Posts in category: Nursing Papers

NURS6501 Advanced Pathophysiology
Week 5 Quiz 
Question 1A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when:
Question 2Which of the following lab tests will the nurse check to help diagnose heart failure and provide insight into its severity?
Question 3A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure?
Question 4A 56-year-old male presents to his primary care provider for a checkup. Physical exam reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is of greatest concern to the nurse?
Question 5A 20-year-old male underwent an echocardiogram to assess chest pain. Results revealed a congenital defect in papillary muscles. Which of the following would the nurse expect to occur?
Question 6A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins?
Question 7Which is the most common type of congenital heart defect the nurse should assess for in infants?
Question 8A 49-year-old male presents to his primary care provider reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?
Question 9What factors make a patient prone to neurogenic shock? Neurogenic shock can be caused by any factor that inhibits the:
Question 10A 15-year-old male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylactic shock. Which assessment findings will the nurse assess for?
Question 11When a patient with left heart failure starts to have a cough and dyspnea, which principle should the nurse remember? Pulmonary symptoms, common to left heart failure, are a result of:
Question 12When a patient asks the nurse what is the most common cause of myocardial ischemia, which statement is the correct response? The most common cause of myocardial ischemia is:
Question 13A 42-year-old female is diagnosed with constrictive pericarditis. The nurse assesses the blood pressure for decreased cardiac output because of:
Question 14A 22-year-old pregnant female presents for a fetal echocardiogram. Tests reveal small left atrium and mitral valve and an absent left ventricle and aortic valve. The diagnosis is hypoplastic left heart syndrome (HLHS). The nurse will anticipate that the treatment for this defect is:
Question 15When a person is in shock, a nurse remembers impairment in cellular metabolism is cause by:
Question 16A 67-year-old female was previously diagnosed with rheumatic heart disease. Tests reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which of the following is the most likely diagnosis recorded on the chart?
Question 17A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nose bleeds. He is diagnosed with rheumatic heart disease. While planning care, which characteristic changes should the nurse remember?
Question 18A newborn experiences frequent periods of cyanosis, usually occurring during crying or after feeding. Which of the following is the most likely diagnosis the nurse will observe on the chart?
Question 19A 28-year-old female presents to the ER reporting severe chest pain that worsens with respirations or lying down. She has a fever, tachycardia, and a friction rub. Based upon the assessment findings, the nurse determines the patient is experiencing:
Question 20A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is:
Question 21An 8-week-old infant presents to her primary care provider for a well-baby check. Physical exam reveals a murmur, and an echocardiogram shows a large ventricular septal defect. If left untreated, what condition should the nurse discuss with the parents?
Question 22A 20-year-old female is being admitted to the hospital with fever and septic shock. Which set of assessment findings would the nurse expect the patient to exhibit?
Selected Answer:
[None Given] Question 23A newborn is suspected of having coarctation of the aorta. Which of the following assessments would aid in diagnosis?
Question 24A nurse is planning care for a patient in shock. Which principle should the nurse remember? During shock states, glucose uptake is usually:
Question 25An infant undergoes an echocardiogram for a suspected heart defect. Tests reveal an opening in the middle of the atrial septum. What term would the nurse use to describe this defect?
Question 26A newborn baby is severely cyanotic. An echocardiogram reveals transposition of the great arteries. A nurse assesses for which of the following, as it usually occurs with this defect?
Question 27A 55-year-old male died of a myocardial infarction. Autopsy would most likely reveal:
Question 28A 30-year-old female presents to her primary care provider with fever, cardiac murmur, and petechial skin lesions. She is diagnosed with infective endocarditis. When the patient wants to know what caused the disease, what is the nurse’s best response? The most likely cause of the disease is:
Question 29A 50-year-old male was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI). He is being treated for shock. His cardiopulmonary symptoms include low blood pressure, tachycardia, and tachypnea. His skin is pale and cool. The primary cause of his shock is most likely:
Question 30Upon assessment of the patient, the nurse finds a widened pulse pressure and throbbing peripheral pulses. Which valve disorder does the nurse suspect?
Question 31When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

week_4_assignment_.docx (26.69 KB)

Week 4 assignment Using the Data/Information/Knowledge/Wisdom Continuum
Have you ever gone online to search for a journal article on
a specific topic? It is amazing to see the large number of journals that are
available in the health care field. When you view the library in its entirety,
you are viewing untapped data. Until you actually research for your particular
topic, there is little structure. Once you have narrowed it down, you have
information and once you apply the information, you have knowledge. Eventually,
after thoughtful research and diligent practice, you reach the level of
wisdom—knowledge applied in meaningful ways.
Are there areas in your practice that you believe should be
more fully explored? The central aims of nursing informatics are to manage and
communicate data, information, knowledge, and wisdom. This continuum represents
the overarching structure of nursing informatics. In this Assignment, you
develop a research question relevant to your practice area and relate how you
would work through the progression from data to information, knowledge, and
wisdom.
To prepare:
Review the information in Figure 6–2 in Nursing Informatics
and the Foundation of Knowledge.
Develop a clinical question related to your area of practice
that you would like to explore.
Consider what you currently know about this topic. What
additional information would you need to answer the question?
