The present project is based upon a case study in which Nandra who is 58 year old female Aboriginal patient suffering from some issues. The report is based upon two cases and in the case of study first, the report provides a deep understanding of medication when a patient is suffering from any disease. The project further identifies the main potential and actual medication problem and also provide recommendation on the treatment strategy that further help to cure the disease. In case of study two report presents the key competencies that should be applied to the pharmacist which is necessary to manage the condition of Nandra by identifying its domain as well as standards.
CASE STUDY 1
Presenting some specific issues that need to be addressed for Nandra's condition with reasons.
Nandra is a 58 year old female Aboriginal patient who feels so tired and un- energetic and after some time she feels itchy rashes on her body which cover her trunk, arms and legs. For a normal human being to carry out their entire routine activities, it is necessary to have a proper body structure and be physically fit (Abu-Gharbieh, Salam and Khan, 2018). As per the case scenario, Nandra is also suffering from tiredness and feels so low for the last many days that is why she is diagnosed and checked by a Pharmacist, As per the report, it has been analysed that her body weight and body temperature is normal but at the time of BP measuring, it has been found up to 170/95 which is considered quite high because for a normal person it should be 120/90. that is why Nandra feels so low and lethargic. In the year 2012, when Nandra was diagnosed there are four major issues has been identified such as hypertension, Left Ventricular, Atrial Fibrillation and Peptic Ulcer disease which is currently diagnosed.
As per medication done currently, Nandra has high blood pressure which shows a result of hypertension because for a normal human being it must vary from 120/80 to 140/90 but a lady has high BP that is the only reason she feels so tired and less energetic and when the laboratory test results come it has been found that urea is high and it has been diagnosed 10H and foe a normal human being it should be vary from 3.1 to 8.1. While on the other side, creatinine is also high i.e. 245 H and for human being it must be vary from 64 to 104. this high Blood pressure may lead to hypertension and sometimes clotting in mind which cause major diseases (Hattingh, Robinson and Kelly, 2018).
As per another medication done, i.e. related to Heart rate and it has been found that the heart rate of Nandra is 150 beats per minutes and for a normal human being, it must be vary from 60 to 100 bps. Therefore, this high heart rates may lead to some major problems such as Atrial Fibrillation in which blood did not properly passes from the chambers and as a result the blood did not flow in entire body. The basis symptoms of this disease are weakness, reduced ability to exercise, fatigue and shortness of breath which actually Nandra feels from last some days.
Another specific issue which can be diagnoses from Nandra is that she found some skin itches in a form of rashes which may be occur because of having issues related to seafood that cause skin rashes in her trunk, arms and legs. As she explained that from last night she is suffering from rashes on her skin which must be diagnoses and a result comes that she has a allergy of sea food items. Further during medication and some laboratory test result, it has been analysed that the calcium level of Nandra's body is low while on the other side phosphate level is high as per normal range. Alanine Aminotransferase is also low as per actual requirement. Therefore, as per blood test report, AST is also high i.e. mark up to 40 while the normal requirement is in between 12 to 36 and Hb is low i.e. found 120 g/l which should be ranges in between 130 to 180 for a normal human being (Adams and et.al., 2018).
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From the above, it has been analysed that Nandra is suffering from two major disease. In order to sort out those above current issues, Nandra should have to take care proper medication in order to fight out those problems. Currently, lady taken following medicines from many years so that it will help to cure her situation. List of medicines are as follows:
- Nordip Capsule â 5 mg which she take from last 5 years
- Spiractin 25 mg- Nandra takes daily 1 tablet from last 5 years.
- Entresto 49/51 for 1 year and takes 1 tablet in a day.
- Lasix 40 mg â twice in a day for last 5 years.
- Crestor is of 40 mg which she takes one in a day for at least 5 years.
- Nexium HP 7- which she takes from last 2 days.
- Xarelto 15mg â 1 tablet in a day from last 3 months.
Presenting the management plan that focus on Nandra's problem with the recommendation
As Nandra faces some major issues in her current situation, as per diagnosed by the pharmacist, a lady is diagnosed and found three major problems in her body names as Skin rashes due to allergy of sea food, peptic Ulcer Disease and Atrial Fibrillation. For these three diseases, the management plan is stated below that is based upon pharmacological and non-pharmacological treatment strategies:
Antibiotic Induces Skin Eruption:
Pharmacological treatment: As Nandra, having some some skin rashes in her trunk, arms and legs and to cure those she has to consult with a chemist or her general practitioner who help her to get rid from this. As per report it has been analysed that she has a allergy of sea food so as per pharmacological treatment doctor suggest her to avoid eating some food which are related to sea or which contain high sodium (BarkerÃÂ¢Ã¢âÂ¬ÃÂHaliski and et.al., 2018). As this skin rashes are not controlled as per time then it may lead to some major issues. In addition to this, pharmacist also treat her with some drugs and provide creams in order to overcome from those allergy issue. Further at a time of serious reaction, a doctor may also treat with drug names as epinephrine that is given by a injection. These are some pharmacological treatment which should be provided to Nandra with proper medication.
