco
- Therapeutic:
allergy, cold,
and cough
remedies,
opioid
analgesic.
-Therapeutic
effects:
-Decrease in
rigorousness of
pain and dominance of
the cough
reflex
(Gunnström et al., 2022).
- Patient has a
stage 3 pressure
ulcer to his
coccyx. The hydrocodone will
assist in relieving pain in the body.

9. -Hydrocodone is
also an
anticholinergic
and could aid
with his urine
incontinence
(Vallerand, 2020).
side effects
-Sedation, euphoria, hallucinations, diplopia, dyspepsia,
- interactions:
Use with
benzodiazepines
as alcohol may
cause profound
sedation leading to death
(Vallerand,
2020).
- Assess blood pressure before and periodically
in the course of intake.
- Check the functioning of the bowel frequentl y (Vallerand,
2020).
- Instruct
patient on how
and when to
ask for and take pain medication.
-Recommend to the patient that hydrocodone is a drug to make
him heal.
- instruct patient to inform the doctor if pain persists.
(Vallerand, 2020).
Frequency: after every three days
Route: Taken Orally

10. -Trade
ProAmatine
-Generic:
Midodrine
Dosage: 10mg
- Therapeutic:
vasopressor
-
pharmacologic:
alpha-1
agonists
-Stimulation of
alpha1-
adrenergic
receptors in veins and
arteries
Therapeutic
effects:
-blood
pressure and
vascular tone
increase
(Vallerand
2020).
Paraplegia:
-This
prescription is
used in the
indicative monitoring of
hypotension in impaired patients.
-Urinary
sickness
this
medicine can

11. assist in preventing
urinary
incontinence
(Vallerand, 2020).
Side effects
- hypertension, dizziness, urinary urge, nervousness, and
confusion
-Drug interaction:
Simultaneous use of alcohol
(Vallerand,2020).
- check the patients’ blood pressure often.
- analyze if the drug
therapy is
successful in the incidence of reducing
hypotension
- monitor and
report signs of
CNS toxicity
- if the medication is used to
Protect the
Incontinence in the urine,
evaluate the
inconsistency to
assist in
determining if
drug therapy
is effective
- evaluate for
paresthesia
(Gunnström et al., 2022).
- Ask the patient to report cases of side effects in the body
(Gunnström et al., 2022).
Question Two

12. Labs and Diagnostic Tests
CMP lab test might be considered in order to monitor glucose
levels. Normal range would be 65-110 mg/dL if an abnormal
finding is seen it could indicate pre-diabetes or diabetes for our
client (Rasmussen University, 2021). A CBC could also be
considered in this case in order to check his WBC due to his
pressure ulcer. White blood cell normally ranges the count
between 5,000 to 10,000 mm³, while an eminent white blood
cell count ranges more than 11,000, which would indicate
inflammation or invasive infection (Rasmussen University,
2021). A diagnostic test could be used to determine the level of
depression experienced by the patient.
Most depressed people will score between 50 and 69; if he
scores between these ranges, he is at greater risk for depression
(Gunnström et al., 2022). A CRP test could be ordered to
determine the amount of CRP in the blood. If our patient’s CRP
is persistently high following his surgery, it could indicate the
presence of postoperative infection.
Conclusion
A set of core competencies can help advance adherence to rules
of a newly designed health care system as shown by the report,
which aims to provide patient-centered treatment, work in
multidisciplinary teams, use evidence-based procedure,
implement improvement activities, and utilize informatics.
Finally, as the committee stresses, narrowing the quality gap
can be realized at least in part by transforming health
professions’ education.
References
Gunnström, M., Zdolsek, J. H., & Hahn, R. G. (2022). Plasma
volume expansion and fluid kinetics of 20% albumin during
general anesthesia and surgery lasting for more than 5 hours.

