An Individual Who Has Abused Over the Counter Medication - Case Study Example

Case Study of an Individual Who Has Abused Over the Counter Medication Student’s Name: Instructor’s Name: Course Code and Name: University: Date Assignment is due: Case Study of an Individual Who Has Abused Over the Counter Medication Introduction This paper is about case study scenario one. It involves a 22 year old female student called Phuong Thi who had to be admitted at the hospital following the ingestion of an unknown amount of Panadol Osteo tablets. During admission, she tearfully said that she has taken the tablets to get rid of a headache that would not go away. The paper will follow a systematic review of the theoretical principles for analysis of the case study that will also include cultural perspectives and health behaviors. In addition nursing consideration for case study analysis be explored including the assessment and discharge arrangements. Theoretical principles for the analysis of the case study The theoretical perspective adopted for this case study is Levinson’s life stages and human development. The theory is appropriate because it explores issues that are involved in adult development. Phuong Thi is 22 years old making her an adult and, knowledge of some of the developmental issues she may be dealing with will shed light on events that have led to her ingestion of excess Panadol Osteo. Levinson suggests that life goes on in a structural manner. These structures define the different patterns that occur in people’s lives at given times (Human growth tripod). There are two concepts in the theory that include the stable period where an individual makes critical choices in their lives and, the transitional period which marks the ending of a step or stage and also the beginning of another (Human growth tripod). The transitional period can go smooth for people or be rocky. Among the six stages described by Levinson, early adult transition (17-22) and entering the adult world (22-28) applies to Phuong Thi. The former involves making vital life choices and the latter involves making decisions about occupation, love, values, friendship and lifestyle (Human growth tripod). Phuong Thi is transitioning from one stage to another. She is meant to make decisions that concern her life such as in love and occupation. This is a greater challenge for her, since she just got out of a relationship and, she has an obligation to work at her parents’ restaurant. She has reached an age that she might need to start life on her own or move out. However, she is still at her parents’ and she is getting over a breakup. The patient is a Vietnamese born in Australia. This means that the type of culture she s exposed to is unique. Culture is affected by the context around which it occurs (Riley 2011). Being immigrants from a different country, her parents most likely had to work harder to get what they have. Economic hardship and Unemployment are among the issues that result in higher risk of drug abuse (Isaacson et al 2005, pp.19-26). Phuong Thi currently works in her parents’ restaurant indicating that she does not have her own job that is independent form her family. Conditions associated with economic problems often go hand in hand with depression and higher stress levels. One of the common indicators of higher stress levels is headaches. She admitted to having a headache that won’t stop implying that she may be stressed. Patterns related to substance abuse are more likely to develop when people live under highly stressful circumstances. In most cases, these individuals often use drugs of opportunity. Phuong Thi is under pressure to perform well at school and work at the restaurant. She said that she took medicine that belongs to her father. This indicates she took the drugs because they were available. According to a document by the Mayo Clinic Staff (Medeiros 2007), people in their teens and early 20s have a higher possibility of being addicts compared to their counterparts. Phuong Thi is 22 years old putting her in this age bracket. Other behaviors that put her in a higher risk include her working while studying. Her friend mentioned that she had been working long hours. This kind of pressure in her lifestyle is a risk factor. Phuong’ Thi is also under stress from her recent breakup. She hasn’t had time to deal with the breakup because she is too busy. Thus, it is affecting her studies and her health. She also had access to the drugs since she knew her father used Panadol Osteo. In addition, another risk factor is lacking sufficient understanding of how prescription drugs are meant to work (Medeiros 2007). Taking another person’s drugs is unsafe. Nursing considerations for the analysis of the case study Phuong Thi is a 22 year old who has been stressed to the point of taking an overdose of Panadol Osteo. Some of the effects of the substance on her health will include constricted pupils, respiratory depression, vomiting and nausea (National Center for Mental Health Promotion and Youth Violence Prevention 2010). These symptoms are specific to abuse of a pain reliever. Other symptoms include an unexpected deterioration in academics. Panadol Osteo is also referred to as Acetaminophen and it contains paracetamol. In extreme cases, the patient may experience liver failure (National Center for Mental Health Promotion and Youth Violence Prevention 2010). The effects of overdose occur in phases. A few hours after the ingestion of an overdose, the patient may exhibit vomiting, sweating, nausea and pallor. However, some patients only exhibit mild symptoms. Between 