Case Study – COLISTIN

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Drug that needs to be research is COLISTIN

Case Study – COLISTIN

SJ is a 68-year-old male (height 165cm, weight 60kg) admitted to the intensive care unit with shortness of breath and is intubated for acute hypoxic respiratory failure. His past medical history includes hypertension, COPD and type II DM. He quit smoking 10 year ago. He has multiple admissions to the hospital for pneumonia. A culture of his sputum confirms infection by Acinetobacter baumanii susceptible to colistin and amikacin. Based on recent PK data for SJ (creatinine = 86.7 ?mol/L) to target a concentration of 2.5 mg/L, calculate SJ’s loading dose of colistimethate sodium (CMS – a prodrug).

YOU must discuss:
1. The basic pharmacology of colistin (including the mechanism(s) of action and toxicities/adverse effects), its clinical uses and dosages/formulations available.
2. The chemical structure/characteristics of colistin related to its interesting pharmacokinetic characteristics and the clinical implication of these unique features.
3. Considerations that you need to factor in while using colistin in special populations (in renally or hepatically impaired, or in obese patients).
4. RESOVE the case study, showing all calculations/steps to determine your answers.

What would you say are the are the four most important lessons you have learned about managed care?

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Just Answer the questions and follow all the instructions. I don’t need neither introduction nor conclusion.

Instructions: Your final class assignment will consist of an essay responding to the five (5) questions enumerated below. You are asked to answer each question completely, using correct grammar and sentence structure. Please do not simply copy and “paste everything”, from your text- think about your answers. Questions 1-4 must be answered in a minimum of two paragraphs. Question 5 will be completed as you deem needed. As we all wish to maintain the highest level of educational integrity, this is an individual’s assignment. We encourage students to interrelate through dialogue, learning and comradery. However, any answers to questions that are or appear to be deliberately the same from one student to another will be graded poorly. I know that this will not happen as I have the highest respect for each of you. However, it is important to be clear. Strive for good work and you will yield a good grade.
1. Managed Health Care has significantly affected the Health Care Delivery system in the United States. In your own words, describe Managed Health Care. What were some of the factors that influenced its development, and describe the advantages and disadvantages of managed care from the perspective of the Patient and Provider?

2. Managed Health Care Organizations administer many functions. Payment is a key element. Please describe the difference between Reimbursement and Payment how do these affect provider behavior? Explain risk based versus non-risk based payment methods and provide some examples of each?

3. Managed Health Care manages several components which include medical services, costs and quality of care. Describe utilization review, its purpose and three utilization methods and functions employed by managed care organizations. Describe Case management and Disease management, compare by providing some examples of each.

4. A Managed Care payer organization uses several managerial and operational functions to accomplish its goals. Describe the difference between Governance and Management and provide examples of each. Describe the difference between sales and marketing and provide some examples of each.

5. What would you say are the are the four most important lessons you have learned about managed care?

Critically evaluate the nursing treatments/interventions provided over a one week period

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Task:
The student is required to present a case study and undertake a critical analysis of the chosen care.

You are required to:

Select a patient with CKD or ESCKD and address the following points for the chosen case:

Describe the presentation, biological, psychological and social aspects of the chosen case; (approx. 500 words)
Review current evidence in relation to the incidence and prevalence of CKD or ESCKD in both indigenous and non-indigenous Australians; (approx. 500 words)
Describe the anatomy and physiology of the chosen case’s primary renal condition; (approx. 500 words) and
Critically evaluate the nursing treatments/interventions provided over a one week period (i.e. if the person is on haemodialysis than you are required to follow the person over 3 HD treatments). This section is to include the nursing responsibilities in relation to observations, monitoring and measuring the patient’s response to nursing, medical and pharmacological interventions (this section is to be written in essay format and NOT as a table) (approx. 1500 words).

What does Chris and Mohammad at Ecohouse know about constructing a teaching facility anyway?’

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Chris and Mohammad are in their final year of a building and construction course at the University of Canberra. They decide to start a eco friendly building business, Ecohouse Pty Limited, which will be based on the UC campus’ business hub. Chris and Mohammad’s business plan is to use their connections with UC’s clubs and societies and Masters Builders connections through UC teaching staff to establish a client base and build a portfolio before they graduate. They will then be able to expand Ecohouse into the broader Canberra and interstate marketplace and launch their building and construction careers.

Ecohouse’s first job is organising, managing and building the construction of the new state of the art e-court for the Faculty of Business, Government & Law. The Faculty is particularly keen to support student enterprise, and the construction proceeds smoothly. Chris and Mohammad are able to use some photographs of the construction progress on their website, and also to promote both the Faculty and Ecohouse on Facebook and Twitter. Social media will be a key tool for Ecohouse’ promotion. Ecohouse is off to a flying start!

Shortly afterwards, Ecohouse is approached by Constructions of Canberra, to propmote, manage and construct the new UC teaching hospital. The UC turns the campus into an area of medical skills and building for an entire weekend.. Unfortunately, the display coincides with the ANU Teaching medical facilities open day. And the ANU medical society is not happy about it. Scheduling two such events on the same day appears to split Canberra’s interested patrons and parties with vested interest, resulting in lower turn out and ticket sales at both events.

Fortunately for Chris and Mohammad, the UC’s Ecohouse online marketing strategy is working the crowd is far bigger than anticipated. The ANU resorts to taking to Twitter to vent their displeasure, tweeting, “Chris at Ecohouse is a selfish bastard” and ‘What does Chris and Mohammad at Ecohouse know about constructing a teaching facility anyway?’

After the event, Chris and Mohammad post several photos from the event on the Facebook pages for Ecohouse and for UC. Not everyone is happy, however. Jenny, a long-time staff member of UC, is disturbed by a photo of herself posing with medical equipment whilst wearing a hard hat. Everyone knows Jenny is a show-off, and the photo was an ironic pose. She didn’t realise that it would end up on Facebook, tagged to her profile so that all her friends would see it. She is humiliated and angry.