NURS 6521: Advanced Pharmacology Week 1–11 

NURS 6521: Advanced Pharmacology Week 1–11

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Week 1 discussion with responses

In order for an advanced practice nurse to function effectively, they must have a thorough understanding of pharmacotherapeutics. Age, genetics, and metabolism are just a few of the elements that determine how a patient responds to medication. Understanding pharmacokinetics and pharmacodynamics is essential for designing a patient-centered pharmacological therapy plan for any patient population. Pharmacokinetics is the study of drug movement throughout the body, and this includes how the drug is absorbed, metabolized, distributed, and excreted. Pharmacodynamics is how the body responds to the drug and the mechanisms of their actions (Rosenthal & Burchum, 2018) NURS 6521: Advanced Pharmacology Week 1–11.

Description of the Patient Case

The patient case experience I would like to discuss was a 70-year-old African- American male, escorted into the emergency department (ED) by police for acute psychosis and manic behavior. The patient was picked up off the streets, handcuffed, and appeared to be homeless. In the initial assessment of the patient, he was extremely agitated, combative, hyperverbal, and was having hallucinations as well. Lorazepam, Haldol, and Benadryl were prescribed by the ordering physician. The patient appeared to be more relaxed and less combative after receiving the IM injection; he was placed under direct monitoring and assigned a safety companion. NURS 6521: Advanced Pharmacology Week 1–11 His behavior worsened one hour after the drug, and he was restrained due to his agitation and combativeness.

The kidneys excrete the majority of medications; pharmacokinetics in patients sixty-five or older is altered by the loss of kidney function (Aymanns, Keller, Maus, Hartman & Czock, 2010; Rosenthal & Burchum, 2018). Due to the complexity of comorbidities, polypharmacy, and age‐related changes in liver/kidneys, pharmacotherapy is challenging, and drug interactions or toxicity can occur ( Boparai & Korc-Grodzicki, 2011).

A modified confusion assessment technique (mCAM-ED) and a reality orientation would be the modified plan of care for this patient. Agitation, restlessness, and hallucinations are common in dementia patients, and effort to reduce agitation rather than sedation is usually the goal of treatment ( Casey, 2015). Instead of Lorazepam, Haldol would be the first medicine of choice, as it has a shorter half-life, causes less drowsiness and respiratory depression, and has minor effects on blood pressure (Calver & Isbister, 2013).

References

Boparai, M., & Korc-Grodzicki, B. (2011). Prescribing for older adults. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 78(4), 613–626. doi: 10.1002/msj.20278

Calver, L., & Isbister, G. K. (2013). Parenteral sedation of elderly patients with acute behavioral disturbance in the ED. The American Journal of Emergency Medicine, 31(6), 970–3. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.ajem.2013.03.026

Casey D. A. (2015). Pharmacotherapy of neuropsychiatric symptoms of dementia. P & T: a peerreviewed journal for formulary management, 40(4), 284–287.

Hasemann, W., Grossmann, F. F., Stadler, R., Bingisser, R., Breil, D., Hafner, M., & Kressig, R. W. (2018). Screening and detection of delirium in older ED patients: performance of the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). A two-step tool. Internal and Emergency Medicine, (6), 915. https://doiorg.ezp.waldenulibrary.org/10.1007/s11739-017-1781-y

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

REPLY QUOTE EMAIL AUTHOR

7 months ago

xx

RE: Discussion 1

COLLAPSE

Nice post xx

You are right that for an advanced practice nurse to function effectively, they must have a thorough understanding of pharmacotherapeutics. The patient was given Lorazepam, Haldol, and Benadryl by the ordering physician and the patient appeared relaxed and less combative after receiving the IM injection, but his behavior worsened one hour after the drug, and he was restrained due to his agitation and combativeness. What probably went wrong? By applying knowledge of pharmacokinetic to drug therapy, advance practice nurse can help maximize beneficial effect to minimize harm(Rosenthal & Burchum, 2018) NURS 6521: Advanced Pharmacology Week 1–11. As a provider you should be aware of some implication because drug responses are not completely predictable , you must monitor for both positive and negative effect to determine either too much or too little medication was administered and remember to check drug interaction. Pharmacodynamics and pharmacokinetics together assist in describing the relationship between the dose and response of a drug(Farinde,2019). Right that the kidneys excrete most medications, considering the patient is 70 years old and kidney function may be impaired which may delay the metabolism and elimination of the medication contribute to his reaction after taking the medication. Meanwhile, modified confusion assessment technique (mCAM-ED) also addresses 4 core features: Acute onset or fluctuating course; Inattention; Disorganized thinking and altered level of consciousness(Gross et al, 2014).

