Rheumatoid Arthritis and Complicated Diverticulitis

Penny, is a 50-year-old woman who has a has a history of rheumatoid arthritis and complicated diverticulitis. She had previously undergone a temporary colostomy and has subsequently undergone successful reversal of the colostomy. After recovery and subsequent return to normal dietary activity, Penny continues to have some discomfort in the lower abdomen and develops a watery diarrhea. The diarrhoea persists despite several return visits to the specialist’s office. She is admitted to hospital so that she can have a series of tests to identify the cause of the diarrhoea. Penny is eventually found to test positive for a Clostridium difficile infection. (400 word) 1 A medication history was taken when Penny was admitted to hospital to undergo her temporary colostomy. Discuss why it is important to take a medication history for new admissions. 2 Consulting the Australian Medicine Handbook and the electronic Therapeutic Guidelines (eTG), select a course of suitable antibiotics for Penny and justify (explain) why this selection is the best option for her. Include the recommended dosing information. 3 Penny is to be discharged from hospital. She will need to take her oral antibiotics for several days after discharge. You are the nurse who must counsel Penny about her discharge medication. Outline the advice you will give Penny. 4 Antimicrobial use may be prophylactic, empirical, or directed against a known organism. Explain whether Penny is receiving prophylactic, empirical, or directed therapy in this case.