List Mrs. Clarke's other medications and identify the rationale ...

[HudsonKB16]

List Mrs. Clarke's other medications and identify the rationale for each prescription.
 
  What will be an ideal response?

Question 2

What factors contribute to the elevated energy expenditure in this patient?
 
  What will be an ideal response?

[rosiehomeworddo]

Answer to Question 1

 Omeprazole: for history of GERD. It is a proton pump inhibitor, which blocks acid production, decreasing gastric acidity. This is prescribed to reduce symptoms of GERD but may also help with IBS, as GERD symptoms (upper GI) can be associated with IBS, such as chest pain or heartburn or abdominal pain.
 Levothyroxine: used to treat hypothyroidism, it is a synthetic version of the thyroid hormone, which increases the metabolic rate and is important for growth and bone health. Rationale: patient has hypothyroidism.
 Vitamin D/calcium supplements: rationale for usage is to compensate for other drugs such as omeprazole, which inhibits calcium absorption; supplementation may be necessary to preserve bone health.
 Lomotil: helps with diarrhea, which patient has recently had several episodes of.

Answer to Question 2

Factors that may contribute to the elevated energy expenditure in this patient include the trauma/stress from the patient's GSW, his various corrective surgeries, mechanical ventilation, an anastomotic leak on day 3 of admission, and fluid/electrolyte/protein losses from the patient's various drains and wound vac.