NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

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NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

Pharmacotherapy for Cardiovascular Disorders

Pharmacokinetics refers to the processes that the body subjects a drug to once it is introduced to the body. These processes include absorption, distribution, metabolism, and excretion. Pharmacodynamics, on the other hand, refers to the effects that drugs cause to the body, like the side effects of the drug. Both pharmacokinetics and pharmacodynamics are affected by factors such as the medical history of a patient, other medication that the patient is using, and patient characteristics, such as age and sex. From the given case study, pharmacokinetics and pharmacodynamics in Patient CB are affected by the medical history of the patient and the current drugs being taken NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders.

Treatment for patients with cardiovascular disease is always a challenge due to many comorbidities involved. These require different drugs, which have different reactions and side effects. Moreover, these reactions are not usually uniform among all patients. Consequently, it is necessary to continually monitor the patient to avoid adverse drug reactions (Mangoni & Jarmuzewska, 2019). Patient CB has a history of stroke and is currently suffering from type 2 diabetes mellitus, hypertension, and hyperlipidemia. All these conditions play a significant role in pharmacokinetics and pharmacodynamics. Diabetes, for example, increases mycobacterial burden among some patients, which affects treatment (Alfarisi et al., 2018). Additionally, patients with diabetes mellitus have difficulties in excreting toxins from the kidney, which puts them at a heightened risk of developing diabetic nephropathy that can potentially complicate their treatment further. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

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The patient, however, is under a Glipizide 10 mg dosage, which helps to prevent kidney damage. Since patient CB is taking multiple medications and is suffering from diabetes, it is easy for toxins to accumulate in the body. Hypertension is another significant condition that affects pharmacokinetics and pharmacodynamics. Since patient CB is suffering from the condition, it is necessary to consider its effects and the significance of pharmacotherapy interventions (Oparil & Schmieder, 2015). For example, the patient is under Verapamil 180 mg CD daily dosage, which helps to lower blood pressure and prevent stroke (Mancia et al., 2014) NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders. The drug, however, has adverse effects on the body of the patient. It slows down the heartbeat rate and may cause severe liver damage and other mild effects, including headaches, nausea, and vomiting. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

In treating the patient, it is necessary to consider the aforementioned side effects of the drugs. The patient is also under a Hydralazine 25 mg dosage, which is used in the treatment of high blood pressure. This drug’s pharmacodynamics is counter to that of Verapamil 180 mg. This is because it increases the heartbeat of the patient, while Verapamil 180 mg lowers the pulse (Flynn, Bradford, & Harvey, 2016). Such counter-reactions may be fatal to the patient and, therefore, using such drugs concurrently is ill-advised. Hyperlipidemia is another condition that is affecting patient CB, and which plays a critical role in pharmacokinetics and pharmacodynamics. Hyperlipidemia means that the level of lipids (such as triglycerides and cholesterol) in the patient’s blood is very high. These lipids are deposited along blood vessels, restricting the flow of blood in the body. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

The high levels of lipid in the blood predispose the patient to stroke or myocardial infarction, commonly known as a heart attack (Navar-Boggan et al., 2015). The patient is under a Simvastatin 80 mg dosage to control the condition. However, this drug has negative effects on patients with diabetes. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders. Therefore, administering Simvastatin 80 mg puts patient CB at risk because he is also suffering from type 2 diabetes mellitus. When prescribing drugs to patients with cardiovascular disease, the physician must pay close attention to all the variables involved to avoid adverse drug reactions. For Patient CB, his conditions complicate pharmacokinetic and pharmacodynamics due to comorbidities NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

References

Alfarisi, O., Mave, V., Gaikwad, S., Sahasrabudhe, T., Ramachandran, G., Kumar, H., … & Raskar, S. (2018). Effect of diabetes mellitus on the pharmacokinetics and pharmacodynamics of tuberculosis treatment. Antimicrobial Agents and Chemotherapy, 62(11), 1-14.