References

Faeinde, A. (2019). Overview of pharmacodynamics. March Manual. Retrieved

From https://www.merckmanuals.com/professional/clinical pharmacodynamic/overview-of

-pharmacodynamics.

Grossmann FF., Hasemann W., Graber A., Bingisser R., Kressig RW., Nickel CH. Screening, detection

and management of delirium in the emergency department-a pilot study on the feasibility of a

new algorithm for use in older emergency department patients: the modified Confusion

Assessment Method for the Emergency Department (mCAM-ED). Scandinavian journal of

trauma, resuscitation, and emergency medicine. 2014;22(1):19

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced

practice providers. St. Louis, MO: Elsevier.

REPLY QUOTE EMAIL AUTHOR

7 months ago

xx

RE: Discussion 1

COLLAPSE

Great post xx.

With the older populations, Ativan can cause a “paradoxical effect.” Instead of having a calming effect, it may cause agitation and confusion. I remember I had a patient close to your similar situation, except my patient had a known alcohol history, and he was calm and oriented. Still, he had a scheduled dose of Ativan that I administered as ordered. An hour later, this patient was a different person, now confused and combative, ripping off lines and monitor. This patient ended up in restraint, and the Ativan was discontinued after speaking to the Physician and explaining what happened. With your case scenario, the homeless patient probably had no sleep. The age factor must have caused the pharmacokinetics effect, which is the medication’s absorption, distribution, metabolism, and excretion. In other to decrease agitation and aggression in people with dementia. Sometimes non-drug options are more effective than medications. Cognitive-behavioral therapy effectively treats chronic insomnia and facilitates benzodiazepine tapering in older adults. (Tannenbaum, 2015)NURS 6521: Advanced Pharmacology Week 1–11.

Reference

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice

(2 nurses and physician assistants nded.) St. Louis, MO: Elsevier.

Tannenbaum C. (2015). Inappropriate benzodiazepine use in elderly patients and its

reduction. Journal of psychiatry & neuroscience: JPN, 40(3), E27-E28.

https://doi.org/10.1503/jpn.140355

REPLY QUOTE EMAIL AUTHOR

7 months ago

xx

RE: Discussion 1

COLLAPSE

Informative post xx,

You discussed the importance of understanding pharmacokinetics and pharmacodynamics. What assessment tool or technique was used to

determine initial course of treatment? Due to patient’s age and increased risk for toxicity would you have ordered a different drug for treatment of

symptoms? I also found some research that states Risperdone is effective in acute management of dementia agitation symptoms. I agree

confusion assessment should be included in this patient’s plan of care. Thank you for sharing your post this week NURS 6521: Advanced Pharmacology Week 1–11.

References

Mühlbauer, V., Luijendijk, H., Dichter, M. N., Möhler, R., Zuidema, S. U., & Köpke, S. (2019). Antipsychotics for agitation and psychosis in people with Alzheimer’s disease and vascular dementia. The Cochrane Database of Systematic Reviews, 2019(4), CD013304. https://doi.org/10.1002/14651858.CD013304

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2 nd ed.) St. Louis, MO: Elsevier

REPLY QUOTE EMAIL AUTHOR

7 months ago

xx

RE: Response #2 to xx

COLLAPSE

xx

Confusion, agitation, combativeness are certainly things we also see in the ICU often, and it is certainly not easy to care for these patients. In your scenario, the patient has different risk factors, such as his age, possible decreased kidney and liver function as well as symptoms of psychosis and mania. Many times, it is uncertain what the outcome will be after administration of antipsychotics and benzodiazepines, as patients respond differently. However, many times lorazepam can have a paradoxical effect on the elderly as a result of age-related alterations in the central nervous system. Prompt identification of reversible causes of delirium is crucial. However, other factors that could interfere with the pharmacokinetics and pharmacodynamics on this patient are if the patient used drugs such as alcohol, heroin, or hallucinogens, as DT’s can often cause severe symptoms of hallucinations and combativeness. (Markota, 2016) You mentioned the patient was homeless, so there is a possibility the patient didn’t have adequate access to medical care, medications or noncompliance.

