Assignment task:
Brian Jamieson is a 77-year-old man who has been admitted to your ward with new onset of atrial fibrillation. He is normally fit and healthy, walks for an hour a day and even has the occasional jog. He has no significant medical history other than mild dyslipidaemia, for which he was commenced on atorvastatin, but ceased after a week due to the side effects. He had COVID approximately 1 month ago and has had an ongoing chest infection, which has now turned into Community Acquired Pneumonia, for which he has been prescribed Ceftriaxone 1gram intravenous (IV) daily and Doxycycline 100mg orally twice a day. His father died at the age of 70 from a massive Myocardial Infarction, and his mother died in her late 80's of natural causes (although she had previously had a haemorrhagic stroke 15 years prior to her death and had multiple Transient Ischaemic Attacks). Brian is commenced on Rivaroxaban for clot prevention and a low dose (2.5 mg) of Bisoprolol to assist with heart strain, however he is refusing to take the Bisoprolol as he states there is nothing wrong with his blood pressure and he has read that Bisoprolol is antihypertensive.
Instructions:
Question 1: With reference to peer-reviewed literature from the last 5 years, analyse the potential consequences of not taking Bisoprolol for Brian's health and describe best evidence-based practice for educating Brian on the importance of taking this medication.
Question 2: With reference to peer-reviewed literature from the last 5 years, compare and analyse two lifestyle modifications that could be recommended for Brian to manage his cardiac condition?
Question 3: With reference to peer-reviewed literature from the last 5 years, create an argument why Brian does not need to take the Bisoprolol.
Question 4: You are required to administer 1 gram of IV Ceftriaxone to Brian at 0800. Analyse current best practice guidelines in regard to labelling requirements and create an argument for change.