13. Anesthesia & Analgesia, 134(6), 1270-1279.
Rasmussen University. (2021). Laboratory Values Resources.
Vallerand, A. H. (2020). Davis's Drug Guide for Nurses (17th
Edition). F. A. Davis Company.
Part 2
FUNDAMENTALS

14. Medical history
Mr. Brown comes from a family of six and is the only male
child out of the six children. He states that he lost his parent to
high blood pressure when he was 35. He reports that he has
been battling this condition for the last six years. During my
assessment, the patient’s blood pressure was found to be
165/90, indicating high blood pressure due to family heredity.
The evaluation and analysis show that Mr. Brown is
experiencing the T3 disease.
Summary of the admitting diagnosis
The admitting diagnosis is T3 disease since the patient was
diagnosed with T3 burst. The patient has a fracture
characterized by agonized injury in the spinal cord. T3 disease
is associated with high total T3 levels or high free T3 levels,
implying that the patient may have hyperthyroidism. Low T3
levels suggest that the patient’s body is producing excess
thyroid hormone patient may have hypothyroidism, a condition
whereby the body does not make sufficient thyroid hormone.
The thyroid produces a hormone known as triiodothyronine,
recognized as T3. It also creates a hormone known as thyroxine,
identified as T4. These hormones regulate body temperature,
heart rate, and metabolism (Shahid et al., 2022). A T3 test is
often ordered if the patient is suspected of having a problem
with their thyroid. In this case, the patient was diagnosed and
admitted for T3 disease, whereby his thyroid was not producing
enough thyroid hormone. The symptoms associated with T3
disease include but are not limited to fatigue, dry skin,
constipation, muscle weakness, depression, elevated blood
cholesterol level, puffy face, hoarseness, and others.
Secondary Medical diagnosis
Prediabetes or Diabetes
The other possible diagnosis for the patient is Prediabetes or
diabetes. The Pathophysiology of Prediabetes is the same as

15. type 2 diabetes, which causes insulin resistance and early beta
cell failure. In Prediabetes, rapid oscillations of insulin
secretion and a decrease in amplitude of large pulses are lost.
The causes of Type 2 diabetes are multifactorial and entail
environmental and genetic elements that affect the functioning
of beta-cell function and muscle, adipose tissue, liver, or
pancreas tissue (Skyler et al., 2017). It is often associated with
insulin resistance, whereby cells do not use insulin properl y. As
a result, the pancreas cannot produce sufficient insulin to meet
the increased demand.
Pressure Ulcer
Pressure ulcers occur due to injuries caused to the skin and the
underlying tissue, mainly due to prolonged pressure on the skin.
Pressure ulcers nearly affect anyone but often affect individuals
confined to a bed or those sitting in a wheelchair or chair for
extended periods (Zaidi & Sharma, 2022). The symptoms
associated with pressure ulcers include discolored skin, warm or
spongy patches on the skin, itchiness or pain in the affected
area, and discolored patches when the skin is pressed.
Inflammation or Invasive Infection
Invasive bacteria are pathogens invading the body where
bacteria are generally absent, such as soft tissues such as
muscle, meninges, and the bloodstream. Examples of bacteria
that cause invasive infection include Streptococcus pneumonia,
Haemophilus influenza, and Neisseria meningitides (von
Lilienfeld-Toal et al., 2019). When invasive infections occur,
they often present very severe diseases that need proper care
and can lead to death.
Depression
The Pathophysiology of depression is associated with a
deficiency of dopamine, serotonin, or norepinephrine in the
central nervous system. The brain uses several chemicals as
messengers to communicate with the nervous system and other
parts of itself. Neurons constantly exchange neurotransmitters
as a way of communicating with each other. All brain functions
require this kind of communication system. Depression is

