case study

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Case Study: Prescribed Drugs with CAMs

Mr. X, a 42-year-old male presents to your primary care practice today complaining of low back pain.

History – Mr. X states that he has had chronic low back pain since he had a skiing accident about 10 years ago. Three days ago, he felt a pulling sensation in his lower back after moving some boxes. The pain intensity increased over the subsequent 24 hours and is now steady, aching in nature, at 3-4 out of 10. Mr. X also has Type2 diabetes, which is well controlled on metformin with a HGA1c of 5.6. He has a history of DVT 4 months ago for which he takes Coumadin, INR is WNL. He is followed by a specialist for this problem. He recently started taking two OTC products; kava kava for what he describes as “anxiety” and CoEnzyme Q10 on the advice of a friend.

Social – Mr. X is a smoker, 1 pack per week for 15 years. No alcohol or drug use. He is employed as an accountant and has medical insurance. He is divorced.
PE/ROS – Complains of low back stiffness and pain on movement with occasional spasms related to moving in certain directions. You note he has mild difficulty getting onto the exam table but gait is normal. He denies weakness/numbness/tingling of legs, no radiation, no change in bowel or bladder habits. BMI 27. All range of motion of the back is decreased by 25%. Straight leg lift is negative bilaterally, DTR intact. All other systems WNL.

Medications:

Metformin 1000mg ER one tab daily – Type II Diabetes controlled

Coumadin 5 mg. daily – Hx of DVT – Controlled

Kava Kava 50 mg. tid – Self-medication for anxiety

CoQ10 – 200 mg. daily. – Self-medication for unknown reason

1. Provide a diagnosis for the patient and your rationale for the diagnosis

2. Provide a treatment plan specifically for this patient, pharmacologic and non-pharmacologic.

3. Comment on the use of OTC products in relation to Mr. X’s current chronic and acute disease diagnoses and medications. Include drug-drug interactions and side effect profiles.

4. Provide an education plan for Mr. X

5. Present this Assignment as a PowerPoint presentation with between 12 and 16 slides (not including opening slide and resource slide).

6. You will use the Narrative notes section of the presentation to include the majority of your evidentiary support of your treatment choices and education of family complete with in-text citations using APA formatting,

Due by the last day of Unit 9 at 11:59 p.m.

Assignment Requirements:

Before finalizing your work, you should:

· be sure to read the Assignment description carefully (as displayed above);

· consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary; and

· utilize spelling and grammar check to minimize errors.

· Submit to and review results of Turnitin. Purdue University Global Student Conduct policy as it relates to plagiarism will be adhered to in this course.

Your writing Assignment should:

· follow the conventions of Standard English (correct grammar, punctuation, etc.);

· be well ordered, logical, and unified, as well as original and insightful;

· display superior content, organization, style, and mechanics; and

· utilize APA 7th edition formatting.

Rubric Title: MN553 Unit 9 Assignment Rubric

Assignment Criteria

Level III

Level II

Level I

Not Present

Criteria 1

Level III Max Points

Points: 8

Level II Max Points

Points: 6.4

Level I Max Points

Points: 4.8

Not Present

0 Points

Correctly diagnosing the patient

· A correct diagnosis is provided with supportive rationale from literature

· A correct diagnosis is provided without rationale

· Does not meet the Criteria

· Does not meet the criteria

Criteria 2

Level III Max Points

Points: 12

Level II Max Points

Points: 9.6

Level I Max Points

Points: 7.2

Not Present

0 Points

Prescribing a treatment plan

· An appropriate and specific treatment plan for the case study patient is provided with rationale from literature for treatment choices.

· A specific treatment plan is provided for the case study patient but is missing less than 50% of pharmacologic and non-pharmacologic treatment with rationale from literature for treatment choices

· A specific treatment plan is provided for the case study patient but is missing more than 50% of pharmacologic and non-pharmacologic treatment with rationale from literature for treatment choices; Or

· Rationale for treatment choices from literature are not provided

· Does not meet the criteria

Criteria 3

Level III Max Points

Points: 11

Level II Max Points

Points: 8.8

Level I Max Points

Points: 6.6

Not Present

0 Points

Over-the-counter medication use discussion

A thorough discussion of the kinetics and dynamics of OTC products is provided and a rationale for including or excluding them from the treatment plan is provided.

· Kinetics and dynamics of OTC products are discussed and are related to the patient's current meds/conditions but specific direction regarding continued use is not included

· Kinetics and dynamics of OTC products are discussed but not related to the patient's current meds/conditions.

· Does not meet the criteria

Criteria 4

Level III Max Points

Points: 8

Level II Max Points

Points: 6.4

Level I Max Points

Points: 4.8

Not Present

0 Points

Education plan

· A thorough education plan for the treatment plan is provided which includes principles of therapeutic communication.

· An education plan is provided which provides more than 50% of necessary information for the treatment plan and includes principles of therapeutic communication

· An education plan is provided but contains less than 50% of necessary information and includes principles or therapeutic communication OR

· Principles of therapeutic communication are not included

· Does not meet the criteria

Criteria 5

Level III Max Points

Points: 8

Level II Max Points

Points: 6.4

Level I Max Points

Points: 4.8

Not Present

0 Points

College-level academic writing

· Professional, peer-reviewed, advanced practice references are used

· Grammar and mechanics of writing demonstrate graduate level work

· Adheres to page number requirements

· The majority of references used are professional, peer-reviewed and advanced practice

· Errors in grammar or mechanics of writing are present but do not interfere with readability

· Adheres to page number requirements

· The minority of references used are professional, peer-reviewed and advanced practice

· Errors in grammar or mechanics of writing are present Which interferes with readability

· Does not adhere to page number

· Does not meet the criteria

Criteria 6

Level III Max Points

Points: 8

Level II Max Points

Points: 6.4

Level I Max Points

Points: 4.8

Not Present

0 Points

Citations and Formatting

· There is a strong attempt to cite all sources using APA style.

· Minor paper formatting errors may occur.

· Minor in-text citation errors may occur.

· All authorship is clear and retrievable.

· There is an overall attempt at APA formatting and citation style.

· Errors in formatting of citation or sources are present.

· All sources have some form of citation and all citations have a matching source.

· Citations generally make authorship clear.

· Major errors in citations or source formatting are present.

· Citation or source information may be missing or incorrect.

· Authorship may be unclear.

· Does not meet the criteria

Maximum Total Points

55

44

33

0

Minimum Total Points

45 points minimum

34 points minimum

1 point minimum

0