The personalized plan of care on this patient might change if the patient was diagnosed with dementia-related psychosis, as the US Boxed Warning for Haloperidol states that using antipsychotic drugs in this context could increase risk of death. (Uptodate, 2017) NURS 6521: Advanced Pharmacology Week 1–11.

References Markota, M., Rummans, T. A., Bostwick, J., & Lapid, M. I. (2016). Benzodiazepine use in older adults: Dangers, management, and alternative therapies. Mayo Clinic Proceedings , 91 (11), 1632–1639. https://doi.org/10.1016/j.mayocp.2016.07.024

Uptodate®. (2017). Emergency Medicine News, 39(10), 34. https://doi.org/10.1097/01.eem.0000526111.87061.c1

How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow?

Questions like these are related to the underlying pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics. As an advanced practice nurse, understanding these fundamental pharmacotherapeutic concepts is important to ensure that the prescription drugs you recommend for your patients will be safe and effective to treat and/or manage their symptoms. Additionally, as the advanced practice nurse, it is your responsibility to ensure that when prescribing prescription drugs, you adhere to the ethical and legal principles set forth for prescribing drugs as an added layer of protection and safety for the patients you will treat.

This week, you will analyze factors that may influence pharmacokinetic and pharmacodynamics processes of a patient and assess the details of a personalized plan of care that you develop based on influencing factors and patient history. You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs, including disclosure and nondisclosure, and analyze the process of writing prescriptions to avoid medication errors.

Learning Objectives

Students will:

  • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients
  • Assess patient factors and history to develop personalized plans of care
  • Evaluate ethical and legal implications related to prescribing drugs
  • Analyze ethical and legal practices of prescribing drugs
  • Analyze strategies to address disclosure and nondisclosure
  • Justify advanced practice nurse strategies to guide prescription drug decision-making
  • Analyze the process of writing prescriptions to avoid medication errors
  • NURS 6521: Advanced Pharmacology Week 1–11

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare

  • Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
  • Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
  • Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
  • Think about a personalized plan of care based on these influencing factors and patient history in your case study.

By Day 3 of Week 1

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

Week 1 Main Discussion Post: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurses, it’s important to understand the impact disorders have on the body as well as how prescribed medications and treatments effect the body (Rosenthal & Burchum, 2021). Each patient’s pharmacokinetics and pharmacodynamics vary based on their age, genetics, gender, ethnicity, behaviors, and disease process (Rosenthal & Burchum, 2021). Working in the Cardiac ICU there are several experiences and observations I have examined in my clinical practice. Each patient plan of care should be individualized to their person pharmacokinetic and pharmacodynamic factors. The purpose of this discussion is to describe a patient case from your experience, observation or clinical practice in the last five years and explain the influence and pharmacodynamic processes of the patient you identified with explanation on detail.

In the CCU there is often a struggle with management of ICU delirium and sedation in the geriatric population. Many times, in our attempt to manage the patients symptoms we often exacerbate their confusion and delirium leading to increased ICU day stays and poor patient outcomes. Its important that we take a patient-centered approach when managing symptoms with current tools and best evidence-based practice (2019 American Geriatric Society Beers Criteria, 2019). When treating the geriatric population it’s important to remember the changes and different functions of the body that occur naturally with aging. Studies have shown that oversedation in the ICU with benzodiazepines increase mechanical ventilatory days and increase rates of delirium with the geriatric populations (Synchev et al., 2021). There is a constant conflict between sedating and over sedating. When attempting to wean a patient off a ventilator there is often a struggle due to the long-lasting effects midazolam and other benzodiazepines not being excreted from the geriatric patient’s population (Synchev et al., 2021). Factors that impact this are poor renal function and decreased hepatic function. This often leads to increase ICU days and inability to wean patients from ventilators NURS 6521: Advanced Pharmacology Week 1–11.