16. associated with imbalances in brain neurotransmitters, including
dopamine, serotonin, or norepinephrine (Kaltenboeck & Harmer,
2018). Serotonin regulates several essential psychological
functions, including aggression, sexual behavior, sleep, eating,
and mood. A decrease in serotonin production results in
depression in some individuals particularly associated with
suicidal thoughts.
Head to toe Assessment
I conducted an assessment on Mr. Brown I obtained his
permission by explaining what was expected of him and what I
will be doing during the process, The assessment started by
staying in an enclosed room to provide privacy and ensure the
environment was conducive. I washed my hands and began
asking focused interview questions while inspecting skin color
for the presence of cyanosis or pallor, nail discoloration,
jugular vein distention, and edema. I also inspect his neck; I ask
Mr. Brown to dorsiflex (extend) the neck and swallow a sip of
water. Palpation of the thyroid gland by standing behind the
patient. Both lobes and the isthmus of the thyroid gland are
palpated for any nodules or diffuse enlargement. Mobility of the
thyroid gland with swallowing was assessed with palpation.
Nodules arising from the thyroid gland typically move with
swallowing. Examination of the thyroid gland is completed by
palpating the regional cervical lymph nodes for any
enlargement. inspecting his rate, and rhythm and I checked for
chest symmetry with inspiratory and expiratory movement.
After the inspection, I listen to the heart sound using the
diaphragm and bell of the stethoscope depending on what I am
listening for. I listened at the aortic, pulmonic, tricuspid, mitral
areas, and Erb’s points respectively. I also listened for carotid
pulses checking for bruits; I listened to lung sounds. I palpated
and compared the rate, rhythm, and quality of arterial pulses
bilaterally, including the carotid, radial, brachial, posterior
tibialis, and dorsalis pedis pulses. I check for skin tenting or

17. swelling, using the palm of my hand I check at the mitral area
for the presence of heaves or thrill. I palpated the anterior and
posterior chest for tactile fremitus while asking her to say 99. I
percussed the chest, and clear, low-pitched sounds were heard
in all areas. I asked about past medical history, any past
hospitalizations, or surgeries.
Questions asked include:
· Do you have a past medical history of blood pressure, stroke,
heart attack, and COPD? Yes, he has a family history of blood
pressure
· Do you have a family history of Thyroid disease or lung
infection such as pneumonia or tuberculosis?
· Do you have any difficulty swallowing?
· Any pain around your neck?
· Do you have any chest pain?
· Any shortness of breath?
· Do you have difficulty breathing?
· Do you Smoke?
· Do you take alcohol?
· Any swelling on your feet?
· Have you ever thought of killing your self
Techniques used are:
Inspection
Palpation
Auscultation
Subjective Data:
· Patient has a past family history of heart disease
· Patient denies any allergic reaction to medication or food.
· Patient denies swelling of the feet
· The patient taking any medications blood pressure
· Reports taking the yearly flu vaccine, up to date on the
COVID vaccine

18. Objective Data
· Inspect his neck, asks Mr. Brown to dorsiflex (extend) the
neck, and swallow a sip of water.
· Palpation of the thyroid gland by standing behind the patient.
Both lobes and the isthmus of the thyroid gland are palpated for
any nodules or diffuse enlargement. Mobility of the thyroid
gland with swallowing was assessed with palpation. Nodules
arising from the thyroid gland typically move with swallowing.
· Listen to the patient’s heart and lung sounds. No murmurs or
rubs were heard in the heart sound; lung sounds were clear.
· Inspected chest expansion. Chest expansion is rhythmic and
symmetrical during inspiratory and expiratory breathing.
· Pulses were 2+ bilaterally in all extremities, capillary refill <3
seconds, no swelling, tenting, or pitting was noted.
· No heaves or lifts were noted in the sternum and anterior chest
wall
References
Kaltenboeck, A., & Harmer, C. (2018). The neuroscience of
depressive disorders: A brief review of the past and some
considerations about the future. Brain and Neuroscience
Advances, 2, 239821281879926.
https://doi.org/10.1177/2398212818799269
Zaidi, S. R., & Sharma, S. (2022). Pressure Ulcer. StatPearls
Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553107/
Shahid, M. A., Ashraf, M. A., & Sharma, S. (2022). Physiology,
Thyroid Hormone. StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK500006/
Skyler, J. S., Bakris, G. L., Bonifacio, E., Darsow, T., Eckel, R.

19. H., Groop, L., Groop, P., Handelsman, Y., ...& Ratner, R. E.
(2017). Differentiation of Diabetes by Pathophysiology,
Natural, History, and Prognosis. American Diabetes
Association, 66(2), 241-255. https://doi.org/10.2337/db16-0806
von Lilienfeld-Toal, M., Wagener, J., Einsele, H., Cornely, O.
A., & Kurzai, O. (2019). Invasive Fungal Infection. Deutsches
Arzteblatt International, 116(16), 271-278.
https://doi.org/10.3238/arztebl.2019.0271