Using the continuum of data, information, knowledge, and
wisdom, determine how you would go about researching your question.
Explore the available databases in the Walden Library.
Identify which of these databases you would use to find the information or data
you need.
Once you have identified useful databases, how would you go
about finding the most relevant articles and information?
Consider how you would extract the relevant information from
the articles.
How would you take the information and organize it in a way
that was useful? How could you take the step from simply having useful
knowledge to gaining wisdom?
By Day 7 of Week 4
Write a 3- to 4-page paper that addresses the following:
Summarize the question you developed, and then relate how
you would work through the four steps of the data, information, knowledge,
wisdom continuum. Be specific.
Identify the databases and search words you would use.
Relate how you would take the information gleaned and turn
it into useable knowledge.
Can informatics be used to gain wisdom? Describe how you
would progress from simply having useful knowledge to the wisdom to make
decisions about the information you have found during your database search.
Your paper must also include a title page, an introduction,
a summary, and a reference page.

walden_nurs6051_all_week_discussions_latest_2017_october.zip (961.07 KB)

Week 1 discussion The Effects of “To Err Is Human” in Nursing Practice
The 1999 landmark study titled “To Err Is Human: Building a
Safer Health System” highlighted the unacceptably high incidence of U.S.
medical errors and put forth recommendations to improve patient safety. Since
its publication, the recommendations in “To Err Is Human’” have guided
significant changes in nursing practice in the United States.
In this Discussion, you will review these recommendations
and consider the role of health information technology in helping address
concerns presented in the report.
To prepare:
Review the summary of “To Err Is Human” presented in the
Plawecki and Amrhein article found in this week’s Learning Resources.
Consider the following statement:
“The most significant barrier to improving patient safety
identified in “To Err Is Human”is a “lack of awareness of the extent to which
errors occur daily in all health care settings and organizations (Wakefield,
2008).”
Review “The Quality Chasm Series: Implications for Nursing”
focusing on Table 3: “Simple Rules for the 21st Century Health Care System.”
Consider your current organization or one with which you are familiar. Reflect
on one of the rules where the “current rule” is still in operation in the
organization and consider another instance in which the organization has
effectively transitioned to the new rule.
By Day 3
Post your thoughts on how the development of information
technology has helped address the concerns about patient safety raised in the
“To Err Is Human” report. Summarize how informatics has assisted in improving
health care safety in your organization and areas where growth is still needed.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 2 discussion
Nursing Informatics
Competencies
Today’s fast-paced health care environment demands nurses to
be skilled not only in their clinical practice or specialty area but in the use
of technology tools that improve practice and lead to better patient care.
Basic and advanced technology competencies are required and expected as
technology increasingly touches and changes the job of every nurse. Numerous
organizations, including the American Nurses Association (ANA), the American
Medical Informatics Association (AMIA), and Healthcare Information and
Management Systems Society (HIMSS), have developed nurse-specific technology
competencies. The challenge for nurses is to identify both needs and training
opportunities.
In this Discussion, you identify the role informatics plays
in your professional responsibilities. You pinpoint personal gaps in skills and
knowledge and then develop a plan for self-improvement.
To prepare:
Review Nursing Informatics: Scope and Standards of Practice
in this week’s Learning Resources, focusing on the different functional areas
it describes. Consider which areas relate to your current nursing
responsibilities or to a position you held in the past. For this Discussion,
identify one or two of the most relevant functional areas.
Review the list of competencies recommended by the TIGER
Initiative. Identify at least one skill in each of the main areas (basic
computer competencies, information literacy competencies, and information
management competencies) that is pertinent to your functional area(s) and in
which you need to strengthen your abilities. Consider how you could improve
your skills in these areas and the resources within your organization that
might provide training and support.
By Day 3
Post the key functional area(s) of nursing informatics
relevant to your current position or to a position you recently held, and
briefly describe why this area(s) is relevant. Identify the TIGER competencies
you selected as essential to your functional area(s) in which you need
improvement. Describe why these competencies are necessary and outline a plan
for developing these competencies. Include any resources that are available to
you within your organization and the ways you might access those resources.
Assess how developing nursing informatics competencies would increase your
effectiveness as a nurse.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using the following approach: Assume the role of a consultant. Respond to
your colleagues as someone who can offer advice on improving their skills on
the competencies they identified as needing improvement.
Week 3 discussion
Standardized Coding
Systems
As a result of the fragmented nature of the health care
system, professionals in various specialty areas of medicine have developed
their own unique sets of terminology to communicate within that specialty. In
the past, limited attention has been given to codifying practices in order for
them to be understood and utilized across disciplines or through different
information technology systems. The implementation of a federally mandated
electronic medical records system, therefore, poses a challenge to nursing
professionals and others who must be prepared to utilize standardized codes for
the new system. Why are coding standards important for promoting consistent,
high-quality care?
According to Rutherford (2008, para. 15), “Improved
communication with other nurses, health care professionals, and administrators
of the institution in which nurses work is a key benefit of using a
standardized nursing language.” In this Discussion you consider the reasoning
behind and the value of standardized codification.
To prepare:
Review the information in Nursing Informatics: Scope and
Standards of Practice. Determine which set of terminologies are appropriate for
your specialty or area of expertise.