Pharmacokinetics and pharmacodynamics are impacted by the geriatrics population by decrease in cardiac output, decreased elasticity of vessels, decreased renal filtration capacity, decreased liver volume, a reduced functioning hepatocyte, and decreased hepatic blood flow (Synchev et al., 2021). As we age there is a decrease in our glomerular filtration rate and decreased renal performance (Synchev et al., 2021). Many sedatives are excreted though the kidneys and with reduced function we see higher plasma level of these medications days after discontinuing. With decreased secretions this leads to the medications lasting longer in the patient’s system, which often leads to longer ventilatory days due to the patient unable to participate in pressure support measures. In addition, ICU delirium with benzodiazepines are seen due to the blocking of γaminobutyric acid pump, affecting reuptake ( Zhang et al., 2021). This results in which thus results in increased levels of the inhibitory neurotransmitter (Zhang et al., 2021).

Strategies and patient-centered care models are important when managing the geriatric populations. (Kirsten et al., 2021). The nurse should also focus on the patient’s disease process and assess for a risk of delirium. Some of these conditions are patients with hypertension, DM, myocardial ischemia, atrial fabulation and heart failure (Ali MA et al., 2021). Its also important for the nurse to assess electrolyte disorders and abnormalities that could contribute and create a combination of ICU delirium (Ali MA et al., 2021) NURS 6521: Advanced Pharmacology Week 1–11. When plasma concentration drug levels were assessed in relation to delirium assessments it showed that medications such as lorazepam had a direct correlation of delirium the following day compared to medications such as dexmedetomidine. (Stollings et al., 2018). Strategies such as this can increase our effectiveness of treating patients based on their disease process and age considerations. In my personal practice I have found that early weaning and titrating off IV sedatives and replacing them with oral medications have increased the success rate of successfully preventing ICU delirium and successful extubating in the geriatric population. Incorporating practice models such as the AGS Beers Criteria has shown to increase outcomes when managing medications in older adults. The tool has shown as being valuable in the acute care setting and is based on a comprehensive approach and a valuable resource to improve medication therapy.

In conclusion, as future advanced practice nurses we need to understand the patient’s body, disease and the impact drugs have on our given patient population. Understanding how drugs are absorbed, distributed, metabolized and excreted are important when providing best patient outcomes.

References

Ali MA, Hashmi M, Ahmed W, et al Incidence and risk factors of delirium in surgical intensive care unit Trauma Surgery & Acute Care

Open 2021;6:e000564. doi: 10.1136/tsaco-2020- 000564

2019 American Geriatrics Society Beers Criteria® Update Expert Panel (2019). American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially

Inappropriate Medication Use in Older Adults. Journal of the American Geriatrics Society, 67(4), 674- 694. https://doi.org/10.1111/jgs.15767

Kirsten Fiest, Tom Stelfox, Philippe Couillard, Colin Casault, & Chel Hee Lee. (2021). Sedation strategy and ICU delirium: a multicenter, population-based

propensity score-matched cohort study. BMJ Open, 11(7). https://doi.org/10.1136/bmjopen-2020-045087

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants

(2 nded.) St. Louis, MO: Elsevier.

Stollings JL, Thompson JL, Ferrell BA, et al. Sedative Plasma Concentrations and Delirium Risk in Critical Illness. Annals of Pharmacotherapy. 2018;52(6):513–521.

doi:10.1177/1060028017753480

Sychev, O. D. Ostroumova, A. P. Pereverzev, A. I. Kochetkov, T. M. Ostroumova, M. V. Klepikova, & E. Yu. Ebzeeva. (2021). Advanced Age as a Risk Factor of

Drug-Induced Diseases. Безопасность и Риск Фармакотерапии, 9(1), 15–24.

https://doi.org/10.30895/2312-7821-2021-9-1-15-24

Zhang, H., Yuan, J., Chen, Q., Cao, Y., Wang, Z., Lu, W., & Bao, J. (2021). Development and validation of a predictive score for ICU delirium in critically ill

patients. BMC Anesthesiology, 21(1), 1–8. https://doi.org/10.1186/s12871-021-01259-z

By Day 6 of Week 1

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion

This mandatory assignment is an acknowledgment that you fully understand the course guidelines.

By Day 3 of Week 1

Submission and Grading Information

Submit Your Assignment by Day 3 of Week 1.

To complete this assignment, follow the link below and answer the questions provided.

Week 1 Assignment

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

  • Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
  • Review the scenario assigned by your Instructor for this Assignment.
  • Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
  • Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
  • Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

  • Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
  • Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
  • Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
  • Explain the process of writing prescriptions, including strategies to minimize medication errors.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK1Assgn2+last name+first initial.(extension)” as the name.
  • Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.