Non- Pharmacological treatment: Having a skin rashes is common but not for Nandra because those rashes are spread in her entire body. As the medicine are taken by her but except from pharmacological treatment, Nandra should also take non- pharmacological treatment such as she may even take Antibiotic medicine which contain sulfa drugs because this help to reduce some rashes (Campitiello and et.al., 2018). Nandra should not eat sea food because she has a allergy of eating seafood. A cool compress or shower is another non- pharmacological treatment which she can also take. While having a issue of skin rashes, she should start avoid contact with her son and also avoid swelling. If in the case of extreme problem she should consult with a Doctor.
Management for Peptic Ulcer disease:
Pharmacological treatment: As Nandra is facing issues related to peptic ulcer and to cure this, she has to take endoscopic therapy under which a patient can be identifying at low risk for re bleeding (Treatment for Ulcer, 2018). Moreover, this therapy reduces the likelihood of recurrent bleeding and on the other side,it reduces the chances of surgery. Another common remedy or suggestion is to take a antibiotic drug to kill H. pylori Bacteria that is the main cause of ulcer disease by taking medication that will help to get rid of acid in a Nandra's stomach. Even by taking protectant, as a medicine which help to coats ulcer in order to protect them from stomach acid.
Non- Pharmacological treatment: Â In order get rid from Ulcer, Nandra should choose a healthy diet which is full of fruits especially contain Vitamin A and C, vegetables and whole grains. Start avoiding milk because milk contain acid which increases the pain of an ulcer. Controlling stress is the another non- pharmacological treatment which Nandra can take. Start taking food which contain probiotics that includes yogurt, cheese and miso etc. Sleeping is the another cure which helps to improve the immune system (Perry and et.al., 2018). By avoiding alcohol and taking less stress is another medication which help to get rid from her ulcer disease.
Pharmacological treatment: As Nandra is faces issues related to having high heart rates and to cure this Nandra can take Antiarrhythmic therapy which help to convert atrial fibrillation into sinus rhythm and to control the rate of heart beats in a patient with permanent atrial . Another pharmacological treatment which a lady can take is anticoagulation and anti- thrombotic therapy that help to prevent thromboembolic complications in a patients (Calkins and et.al., 2017). Nandra has suffering from high BP as well as high heart beats so it is quite necessary for her to take proper medication and consult with doctor after every interval of time in order to overcome her problem.
Non- Pharmacological treatment: there are so many non-pharmacological treatments that are affordable and Nandra can used such as by using pace maker and radio- frequency ablation a patient can get rid from the problem from some time (January and et.al., 2014). This medication helps to control their heartbeat but by using this medication, Nandra has to take some proper precaution which further help in her improvement. Even if she has some major issue then she have to consult with a doctor for further improvements.
CASE STUDY 2
Presenting the key competencies of a Pharmacist
According to the National Competencies Standards Framework for Pharmacists in Australia 2016, which shows the skills, attributes and knowledge of pharmacists. Basically, it includes 5 domains such as professionalism and ethics, communication and collaboration, medicine management and patient care, leadership and management, education and research (Go et.al., 2018). These five qualities must be in a pharmacist in order to treat their patient in a better way. In the case of Nandra, if the pharmacist has a deep knowledge related to their fieldwork then, they will treat their patient in a better way and on the other side, they should also have good collaboration with their team members so that they all share their expertise and even take a responsibility for better decision making. If the pharmacist has good or sufficient knowledge, skills and attributes to perform the specific task or functions to the desired standard then it will be helpful for a patient as well as a doctor to cure in an effective way (Nielsen et.al., 2018).
Having the best management and leadership style is considered an important domain as per National Competency Standards Framework for Pharmacists in Australia (2016). Having good communication is another key competency that helps to express their own views in front of their patients so that it clearly expresses the complex relationship between the ideas and purpose. In the context of Nandra's case, pharmacists must have the ability of professionalism and ethics that reflect their core capabilities towards their work (Roselli et.al., 2018).
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By summing up the above report, it has been concluded that Nandra is suffering from any disease such as hypertension, skin rashes, Atrial Fibrillation, Peptic Ulcer which should be cured by using both pharmacological as well as non-pharmacological methods. So that it will help to cure or to overcome the problem. The report also provides some management strategies or recommendations that further help cures the disease. In addition to this using National Competency Standards Framework for Pharmacists in Australia (2016) help to identify the skills and attributes that Pharmacist must possess in order to treat their patients.
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