Reflect on the importance of continuity in terminology and
coding systems.
In the article, “Standardized Nursing Language: What Does It
Mean for Nursing Practice?” the author recounts a visit to a local hospital to
view its implementation of a new coding system. One of the nurses commented to
her, “We document our care using standardized nursing languages but we don’t
fully understand why we do” (Rutherford, 2008, para. 1). Consider how you would
inform this nurse (and others like her) of the importance of standardized
nursing terminologies.
Reflect on the value of using a standard language in nursing
practice. Consider if standardization can be limited to a specialty area or if
one standard language is needed across all nursing practice. Then, identify
examples of standardization in your own specialty or area of expertise. Conduct
additional research using the Walden Library that supports your thoughts on
standardization of nursing terminology.
By Day 3
Post an explanation of why nurses need to document care
using standardized nursing languages and whether this standardization can be
limited to specialty areas or if it should be across all nursing practice.
Support your response using specific examples from your own specialty or area
of expertise and using at least one additional resource from the Walden
Library.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 4 discussion
Current Information
and Communication Technologies
With so much attention focused on health care reform, it is
important that nurses be given the opportunity to use high-quality technology
tools. These tools can increase access to vital medical information, promote
effective communication among health care professionals, and improve the
patient experience. By actively seeking out and adopting these tools, nurses
can greatly enhance the quality and safety of care that they provide.
This Discussion focuses on identifying quality technology
tools that increase the ability of nurses to provide safe, effective care.
To prepare:
Review the various technology tools described in this week’s
Learning Resources.
Identify a recently adopted information, education, or
communication technology tool in your specialty area. Reflect on how it is used
and how its use impacts the quality of care.
Consider how your identified technology tool might impact
nursing practice if it were more widely used. What are some barriers preventing
increased usage? How could wider implementation be facilitated?
By Day 3
Post a description of a current or new information,
education, or communication technology tool that is being used in your
specialty area and assess its impact on the quality of care. Highlight the
effect that increased use of this technology would have on nursing practice and
discuss the barriers that are slowing or hindering its adoption. Summarize how
adoption of the technology tool could be facilitated.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 5 discussion
Electronic Health
Records
Electronic health records (EHRs) are at the center stage of
the effort to improve health care quality and control costs. In addition to
allowing medical practitioners to access and record clinical documentation at
much faster rates, EHRs are also positively influencing care delivery and
nurse-patient interaction. Yet despite the potential benefits of EHRs, their
implementation can be a formidable task that has broad-reaching implications
for an entire health care organization.
In this Discussion, you appraise strategies for obtaining
the benefits and overcoming the challenges of implementing and using electronic
health records.
To Prepare:
Review the Learning Resources focusing on the implementation
of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with
implementing EHRs. What were some positive aspects of the implementation? What
suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation
process. Were concerns handled effectively?
If you have not had any experiences with an EHR
implementation, talk to someone who has and get his or her feedback on the
experience.
Search the Walden Library for examples of effective and poor
implementation of EHRs.
By Day 3
Post an overview of at least three challenges in the
implementation of electronic health records and provide an example of each
challenge. Develop strategies for addressing each challenge based on what has
been demonstrated to be successful. Cite your resources.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 6 discussion
Successful
Implementation of Electronic Health Information Technology
Since the inception of the HITECH Act, health organizations
have faced increased pressure to update their health information technology
(HIT) resources. As discussed last week, many believe that the increased use of
electronic health records and the quick and efficient communication afforded by
HIT can lead to improved quality of patient care. Yet there are significant
costs associated with implementing such systems. What can organizations do to
ensure that the correct system is selected and that the system will be
appropriate for those required to use it? Who should be involved in those
decisions?
This week introduces the systems development life cycle and
discusses how it can guide an organization through the complexities of adopting
a new HIT system. In this Discussion, you are asked to consider the role of
nurses in the SDLC process.
To prepare:
Review the steps of the systems development life cycle.
Think about your own organization, or one with which you are
familiar, and the steps the organization goes through when purchasing and
implementing a new HIT system.
Consider what a nurse could contribute to decisions made at
each stage when planning for new health information technology. What might be
the consequences of not involving nurses?
Reflect on your own experiences with your organization
selecting and implementing new technology. As an end user, do you feel you had
any input in the selection or and planning of the new HIT system?
By Day 3
Post an analysis of
the ramifications of an organization not involving nurses in each stage of the
systems development life cycle when purchasing and implementing a new HIT
system. Give specific examples of potential issues at each stage and how the
inclusion of nurses could help avoid such issues.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 7 discussion
Understanding
Workflow Design
As you explored last week, the implementation of a new
technology can dramatically affect the workflow of an organization. Newly
implemented technologies can initially limit the productivity of users as they
adjust to their new tools. Such implementations tend to be so significant that
they often require workflows to be redesigned in order to achieve improvements
in safety and patient outcomes. However, before workflows can be redesigned,
they must first be analyzed. This analysis includes each step in completing a
certain process. Some systems duplicate efforts or contain unnecessary steps
that waste time and money and could even jeopardize patient health care. By
reviewing and modifying the workflow, you enable greater productivity. This
drive to implement new technologies has elevated the demand for nurses who can
perform workflow analysis.