Flynn, J. T., Bradford, M. C., & Harvey, E. M. (2016). Intravenous hydralazine in hospitalized children and adolescents with hypertension. The Journal of Pediatrics, 168, 88-92. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., … & Galderisi, M. (2014). 2013 ESH/ESC Practice guidelines for the management of arterial hypertension: ESH-ESC: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Blood Pressure, 23(1), 3-16.

Mangoni, A. A., & Jarmuzewska, E. A. (2019). The influence of heart failure on the pharmacokinetics of cardiovascular and non‐cardiovascular drugs: A critical appraisal of the evidence. British Journal of Clinical Pharmacology, 85(1), 20-36.

Navar-Boggan, A. M., Peterson, E. D., D’Agostino Sr, R. B., Neely, B., Sniderman, A. D., & Pencina, M. J. (2015). Hyperlipidemia in early adulthood increases long-term risk of coronary heart disease. Circulation, 131(5), 451-458.

Oparil, S., & Schmieder, R. E. (2015). New approaches in the treatment of hypertension. Circulation Research, 116(6), 1074-1095.

Assignment: Pharmacotherapy for Cardiovascular Disorders

…heart disease remains the No. 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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders.

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 NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School 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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

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. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

NURS_6521_Week2_Assignment_Rubric

Excellent Good Fair Poor
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Points Range: 23 (23%) – 25 (25%)
The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
Points Range: 20 (20%) – 22 (22%)
The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
Points Range: 18 (18%) – 19 (19%)
The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
Points Range: 0 (0%) – 17 (17%)
The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Points Range: 27 (27%) – 30 (30%)

The response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy.

Accurate, complete, and aligned examples are provided to support the response.
Points Range: 24 (24%) – 26 (26%)

The response accurately describes how changes in the processes might impact the patient’s recommended drug therapy.

Accurate examples may be provided to support the response.
Points Range: 21 (21%) – 23 (23%)

The response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy.

Inaccurate or vague examples are provided to support the response.
Points Range: 0 (0%) – 20 (20%)

The response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing.

Inaccurate and vague examples may be provided to support the response, or is missing. NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.
Points Range: 27 (27%) – 30 (30%)

The response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.

The response includes an accurate and detailed explanation to support the recommended improvements.
Points Range: 24 (24%) – 26 (26%)

The response accurately explains how to improve the patient’s drug therapy plan.

The response may include an accurate explanation to support the recommended improvements.
Points Range: 21 (21%) – 23 (23%)

The response inaccurately or vaguely explains how to improve the patient’s drug therapy plan.

The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.
Points Range: 0 (0%) – 20 (20%)

The response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing.

The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors.  NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors
Total Points: 100

NURS 6521 week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders

NURS 6521 week 3 Assignment: Asthma and Stepwise Management

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NURS 6521 week 3 Assignment: Asthma and Stepwise Management

  • The Stepwise Management of Asthma
  • Introduction
  • A stepwise approach to asthma management can involve both step-down or step-up therapies.
  • Step-down therapy entails initiating a high-dose treatment and reducing it during successive visits if control has not been adequately accomplished (Falk, Hughes, & Rodgers, 2016). The reverse is true for the step-up approach.

Asthma affects both children and adults and is a major health concern globally. The prevention of symptoms by controlling airway hyperreactivity and inflammation is the principal goal of treatment.

  • Long-term Control and Quick Relief Treatment
  • Long-term control involves taking medication on a daily basis to accomplish and maintain the control of chronic asthma.
  • Common medication used in achieving long-term control include Advair, QVAR, Flovent, Pulmicort, and Singulair (Bonewit-West, Hunt, & Applegate, 2015).
  • Contrarily, quick relief medications afford fast relief for congested or tight airways and associated symptoms of wheezing, chest tightness, and coughing that attend asthma.
  • Medications used for quick relief include Maxiar, Proventil HFA, ventolin HFA, Xopenex, albuterol, and ProAir HFA.

