Essentials of Pharmacy and Medicines Optimisation Assignment | Essay Help Services

3000 words essay 100% weighing which relates to 1.) pharmacological processes 2.) medicines management 3.) nursing care 4.) safe practice two cases will be presented and can choose either case study 1 or 2. each has different guidelines i have also attached an example

Case Study 1: September 2017
Critically discuss the case study in relation to the issues of crushing medication and potential covert drug administration. Your assignment should focus on: pharmacological processes, medicines management issues, nursing care and safe practice and the nurse’s role.
Lyrics Okeke has been qualified for six months and works full-time on a cardiothoracic ward. He has recently joined a nursing agency to earn extra money and has a shift booked for Saturday night in a local nursing home called The Glades. The Glades currently has 24 residents and Lyrics is on duty with one staff nurse, Chioma and one health care support worker, Pablo. Chioma has worked at Glades for 15 years and Pablo for 5 years.
Jenny Jefferson was recently admitted to the Glades from hospital following a right sided ischaemic cerebrovascular accident (CVA). Jenny is a 94 year old widow with no children or next of kin (NOK) and following a case conference it was decided she would not be able to cope alone in her 3rd floor flat with a care package and required full time nursing care.
Currently Jenny has a dense left sided weakness in both her left arm and leg and is unable to stand unaided or walk. She is now wheelchair bound and requires hoisting in and out of bed and onto the toilet. She is unable to eat or drink due to swallowing difficulties following the stroke and has a percutaneous endoscopic gastrostomy (PEG) tube in place. Jenny is fed overnight and all her medication is administered via the PEG tube. Jenny is fully competent and alert but has expressive aphasia, she enjoys reading Mills and Boon romance novels, listening to radio 4 and classical music.
Jennie’s Past Medical History
Hypertension
Depression
Hyperlipidaemia
Irritable bowel syndrome (IBS)
Gastro oesophageal reflux disease (GORD)
Osteoarthritis
Stable angina
Penicillin allergy: rash
Jennie’s current medication:
Ramipril, 5 mg daily
Gaviscon, 5-10ml four times a day, as required
Furosemide, 20mg daily
Fluoxetine 20mg, once a day
Paracetamol, 1 gram as required
Atorvastatin, 40mg once a day at night.
Ibuprofen, 200mg, three times a day
Zopiclone, 5mg once a day at night
Omeprazole 40mg once a day
Diclofenac, 50mg, three times a day, as required
Adizem: XL, 120mg daily (diltiazem hydrochloride)
Erythromycin: 500mg, twice a day for 5 days for a recently diagnosed chest infection
Lyrics has been allocated to care for Jennie during the night shift. Jennie is calm and settled in bed listening to radio 4 and due her 22:00hr medication. Chioma, the permanent staff nurse is undertaking the drug round and proceeds to crush all of Jennie’s medication in a pestle and mortar with sterile water and administer them altogether via the PEG tube. When Lyrics questions this practice, Chioma states ‘this is how we always give medication to patients who cannot swallow and have a PEG tube: ‘it’s easy and quick for the nurses and the patient’.

Case Study 2: September 2017
Critically discuss the case study in relation to Rosemary’s post-operative pain management. Your assignment should focus on: pharmacological processes, medicines management issues, nursing care and safe practice and the nurse’s role.
Rosemary Reynolds is 76 years old with a past medical history of rheumatoid arthritis. She has experienced increasingly severe pain, swelling and stiffness in her right knee for the past two years. Treatment with physiotherapy and exercises and regular steroid injections has not been effective and Rosemary has now decided to undergo a right total knee replacement. Rosemary’s symptoms affect her quality of life and prevent her from leading an active social life and disrupt her sleep pattern. Rosemary is otherwise fit and well and has no other relevant past medical history and lives alone in a ground floor flat with regular visits from her daughter.
Rosemary underwent a right total knee (arthroplasty) replacement 3 day ago and is now back on the orthopaedic ward. Her surgery was uneventful and there were no complications during the surgical procedure.
Rosemary is only managing very small amounts of food and fluids due to persistent nausea, frequent vomiting and mild dyspepsia. She has not had her bowels open since before the surgery (5 day post operatively) and is experiencing mild pruritus to her trunk and back. She has a small dressing on her knee wound, which is showing no signs of infection and is wearing anti embolism stockings (AES).
Rosemary has a morphine patient controlled analgesia pump (PCA) in progress and is managing to gently mobilise the short distance to the toilet and back with the assistance of a walking frame and one nurse. She is finding her physiotherapy exercises difficult to manage due to persistent nausea, pain and fatigue.
The nurse caring for Rosemary today has just completed a pain assessment using the numerical rating scale tool (NRS). Where 1-3 is calculated as mild pain and 7-10 as severe pain (Figure 1). Rosemary has stated that she is experiencing moderate to severe pain which she rates as 6-7 when mobilising and mild to moderate pain: 3-4 when resting in her chair. Her current sedation score according to the Alert, Confusion, Verbal, Pain and Unresponsive tool (ACVPU) (NEWS2 2017) is recorded as alert. All clinical observations are within normal parameters. She continues to experience persistent nausea and vomited once after breakfast this morning, her back and chest remain itchy with no visible rash present.
Figure 1: numerical rating scale tool.
Rosemary’s current medication regime: Drug Dose
Intravenous (IV) morphine PCA
50mg/50ml (concentration of 1mg/ml).
There is no continuous or background infusion 1mg (1ml) bolus with a lock out period of 5 minutes. Total dose: 12mg/hr
Paracetamol (acetaminophen)
1 gram every 6 hours: maximum daily amount 4 grams (PO)
Enoxaparin sodium
40mg once a day, subcutaneous (S/C)
Ondansetron
8mg twice a day (PO)
Diclofenac
50mg three times a day (PO), when required
Lactulose 15ml
Twice a day (PO)