In this Discussion you explore resources that have been
designed to help guide you through the process of workflow assessment.
To prepare:
Take a few minutes and peruse the information found in the
article “Workflow Assessment for Health IT Toolkit” listed in this week’s
Learning Resources.
As you check out the information located on the different
tabs, identify key concepts that you could use to improve a workflow in your
own organization and consider how you could use them.
Go the Research tab and identify and read one article that
is of interest to you and relates to your specialty area.
By Day 3
Post a summary of three different concepts you found in
“Workflow Assessment for Health IT Toolkit” that would help in redesigning a
workflow in the organization in which you work (or one with which you are
familiar) and describe how you would apply them. Next, summarize the article
you selected and assess how you could use the information to improve workflow
within your organization. Finally, evaluate the importance of monitoring the
effect of technology on workflow.
Read a selection of your colleagues’ responses. Focus
particularly on questions raised for which you can add comments based on your
experiences or situations. Consider how your colleagues’ postings reflect
and/or differ from your own perceptions and opinions. Review the Learning
Resources for any clarification needed before responding.
By Day 6
Respond to at least two of your colleagues on two different days
using one or more of the following approaches
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 8 discussion
Using Health
Information Technology as a Source of Evidence-Based Practice
Before the digital revolution, health information technology
supplied very limited support for evidence-based practice. If nurses wanted to
be informed about cutting-edge research, their best bet was to either subscribe
to leading journals or make periodic trips to the library. With the
establishment of research databases, however, nurses became empowered to learn
about and facilitate interdisciplinary and translational research. Databases
are just one example of how health information technology supports
evidence-based practice.
To prepare:
Read the following scenario from the text (McGonigle &
Mastrian, 2011, p. 482):
Twelve-hour shifts are problematic for patient and nurse
safety, and yet hospitals continue to keep the 12-hour shift schedule. In 2004,
the Institute of Medicine (Board on Health Care Services & Institute of
Medicine, 2004) published a report that referred to studies as early as 1988
that discussed the negative effects of rotating shifts on intervention accuracy.
Workers with 12-hour shifts realized more fatigue than workers on 8-hour
shifts. In another study done in Turkey by Ilhan, Durukan, Aras, Turkcuoglu,
and Aygun (2006), factors relating to increased risk for injury were age of 24
or less, less than 4 years of nursing experience, working in the surgical
intensive care units, and working for more than 8 hours.
Consider how the resources identified in the scenario above
could influence an organization’s practice.
Select an issue in your practice that is of concern to you.
Using health information technology, locate at least three evidence-based
practice resources that address your concern and that could possibly inform
further action.
By Day 3
Post a description of your practice concern. Outline how you
used health information technology to locate evidence-based practices that
address this concern. Cite and include insights from the resources. Analyze how
health information technology supports evidence-based practice.
Read a selection of your colleagues’ responses. Focus
particularly on those questions raised to which you can add comments based on
shared experiences or situations. Consider how your colleagues’ postings
reflect and/or differ from your own perceptions and opinions. Review the
Learning Resources for any clarification needed before responding.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 9 discussion
HITECH Legislation
In order for organizations to receive the incentives offered
through the HITECH legislation, they must be able to demonstrate that they are
using the technology in meaningful ways. The following criteria for meaningful
use must be evident to qualify for EHR incentives (U.S. Department of Health
& Human Services, 2012). The technology must:
Improve quality, safety, and efficiency, and reduce health
disparities
Engage patients and families
Improve care coordination
Improve population and public health
Ensure adequate privacy and security protections for
personal health information
For this Discussion you consider the impact of the
meaningful use criteria of the HITECH legislation on the adoption of health
information technology.
To prepare:
Review the Learning Resources on the HITECH legislation and
its primary goals.
Reflect on the positive and negative impact this legislation
has had on your organization or one with which you are familiar.
Consider the incentives to encourage the use of EHRs. Focus
on the definition of meaningful use and how it is measured.
Reflect on how the incentives and meaningful use impact the
quality of patient care.
Find an article in the Walden Library dealing with one of
the criteria to qualify for meaningful use and how it has been successfully
met.
By Day 3
Post a description of how HITECH legislation has positively
or negatively impacted your organization. Address how its related incentives
influence the adoption of health information technology in health care and
impact the quality of patient care. Provide a summary of the article you
identified and explain how it demonstrates the ability of health information
technology to meet the requirements of meaningful use.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional background
information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 10 discussion
Security of Health
Care Records
With the increase of health information technology used to
store and access patient information, the likelihood of security breaches has
also risen. In fact, according to the Canadian Medical Association Journal
(CMAJ):
In the United States, there was a whopping 97% increase in
the number of health records breached from 2010 to 2011… The number of patient
records accessed in each breach has also increased substantially, from 26,968
(in 2010) to 49,394 (in 2011). Since August 2009, when the US government
regulated that any breach affecting more than 500 patients be publicly
disclosed, a total of 385 breaches, involving more than 19 million records,
have been reported to the Department of Health and Human Services.
A large portion of those breaches, 39%, occurred because of
a lost, stolen, or otherwise compromised portable electronic device—a problem
that will likely only get worse as iPads, smartphones, and other gadgets become
more common in hospitals. (CMAJ, 2012, p. E215).
