Question

. John King, 60 years of age, is a male patient who is admitted with the diagnosis of multiple myeloma. He presents with a spinal fracture of the fifth lumbar vertebrae. The patient is scheduled for a vertebroplasty of the spinal fracture. The patient is to remain on bed rest and should be log rolled. Osteolytic lesions are seen in x-rays of the skull, vertebrae, and ribs. The patient has hypercalcemia. The patient’s uric acid level is elevated. The patient has orders for zoledronic acid (Zometa), thalidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen, and Vicodin. (Learning Objective 5)

a. What nursing management should the nurse provide the patient?

b. Explain the indication and action of the various medications ordered to treat the patient’s symptoms.

Answer 1

a. ANS: Nursing management provides to the patient:

Patient is bedridden therefore needs adequate bed care including bowel and bladder care

Good oral hygiene

Frequent turning to prevent bed sores

Administering the medications correctly to ensure patient is pain free

Feeding- nurse has to ensure the patient gets enough nutritional help

Education as regards the condition

Counseling as regards the condition

b. ANS: Indication and various medications ordered to treat the patient's symptoms:

Zoledronic acid (Zometa)- Used for treatment of hypercalcemia

Thalidomide (Thalomod)- it is the main treatment first line drug for multiple myeloma

Allopurinol (Zyloprim)- It antagonizes uric acid production and thus it is given in this case to reduce uric acid levels

Calcitonin- A hormone given for the treatment of hypercalcemia to reduce the serum calcium levels

Ibuprofen- is an anti-inflammatory and analgesic

Vicodin- it is a combination of acetaminophen and hydrocodone thus an effective analgesic.