Reply to my peers

Peer 2

1. Is there any additional subjective or objective information you need for this client? Explain.  

I would first begin by asking if Mr. JD has taken any recent medications that has helped with his symptoms. I would also ask if anyone in his household has been sick recently. I would also ask for more of his medical history for example if he is a current or former smoker. I would assess for any shortness of breath or wheezing.  

2. Would you treat Mr. JDs cold? Why or why not? 

I would first explain to Mr. JD that the common cold is a self-limiting upper respiratory tract infection and it is caused by the rhinovirus, coronavirus or the adenovirus and usually resolves within 7-10 days (Ismail & Schellack, 2018). Since it has been two weeks with these symptoms, yes, I would treat him. It sounds like Mr. JDs symptoms could be a bacterial sinus infection which I would recommend antibiotic treatment.  

3. What would you prescribe and for how many days? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings. 

I would prescribe Amoxicillin- Clavulanate (Augmentin). The first choice for antibiotic therapy in acute sinusitis is amoxicillin with or without clavulanate (Woo & Robinson, 2019). For an adult the dose is 500 mg given three times a day, and the course normally lasts for 5 to 7 days. “Amoxicillin is a broad-spectrum beta-lactam antimicrobial originally derived from penicillin. It is a bactericidal agent that targets and kills bacteria by inhibiting the biosynthesis of the peptidoglycan layer of the bacterial cell wall. Amoxicillin works by binding to these PBPs and inhibiting peptidoglycan synthesis, which interrupts the construction of the cell wall and ultimately leads to the destruction, or lysis, of the bacteria. Amoxicillin-clavulanate is largely safe and well-tolerated in the general population, with the vast majority of adverse effects being only mild gastrointestinal symptoms. The single most common complaint is diarrhea, but others include nausea, vomiting, loose stools, and abdominal discomfort. Caution is warranted when treating patients on hemodialysis or with severe renal impairment with creatinine clearance less than 30 mL/minute. As this antibiotic primarily gets renally excreted, individuals with renal disease will need dose adjustments and closer monitoring” (Evans, 2021).  

4. Would this treatment vary if Mr. JD was a 10 year-old 78 lb child? Include the class of the medication, mechanism of action, dosing, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings 

If Mr. JD was a 10 year old the daily dose is 45 mg/kg/d for standard dose divided into two or three doses for 10 to 14 days (Woo & Robinson, 2019). This medication is renally excreted and half life is 1.3 hours.  

5. What health maintenance or preventive education is important for this client based on your choice medication/treatment? 

I would advise Mr. JD to monitor his stools for becoming watery or bloody and to notify provider right away if it occurs. I would also educate him to make sure he finishes his full course of antibiotics even if he feels better. Also to seek medical care if he experiences any allergic reactions to the medication.  

Evans, J. (2021, March 3). Amoxicillin CLAVULANATE. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK538164/. 

Ismail, H., & Schellack, N. (2018). Colds and flu -- an overview of the management. Professional Nursing Today, 22(1), 3–12.  

Woo, T. & Robinson, M. (2019). Pharmacotherapeutics for advanced practice nurse prescribers with Davis Edge (5th ed.).F.A. Davis Company. ISBN: 9780803669260.