Consider your own experiences. Does your organization use
portable electronic devices? What safeguards are in place to ensure the
security of data and patient information? For this Discussion you consider
ethical and security issues surrounding the protection of digital health
information.
To prepare:
Review the Learning Resources dealing with the security of
digital health care information. Reflect on your own organization or one with
which you are familiar, and think about how health information stored
electronically is protected.
Consider the nurse’s responsibility to ensure the protection
of patient information. What strategies can you use?
Reflect on ethical issues that are likely to arise with the
increased access to newer, smaller, and more powerful technology tools.
Consider strategies that can be implemented to ensure that
the use of HIT contributes to an overall culture of safety.
By Day 3
Post an analysis of the nurse’s responsibility to protect
patient information and the extent that HIT has made it easier or more
difficult to protect patient privacy. Comment on any security or ethical issues
related to the use of portable devices to store information. Assess the
strategies your organization uses to safeguard patient information and how
these promote a culture of safety. Describe an area where improvement is needed
and one strategy that could address the situation.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 11 discussion
Health Literacy
In order to effectively manage their own health, individuals
need to have competencies in two areas—basic literacy and basic health
literacy. What is the difference? Basic literacy refers to the ability to read,
even simple language. Health literacy is defined as, “the degree to which
individuals have the capacity to obtain, process, and understand basic health
information and services needed to make appropriate health decisions” (National
Coalition for Literacy, 2009). Unfortunately, according to a Department of
Education report on health literacy, only 12% of adults aged 16 and older are
considered to have a proficient level of health literacy (U.S. Department of
Education, 2006). Acquiring health literacy skills has become more complicated
with the explosion of online health information, some credible and some
misleading.
In this Discussion, you focus on how to help individuals
find credible information on the Internet and develop strategies nurses can use
to increase the health literacy of their patients.
To prepare:
Think about the nurse’s role in improving the health
literacy of patients.
Consider the many ways patients access health information,
including blogs, social media, patient portals, websites, etc.
Reflect on experiences you have had with patients who
self-diagnose using online medical sources.
Using the Internet, the Walden Library, or other trustworthy
sources, identify a resource that you could introduce to patients to help them
evaluate the credibility of health information found online.
What are some strategies you could employ to improve the
health literacy of patients?
By Day 3
Post your assessment of the nurse’s role in improving the
health literacy of patients. Then, identify the resource you would recommend to
patients for evaluating online health information and why it would be
beneficial. Describe additional strategies for assisting patients in becoming
informed consumers of online health information.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 1
discussion
Discussion: Pharmacokinetics and Pharmacodynamics
As an advanced practice nurse assisting physicians in the
diagnosis and treatment of disorders, it is important to not only understand
the impact of disorders on the body, but also the impact of drug treatments on
the body. The relationships between drugs and the body can be described by
pharmacokinetics and pharmacodynamics. Pharmacokinetics describes what the body
does to the drug through absorption, distribution, metabolism, and excretion,
whereas pharmacodynamics describes what the drug does to the body. When
selecting drugs and determining dosages for patients, it is essential to
consider individual patient factors that might impact the patient’s
pharmacokinetic and pharamcodynamic 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.
In this Discussion, you reflect on a case from your past clinical experiences
and consider how a particular patient’s pharmacokinetic and pharmacodynamic
processes altered his or her response to a drug.
To prepare:
Review this week’s media presentation with Dr. Terry
Buttaro, as well as Chapter 2 of the Arcangelo and Peterson text, and the Scott
article in the Learning Resources. Consider the principles of pharmacokinetics
and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical
practices from the last five years. Select a case from the last five years that
involves a patient whose individual differences in pharmacokinetic and
pharmacodynamic factors altered his or her anticipated response to a drug. When
referring to your patient, make sure to use a pseudonym or other false form of
identification. This is to ensure the privacy and protection of the patient.
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.
With these thoughts in mind:
By Day 3
Post a description of the case you selected. Then, describe
factors that might have influenced pharmacokinetic and pharmacodynamic
processes of the patient from the case you selected. Finally, explain details
of the personalized plan of care that you would develop based on influencing
factors and patient history in your case.
By Day 6
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 pharmadynamic processes of the patients in their case studies. In addition,
suggest how the personal care plan might change if the age of the patient were
different and if the patient had a comorbid condition such as renal failure,
heart failure, or liver failure.
Week 2
discussion
Discussion: Ethical and Legal Implications of Prescribing
Drugs
What type of drug should you prescribe based on your
patient’s diagnosis? How much of the drug should the patient receive? How often
should the drug be administered? When should the drug not be prescribed? Are
there individual patient factors that could create complications when taking
the drug? Should you be prescribing drugs to this patient?
These are some of the questions you might consider when
selecting a treatment plan for a patient. As an advanced practice nurse
prescribing drugs, you are held accountable for people’s lives on a daily
basis. 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. In this Discussion, you explore
ethical and legal implications of scenarios and consider how to appropriately
respond.
Scenario 1:
As a nurse practitioner, you prescribe medications for your
patients. You make an error when prescribing medication to a 5-year-old
patient. Rather than dosing him appropriately, you prescribe a dose suitable
for an adult.
