Question

John Miller, a 65-year-old patient, has arrived at the clinic for a return-to-work visit. He has...

John Miller, a 65-year-old patient, has arrived at the clinic for a return-to-work visit. He has a history of hypertension, diabetes Type 2, myocardial infarction (MI) 4 years ago, and congestive heart failure (CHF). He has been taking glyburide 2.5 mg daily, captopril 25 mg twice a day, and HCTZ 25 mg daily. He is here for a blood pressure check and the physician wants to evaluate the medications he just started 3 months ago. He also is scheduled for a pneumococcal immunization. As you read through this chapter, think about what the medical assistant should do next and why.

Discussion Questions:

  1. What questions do you need to ask Mr. Miller during his initial interview regarding his medications?
  2. When you get ready to administer the pneumococcal immunization, Mr. Miller states that he had a bad reaction the last time he received a shot. What should you do?
  3. If the site of the injection from his last visit was just irritated due to the medication, what could be done to reduce the irritation for his next IM injection?

Homework Answers

Answer #1

1.In the initial interview we should ask about the side effects and therapeutic effects of medications, like hypoglycemia, hypotension and common nutritional implications of hydrochlorothiazide like depletion of sodium, potassium, magnesium and zinc

2. If the patient reports of having bad reactions after previous pneumococcal vaccination, I shall ask about the symptoms of those reactions and find out whether it was mild or anaphylactic reactions and decide to administer the vaccine or not

3. To minimize irritation and discomfort apply ice or over the counter topical numbing cream before rubbing with the alcohol swab and allow alcohol to dry completely before pricking the needle

Apart from this I should explain the patient that mild irritation happens after vaccination and it will subside on its own in couple of days and need not to do anything about them

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