Grading Criteria

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Week 1 Assignment 2 Rubric

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Submit your Week 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 1

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Week 1 Assignment 2

Looking Ahead: Week 2 Assignment

Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options.

This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs.

Learning Objectives

Students will:

  • Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes
  • Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies
  • Evaluate drug therapy plans for cardiovascular disorders

Required Readings (click to expand/reduce)

Required Media (click to expand/reduce)

…heart disease remains the №1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke-some of the leading risk factors for heart disease…

-Murphy et al., 2018

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.

Photo Credit: Getty Images/Science Photo Library RF

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare

  • Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
  • Review the case study assigned by your Instructor for this Assignment.
  • Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
  • Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
  • Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
  • Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

By Day 7 of Week 2

Write a 2- to 3-page paper that addresses the following:

  • Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
  • Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 2 Assignment Rubric

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Submit your Week 2 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 2

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Week 2 Assignment

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will examine strategies for the treatment and management of respiratory disorders, including asthma. You will analyze asthma and stepwise management and consider the impact of this approach for patient health.

Next Week

To go to the next week:

Asthma and chronic obstructive pulmonary disease (COPD) are significant public health burdens. Currently, more than 25 million people in the United States have asthma (HealthyPeople.gov, 2019). As an advanced practice nurse, you will likely encounter patients who will present with respiratory disorders, including asthma or COPD. Understanding specific treatment protocols as well as the types of pharmacotherapeutics used to treat respiratory disorders is important to ensure the effective and safe delivery of advanced nursing practice.

This week, you will evaluate drug therapy plans for patients who present with asthma and analyze the stepwise approach to asthma treatment and management from a patient in your professional practice.

Reference: HealthyPeople.gov. (2019). Respiratory diseases. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases

Learning Objectives

Students will:

  • Evaluate drug therapy plans for asthma
  • Assess the impact of asthma treatments on patients
  • Analyze the stepwise approach to asthma treatment and management

One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To Prepare

  • Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
  • Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
  • Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

By Day 7 of Week 3

Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:

  • Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
  • Explain the stepwise approach to asthma treatment and management for your patient.
  • Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 3 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
  • NOTE: SafeAssign does not accept files over 10MB in size. Please attempt to keep your files under 10MB.

Grading Criteria

To access your rubric:

Week 3 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 3 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 3

To participate in this Assignment:

Week 3 Assignment

Next Week

To go to the next week:

Module 3

Learning Objectives

Students will:

To Prepare By Day 7 of Week 4

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

Submission and Grading Information

Grading Criteria

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Week 4 Assignment Rubric

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Submit your Week 4 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 4

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Week 4 Assignment

Next Week

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Module 4

The endocrine system includes eight major glands throughout the body which affect such things as growth and development, metabolism, sexual function, and mood (National Institutes of Health). Some of the most commonly diagnosed endocrine disorders include hypothyroidism, diabetes, and Hashimoto’s disease. Not surprisingly, treating any one endocrine disorder may have effects on other body systems or their functions. As an advanced practice nurse, treating patients who may suffer from endocrine disorders requires an acute understanding of the structure and function of the endocrine system. Additionally, a solid understanding of patient factors and behaviors will assist in developing the best drug therapy plans possible to treat your patients. Some of most commonly diagnosed endocrine disorders include

This week, you differentiate the types of diabetes and examine the impact of diabetes drugs on patients. You also evaluate alternative drug treatments and patient education strategies for diabetes management.

Reference: National Institutes of Health. (n. d.). National Institute of Diabetes and Digestive and Kidney Disorders. Endocrine diseases. Retrieved July 3, 2019 from https://www.niddk.nih.gov/health-information/endocrine-diseases

Learning Objectives

Students will:

  • Differentiate types of diabetes
  • Evaluate the impact of diabetes drugs on patients
  • Evaluate alternative drug treatments and patient education strategies for diabetes management

For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.

Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/

To Prepare

  • Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
  • Select one type of diabetes to focus on for this Discussion.
  • Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
  • Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.

By Day 3 of Week 5

Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.

By Day 6 of Week 5

NURS 6521: Advanced Pharmacology Week 1–11 Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 5 Discussion Rubric

Post by Day 3 of Week 5 and Respond by Day 6 of Week 5

To Participate in this Discussion:

Week 5 Discussion

Looking Ahead: Midterm Exam

Next Week

To go to the next week:

Module 5 

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