Scenario 2:
A friend calls and asks you to prescribe a medication for
her. You have this autonomy, but you don’t have your friend’s medical history.
You write the prescription anyway.
Scenario 3:
You see another nurse practitioner writing a prescription
for her husband who is not a patient of the nurse practitioner. The
prescription is for a narcotic. You can’t decide whether or not to report the
incident.
Scenario 4:
During your lunch break at the hospital, you read a journal
article on pharmacoeconomics. You think of a couple of patients who have
recently mentioned their financial difficulties. You wonder if some of the
expensive drugs you have prescribed are sufficiently managing the patients’
health conditions and improving their quality of life.
To prepare:
Review Chapter 1 of the Arcangelo and Peterson text, as well
as articles from the American Nurses Association, Anderson and Townsend, the
Drug Enforcement Administration, and Philipsend and Soeken.
Select one of the four scenarios listed above.
Consider the ethical and legal implications of the scenario
for all stakeholders involved such as the prescriber, pharmacist, patient, and
the 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.
With these thoughts in mind:
By Day 3
Post an explanation of the ethical and legal implications of
the scenario you selected on all stakeholders involved such as the prescriber,
pharmacist, patient, and the patient’s family. Describe two strategies that
you, as an advanced practice nurse, would use to guide your decision making in
this scenario.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different scenario than you did, in one or more of the following ways:
Suggest additional ethical and legal implications for all
stakeholders in your colleagues’ scenarios.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Week 3
discussion
Discussion: Pharmacotherapy for Cardiovascular Disorders
As the leading cause of death in the United States for both
men and women, cardiovascular disorders account for 7 million hospitalizations
per year (NCSL, 2012). This is the result of the extensive treatment and care
that is often required for patients with these disorders. While the incidences
of hospitalizations and death are still high, the mortality rate of
cardiovascular disorders has been declining since the 1960s (CDC, 2011).
Improved treatment options have contributed to this decline, as well as more
knowledge on patient risk factors. 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.
Consider the following case studies:
Case Study 1:
Patient AO has a history of obesity and has recently gained
9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia.
Drugs currently prescribed include the following:
Atenolol 12.5 mg daily
Doxazosin 8 mg daily
Hydralazine 10 mg qid
Sertraline 25 mg daily
Simvastatin 80 mg daily
Case Study 2:
Patient HM has a history of atrial fibrillation and a
transient ischemic attack (TIA). The patient has been diagnosed with type 2
diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs
currently prescribed include the following:
Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun
Aspirin 81 mg daily
Metformin 1000 mg po bid
Glyburide 10 mg bid
Atenolol 100 mg po daily
Motrin 200 mg 1–3 tablets every 6 hours as needed for pain
Case Study 3:
Patient CB has a history of strokes. The patient has been
diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs
currently prescribed include the following:
Glipizide 10 mg po daily
HCTZ 25 mg daily
Atenolol 25 mg po daily
Hydralazine 25 mg qid
Simvastatin 80 mg daily
Verapamil 180 mg CD daily
To prepare:
Review this week’s media presentation on hypertension and
hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson
text.
Select one of the three case studies, as well as 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.
With these thoughts in mind:
By Day 3
Post an explanation of how the factor you selected might
influence the pharmacokinetic and pharmacodynamic processes in the patient from
the case study you selected. Then, describe how changes in the processes might
impact the patient’s recommended drug therapy. Finally, explain how you might
improve the patient’s drug therapy plan.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different case study than you did, in one or more of the following ways:
Provide alternative recommendations for drug treatments.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Week 4
discussion
Discussion: Pharmacotherapy for Respiratory Disorders
To the untrained ear, most coughs sound the same. However,
as you might recall from past clinical experiences, a simple cough can lead to
a patient diagnosis of a common cold, pneumonia, or even a chronic obstructive
pulmonary disease (COPD). Although it can sometimes be challenging to diagnose
a patient based on common respiratory symptoms such as congestion, coughing,
and wheezing, it is important to be able to distinguish minor differences as
even mild symptoms might require intervention with drug treatments. When
recommending potential treatment options, advanced practice nurses must
consider how individual patient factors might impact the effects of prescribed
drugs.
To prepare:
Review Chapter 26 and Chapter 27 of the Arcangelo and
Peterson text.
Select and research one of the following respiratory
disorders: the common cold, pneumonia, or a chronic obstructive pulmonary
disease (COPD) such as emphysema or chronic bronchitis. Consider types of drugs
that would be prescribed to patients to treat symptoms associated with this
disorder.
Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how this factor might impact effects of
prescribed drugs, as well as any measures you might take to help reduce
negative side effects.
With these thoughts in mind:
By Day 3
Post a description of the respiratory disorder you selected
including types of drugs that would be prescribed to patients to treat
associated symptoms. Then, explain how the factor you selected might impact
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different respiratory disorder than you did. If the disorder you selected is
primarily associated with the upper respiratory system, respond to colleagues
who selected disorders primarily associated with the lower respiratory system.
Provide alternative recommendations for drug treatments.