September 2017: Case study 1: Essay Guidelines
Introduction (5-15%)
 Provides structure to the essay
 Provides the reader with an outline of the essay and what to expect
 Present the topics logically and follow this sequence in main body of the essay
 Third person only: no ‘I’ or ‘ME’
 Outline the topics you are going to present in the essay (logically and sequentially)
 Make it clear but short and succinct: 1 paragraph max.
 Make reference to the case study: do not reproduce all the details
 Introduce your topic with some relevant background information on the topic: make it short, snappy and interesting: grab the reader’s attention right at the beginning
 This assignment will critically examine, explore, discuss, highlight or address………… Main Body (70-80%)
 Use the information presented in the case study to illustrate and critically discuss the 4 required areas of the essay:
1. Pharmacological processes
2. Medicines management
3. Nursing care
4. Safe practice and the nurse’s role
 Use clearly defined (short) paragraphs
 One topic or subject area per paragraph
 Logical approach: sequence your paragraphs to aid structure and flow of your topics: helps the reader to understand your essay
 Include the case study throughout: refer back to the case study and use the information to illustrate your points/subjects
 Do not provide long explanations of the pharmacology principles and processes: use them to critically discuss and illustrate the drugs in the case study
1. Pharmacological processes:
 Pharmacokinetics: ADME, bioavailability, plasma half-life, peak plasma concentration
 Pharmacodynamics: mechanism of action, side effects, selectivity, affinity and efficacy
 Adverse effects/interactions: in relation to crushing medication
2. Medicines Management:
 What is the nurses role and responsibilities in drug administration: 6Rs and pharmacology knowledge
 Professional issues: consent, accountability and appropriate knowledge and understanding in relation to crushing medication/ potential covert drug administration
 Nurses roles and responsibilities in relation to assessment before, during and after drug administration
 Nurses roles and responsibilities with regard to the evaluation and effectiveness of the medication and side effects: ADRs and monitoring
 Nurses roles and responsibilities in relation to education, training and concordance issues: patient, self and staff
 Mode/route of delivery of the medication: pharmacological and patient issues
September 2017: Case study 1: Essay Guidelines
3. Nursing care:
 Focus on crushing medication and potential covert drug administration and the nurses role and responsibilities in the scenario
 Legal, professional, clinical and ethical issues of crushing medication and potential covert drug administration.
4. Safe practice and the nurses role:
 To some extent this may be incorporated in the other areas of the essay
 Accountability, consent, knowledge and understanding and the 6Rs
 Critical thinking and decision making skills
 Professional, ethical and legal issues: NMC (2015) The Code and RPS (2018 and 2019) Conclusion (5-15%)
 Succinctly summarise the key points in your essay: ‘cherry pick’ the important points you have presented here
 Make it short and snappy: 1 paragraph at the very most
 No reflection required
 Make it clear you have begun your conclusion, I.E. ‘to conclude’ or ‘to summarise’
 Reference where appropriate
 Do not add any new information
 Use the third person only
 No reflection on what you have learnt writing this essay: factual only based on your essay contents
References
 Must demonstrate you have read widely and appropriately around your topic areas
 Use the Harvard Referencing System accurately and correctly
 Strictly alphabetical: no numbers or bullet points
 Do no use non-academic sources to support your points/topics
 Contemporary and up-to-date sources should be used
September 2017: Case study 1: Essay Guidelines
Your essay: A Quick Checklist
 Have I read the marking grid?
 Am I writing at the appropriate level?
Introduction
 Am I writing in the third person only?
 Is my introduction short and succinct?
 Have I logically and succinctly set out my topic areas?
Main body
 Am I using short, clearly defined paragraphs?
 Do the paragraphs link well together or are the topics/subjects disjointed throughout the essay?
 Is there logical sequence and flow to my work that makes sense to the reader?
 Have I carefully proof read my essay? Does it make sense?
 Is my grammar, punctuation, spelling and sentence construction correct throughout my essay? Does it make sense?
 Am I presenting and making reference to the case study contents throughout my essay? The name of the patient and details should appear from beginning to the end of the essay
 Am I supporting my points with relevant up-to-date literature?
 Am I comparing /contrasting my topics/points with relevant up-to-date literature?
Conclusion
 Is it clear I have begun to conclude or sum up my essay?
 Have I included the key points from my essay related to my topics?
 Have I appropriately referenced?
 Is my conclusion one paragraph only?
 Am I writing in the third person only?
 There is no reflection of what I have learnt in my conclusion?
Referencing
 Have I accurately used the Harvard Referencing System throughout the essay?
 Is my reference list alphabetical with no bullet points or numbering?
 Are the dates and names correct in my main text and terminal reference list?
 Have I used the author name and date only in the main text: no journal or book names?
 Have I referenced quotes correctly with the page number in the main text?
Have I mainly used primary sources of literature in the essay?