24 and 72 hours after ingestion, the patient may exhibit signs of liver damage. This occurs within the hepatocytes as they try to metabolize the drug (Bartlett 2004, pp.281–283). The extent or severity of the overdose varies depending on the amount taken and appropriate treatment. Consequently, this case study is focused within 72 hours because Phuong Thi was taken to the hospital after the overdose. The third phase of toxicity is not applicable in this case. Among the most effective methods of diagnosing paracetamol toxicity (poisoning of the blood by paracetamol) is through a paracetmol blood test. The Rumack-Mathew nomogram drug is used in this test. It works by giving an estimation of the threat of toxicity (Bartlett 2004, 281–283). The conclusion arrived at after the serum concentration of the paracetamol is checked after a certain number of hours. Potential hepatoxcity is determined by tracing the level of paracetamol along the nomogram (Bartlett 2004, pp.281–283). The blood test on Phuong Thi was ordered after 6 hours which raises the accuracy of the results. If a paracetamol level is drawn following the first four hours since ingestion or less, the true levels in the system will be underestimated. This is a consequence of the process of absorption from the gastrointestinal tract still going on. Another factor that makes timing vital is that timed serum level plotting is most effective for indicating if there is any liver injury. She will need Gastric decontamination. Within the first two hours, this is the most effective in adults. The decontamination should be done using Activated Charcoal. The charcoal absorbs the paracetamol and reduces the rate of absorption going on in the gastrointestinal tract (Spiller & Sawyer 2007, pp.141–144.). The saline administered will help in diluting the paracetamol in the blood. Acetylcysteine is an antidote for administration in a case of paracetamol toxicity (Heard 2008, pp.285–292). When administered, it replenishes an individual’s body store of glutathione (Brok et al 2006). It is more effective if administered less than 8 hours after the patient ingests panadol osteo. The time frame guarantees the survival of the patient through the reduction of hypertoxicity. Other than needing treatment, Phuong Thi will need psychiatric evaluation so that a long term plan for counseling and psychiatry can be established. Her admission of problems was tearful signifying that she wanted to be helped. The therapy will help her as she deals with the breakup. In addition, she will get help in terms of organizing her life so that she is not overworked or under pressure she cannot handle. This means that she will also need guidance on how to handle situations with high pressure. She will therefore be able to balance the duties she has in life. Therapy will help her in developing coping strategies for stressful situations. This is important because they are inevitable in life. Some of the recommendations for coping strategies include emotion and problem centered coping. Phuong Thi would need to learn these two strategies for use now and in the future. A problem solving approach would teach her to take a certain action to correct a problematic situation thus, curbing the development of negative feelings. The emotional approach will teach her to eliminate or moderate any negative emotions directly. Her family and friends should be involved in her treatment in terms of offering their support (Miller & Brown 2007, pp.810). Conclusion The case study presented a female patient called Phuong Thi who was admitted because of taking an overdose of Panadol Osteo. She appears to be stressed by the situations in her life which include a breakup, decline in academics, working long hours and a headache. The headache could be a manifestation of the stress in her life. She took the drugs because of her stress and, she will need continuous therapy for the stress. Levinson’s life stages theoretical perspective explains the issues that she is dealing with including some of the sources of her stress. The key to ensuring she does not take an overdose again is to guide her through improving her mental health state. List of References Bartlett, D 2004, Acetaminophen Toxicity, Journal of Emergency Nursing: JEN : Official Publication of the Emergency Department Nurses Association, vol. 30, no. 3, pp. 281–283. Brok, J, Buckley, N & Gluud, C 2006, Brok, Jesper. ed. "Interventions for Paracetamol (acetaminophen) overdose. Cochrane Database of Systematic Reviews. Viewed 20 August, 2012 . Heard, K J 2008, Acetylcysteine for Acetaminophen Poisoning, The New England Journal of Medicine, vol. 359, no. 3, pp. 285–292. Human Growth Tripod, Daniel Levinson: Theories of Life Stages and Human Development, Viewed August 19, 2012, . Isaacson, H, Hopper, J, Alford, D, Parran, T et al 2005, Prescription Drug Use and Abuse, Postgraduate Medicine, vol. 118, no. 1, pp. 19-26. Medeiros, J 2007, A Theoretical Perspective on Substance Abuse: A Sociocultural Approach, Viewed August 19, 2012, . Miller, M & Brown, R 2007, American Family Physician, vol. 75, no. 6, 810.  National Center for Mental Health Promotion and Youth Violence Prevention 2010, Prescription Drug Abuse by Adolescents, Viewed August 19, 2012, . Riley, R 2011, Prescription Drug Addiction Is Becoming A Big Problem In Australia And Costing Lives, Sunday Herald Sun, Viewed August 19, 2012, . Spiller, HA & Sawyer, TS 2007, Impact of activated Charcoal After Acute Acetaminophen Overdoses Treated with N-acetylcysteine, The Journal of Emergency Medicine, vol. 33, no. 2, pp. 141–144. Read More