Week 5
discussion
Discussion: Pharmacotherapy for Cardiovascular Disorders
Neurological disorders, such as headaches, seizure
disorders, sleep disorders, depression, and dementia can present several
complications for patients of all ages. These disorders affect patients
physically and emotionally, impacting judgment, school and/or job performance,
and relationships with family and friends. Since these disorders may have
drastic effects on patients’ lives, it is important for advanced practice
nurses to effectively manage patient care. With patient factors and medical
history in mind, it is the advanced practice nurse’s responsibility to manage
the diagnosis, treatment, and education of patients with neurological
disorders.
To prepare:
Review this week’s media presentation on pharmacology for
the nervous system.
Select one of the following neurological disorders:
headaches, seizure disorders, sleep disorders, depression, or dementia.
Consider the types of drugs that would be prescribed to patients to treat
symptoms associated with this disorder.
Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how this factor might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.
With these thoughts in mind:
By Day 3
Post a description of the neurological disorder you selected
including types of drugs that would be prescribed to patients to treat
associated symptoms. Then, explain how the factor you selected might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different neurological disorder than you did. Provide recommendations for
alternative drug treatments and patient education strategies for treatment and
management.
Week 6
discussion
Discussion: Pharmacotherapy for Endocrine and Musculoskeletal
Disorders
Patients with endocrine and musculoskeletal disorders often
require long-term treatment and care resulting in the need for extensive
patient education. By appropriately educating patients, advanced practice
nurses can assist patients with the management of their disorders. In clinical
settings, patients with endocrine and musculoskeletal disorders typically seek
treatment for symptoms that pose problems to their everyday lives as ordinary
tasks may become difficult to complete. For instance, patients might have
difficulty walking short distances, preparing meals, or even running errands.
To reduce these symptoms and additional health risks, it is essential to
develop drug therapy plans with individual patient factors in mind.
To prepare:
Select one of the following endocrine or musculoskeletal
disorders: thyroid disease, osteoarthritis, rheumatic arthritis, gout, multiple
sclerosis, or fibromyalgia. Consider the types of drugs that would be
prescribed to patients to treat symptoms associated with this disorder.
Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how this factor might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.
With these thoughts in mind:
By Day 3
Post a description of the endocrine or musculoskeletal
disorder you selected including types of drugs that would be prescribed to
patients to treat associated symptoms. Then, explain how the factor you
selected might impact the effects of prescribed drugs, as well as any measures
you might take to help reduce negative side effects.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different endocrine or musculoskeletal disorder than you did. Provide
recommendations for alternative drug treatments and patient education
strategies for treatment and management.
Week 7
discussion
Discussion: Pharmacotherapy for Gastrointestinal and
Hepatobiliary Disorders
Gastrointestinal (GI) and hepatobiliary disorders affect the
structure and function of the GI tract. Many of these disorders often have
similar symptoms such as abdominal pain, cramping, constipation, nausea,
bloating, and fatigue. Since multiple disorders can be tied to the same
symptoms, it is important for advanced practice nurses to carefully evaluate
patients and prescribe treatment that targets the cause rather than the
symptom. Once the underlying cause is identified, an appropriate drug therapy
plan can be recommended based on medical history and individual patient
factors. In this Discussion, you examine a case study of a patient who presents
with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate
drug therapy plan.
Consider the following case study:
Patient HL comes into the clinic with the following
symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug
abuse and possible Hepatitis C. HL is currently taking the following
prescription drugs:
Synthroid 100 mcg daily
Nifedipine 30 mg daily
Prednisone 10 mg daily
To prepare:
Review this week’s media presentation on pharmacology for
the gastrointestinal system.
Review the provided case study. Reflect on the patient’s
symptoms, medical history, and drugs currently prescribed.
Think about a possible diagnosis for the patient. Consider
whether the patient has a disorder related to the gastrointestinal and
hepatobiliary system or whether the symptoms are the result of a disorder from
another system or other factors such as pregnancy, drugs, or a psychological
disorder.
Consider an appropriate drug therapy plan based on the
patient’s history, diagnosis, and drugs currently prescribed.
With these thoughts in mind:
By Day 3
Post an explanation of your diagnosis for the patient
including your rationale for the diagnosis. Then, describe an appropriate drug
therapy plan based on the patient’s history, diagnosis, and drugs currently
prescribed.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who diagnosed the
patient differently than you did, in one or more of the following ways:
Provide alternative recommendations for drug treatments.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Week 8
discussion
Discussion: Drug Treatments for HIV/AIDS
While HIV/AIDS is still currently incurable, the prognosis
for patients with this infectious disease has improved due to advancements in
drug treatments. Consider the case of Kristy Aney. Kristy was diagnosed with
HIV in 1992 and was told she would survive, at most, 10 more years. Despite
unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis,
she has witnessed tremendous improvements in HIV/AIDS treatments which have
helped patients live longer with fewer side effects. While she acknowledges
that these drug treatments have kept her alive, she fears that improvements in
drug therapy have led to more people becoming complacent about the disease
(Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in
the United States is higher than it has ever been (CDC, 2012). This poses the
question: Is there a relationship between drug advancements, societal
complacency, and infection?
To prepare:
Review Chapter 49 of the Arcangelo and Peterson text, as
well as the Krummenacher et al. and Scourfield articles in the Learning
Resources.
