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Case Study
Mrs. Walker You are a Practical Nurse working in acute care and have been assigned Mrs. Walker, 55 years old. Mrs. Walker is refusing her captopril today because it makes her cough.
Primary medical diagnosis: Hypertension related to coronary artery disease
Secondary medical diagnosis: Hypothyroidism.
History: Mrs. Walker is currently using a salt substitute (e.g., Morton) to help with her blood pressure. She weighs 65 kg and is 160 cm in height.
Doctors’ Orders: Medications ï‚· Levothyroxine (Synthroid) 75 mcg PO in AM before meals ,ï‚· Captopril 25 mg PO BID after meals
Medications Available on the Unit: ï‚· Levothyroxine 50 mcg tablets ,ï‚· Captopril 12.5 mg tablets
Read the case study and answer the following questions based on the rights of medication administration.
o For each medication ordered clearly identify the following 
Right medication & Right reason:
o Patient’s medical diagnosis that relates to the medication
o The mechanism of action (effect)
o The pharmacological class 
Right dose: ï‚·
Calculate the ordered dosage (show calculation) ï‚·
Identify if the dosage is safe (provide rationale) 
Right time: ï‚·
indicate if the drug is ordered at the right time and frequency 
Right route: ï‚·
Identify the abbreviations indicated in the order 
Right patient: ï‚·
Indicate how you would verify you have the right patient 
Right documentation: ï‚·
Indicate when documentation would occur 
Right assessment: ï‚·
Identify 1 priority pre-assessment for each medication ï‚·
Identify 1 priority post-assessment for each medication 
Right patient education ï‚·
Indicate 1 teaching point for each medication (teaching information can be found in your drug guide) 
Right to refuse: ï‚·
Provide one NANDA diagnosis based on a patient refusing their medication (see p. 109 in Lilley et al.) ï‚· Include 1 diagnosis statement ï‚·
Include 1 outcome statement ï‚·
Include 1 intervention
o Salt Substitute: 
Explain the patient teaching that would be done for the salt substitute 
Explain why this teaching is importantÂ
SCIENCE
HEALTH SCIENCE
NURSING