Reflect on whether or not the prevalence of HIV cases might
be attributed to increased complacency due to more advanced drug treatment
options for HIV/AIDS.
Consider how health care professionals can help to change
perceptions and make people more aware of the realities of the disease.
Think about strategies to educate HIV positive patients on
medication adherence, as well as safe practices to reduce the risk of infecting
others.
With these thoughts in mind:
By Day 3
Post an explanation of whether or not you think the
prevalence of HIV cases might be attributed to increased complacency due to
more advanced drug treatment options.Then, explain how health care
professionals can help to change perceptions and increase awareness of the
realities of the disease. Finally, describe strategies to educate HIV positive
patients on medication adherence, as well as safe practices to reduce the risk
of infecting others.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who provided a
different rationale than you did, in one or more of the following ways:
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Week 9
discussion
Discussion: Pharmacotherapy for Hematologic Disorders
In the 1970s, the average lifespan for patients diagnosed
with sickle cell disease was 14 years. Today, the average lifespan has
increased to 50 years and beyond (TriHealth, 2012). The patient prognosis for
many other hematologic disorders such as hemophilia and cancer continue to
improve as well. This can be attributed to advancements in medical care—specifically
drug therapy and treatment. When managing drug therapies for patients, it is
essential to continuously examine current treatments and evaluate the impact of
patient factors on drug effectiveness. To prepare for your role as an advanced
practice nurse, you must become familiar with common drug treatments for
various hematologic disorders seen in clinical settings.
To prepare:
Select one of the following hematologic disorders: anemia,
hemophilia, cancer, sickle cell anemia, thalassemia, thrombolytic disorders, or
white blood cell disorders. Consider the types of drugs that would be
prescribed to patients to treat symptoms associated with this disorder.
Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how this factor might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.
With these thoughts in mind:
By Day 3
Post a description of the hematologic disorder you selected
including types of drugs that would be prescribed to patients to treat
associated symptoms. Then, explain how the factor you selected might impact the
effects of prescribed drugs, as well as any measures you might take to help
reduce negative side effects.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different hematologic disorder than you did. Provide recommendations for
alternative drug treatments and patient education strategies for treatment and
management.
Week 10
discussion
Discussion: Hormone Replacement Therapy
In recent years, hormone replacement therapy has become a
controversial issue. When prescribing therapies, advanced practice nurses must
weigh the strengths and limitations of the prescribed supplemental hormones. If
advanced practice nurses determine that the limitations outweigh the strengths,
then they might suggest alternative treatment options such as herbs or other
natural remedies, changes in diet, and increase in exercise.
Consider the following scenario:
As an advanced practice nurse at a community health clinic,
you often treat female (and sometimes male patients) with hormone deficiencies.
One of your patients requests that you prescribe supplemental hormones. This
poses the questions: How will you determine what kind of treatment to suggest?
What patient factors should you consider? Are supplemental hormones the best
option for the patient, or would they benefit from alternative treatments?
To prepare:
Review Chapter 56 of the Arcangelo and Peterson text, as
well as the Holloway and Makinen and Huhtaniemi articles in the Learning
Resources.
Review the provided scenario and reflect on whether or not
you would support hormone replacement therapy.
Locate and review additional articles about research on
hormone replacement therapy for women and/or men. Consider the strengths and
limitations of hormone replacement therapy.
Based on your research of the strengths and limitations,
again reflect on whether or not you would support hormone replacement therapy.
Consider whether you would prescribe supplemental hormones
or recommend alternative treatments to patients with hormone deficiencies.
With these thoughts in mind:
By Day 3
Post a description of the strengths and limitations of
hormone replacement therapy. Based on these strengths and limitations, explain
why you would or why you would not support hormone replacement therapy. Explain
whether you would prescribe supplemental hormones or recommend alternative
treatments to patients with hormone deficiencies and why.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who provided a
different rationale than you did, in one or more of the following ways:
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Week 11
discussion
Discussion: Off-Label Drug Use in Pediatrics
The unapproved use of approved drugs, also called off-label
use, with children is quite common. This is because pediatric dosage guidelines
are typically unavailable since very few drugs have been specifically
researched and tested with children.
When treating children, prescribers often adjust dosages
approved for adults to accommodate a child’s weight. However, children are not
just “smaller” adults. Adults and children process and respond to drugs
differently in their absorption, distribution, metabolism, and excretion.
Children even respond differently during stages from infancy to adolescence.
This poses potential safety concerns when prescribing drugs to pediatric
patients. As an advanced practice nurse, you have to be aware of safety
implications of the off-label use of drugs with this patient group.
To prepare:
Review the Bazzano et al. and Mayhew articles in the
Learning Resources. Reflect on situations in which children should be
prescribed drugs for off-label use.
Think about strategies to make the off-label use and dosage
of drugs safer for children from infancy to adolescence. Consider specific
off-label drugs that you think require extra care and attention when used in
pediatrics.
With these thoughts in mind:
By Day 3
Post an explanation of circumstances under which children
should be prescribed drugs for off-label use. Then, describe strategies to make
the off-label use and dosage of drugs safer for children from infancy to
adolescence. Include descriptions and names of off-label drugs that require
extra care and attention when used in pediatrics.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who provided a
different rationale than you did, in one or more of the following ways:
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.