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Long-term medications are broadly categorized as corticosteroids, immunomodulators, leukotriene modifiers, and long-acting beta agonists. Quick relief medicines, on the other hand, relieve the symptoms of asthma immediately they happen.

  • Potential Impacts of Medication on Patients
  • Medications for both long-term control and the quick relief of asthma can have side effects on patients.
  • Inhaled corticosteroids prevent symptoms, but do not relieve an attack when it has begun (Gibson, 2019).
  • Possible side effects of inhaled corticosteroids include oral candidiasis, sore throat and mouth, short-term dysphonia, reduced bone density (adults), cataract, glaucoma, spasms of the trachea (reflex coughs), and slightly reduced growth in children (Walsh, 2019).
  • Beta antagonists (short- and long-acting) can cause increased pulse rate, anxiety, rash, dizziness, and headache. NURS 6521 week 3 Assignment: Asthma and Stepwise Management

Gargling and rinsing after using inhaled corticosteroids can prevent local adverse effects. The side effects of beta antagonists resolve quickly. However, rescue inhaler should not be overused, as doing so increases the risk of a severe attack.

  • The Stepwise Approach – Patients
  • The stepwise approach to the treatment and management of asthma can involve a step-down therapy or step-up therapy (Bernstein& Mansfield, 2019).
  • Step-up therapy involves beginning with low-dose treatment that is increased gradually until optimal control is achieved.
  • Step-won therapy, contrarily, involves starting with a higher dose that is reduced gradually as stability in the control of asthma is achieved.
  • Step-down therapy seems to be more effective and beneficial in the treatment and management of asthma.

 

Doctors often recommend following the step-down approaches for those with confirmed cases of asthma. This is because it makes it possible to reduce the exposure to potentially detrimental impacts of medication, in addition to simplifying the medication regimen of the patient. This encourages better adherence.

  • The Step-Wise Approach-Care Providers
  • The step-wise approach helps both care providers and patients to gain and maintain control of asthma.
  • Health care providers use the approach to complement, not replace, clinical decision-making needed in meeting the needs of individual patients (Craig, 2014).
  • Alternative treatments are often used and, in the event of inadequate response, these are discontinued and the preferred treatment used before stepping up. NURS 6521 week 3 Assignment: Asthma and Stepwise Management
  • The stepwise approach helps both care providers and patients to control and manage effectively.
  • Conclusion
  • Asthma is often an underdiagnosed and undertreated condition.
  • The widespread availability and use of inhaled corticosteroids has reduced adverse events and improved outcomes.
  • The stepwise approach – which includes step-up and step-down therapies – is one of the methods used in achieving the control, management, and treatment of the condition.
  • The approach should be used strictly as an complement, and not as a replacement for care decisions required to meet the needs of individual patients.
  • References
  • Falk, N. P., Hughes, S. W., & Rodgers, B. C. (2016). Medications for chronic asthma. American Family Physician, 94(6), 454-462.
  • Bernstein, J. A., & Mansfield, L. (2019). Step-up and step-down treatments for optimal asthma control in children and adolescents. Journal of Asthma, 56(7), 758-770.
  • Craig, T. J. (2014). Physician implementation of asthma management guidelines and recommendations: 2 case studies. Journal of the American Osteopathic Association, 114(11), eS4-eS15.
  • Bonewit-West, K., Hunt, S., & Applegate, E. (2015). Today’s medical assistant: Clinical & administrative procedures. London, UK: Elsevier Saunders.
  • Gibson, P. (2019). Monitoring asthma. Boca Raton, FL: Taylor & Francis.
  • Walsh, B. K. (2019). Neonatal and pediatric respiratory care. St. Louis, MO: Elsevier.

Assignment: Asthma and Stepwise Management

Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.

 

Photo Credit: Getty Images

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.

NURS_6521_Week3_Assignment_Rubric

Excellent Good Fair Poor
Describe the 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.
Points Range: 27 (27%) – 30 (30%)
The presentation clearly and accurately describes in detail the long-term control and quick relief treatment options for the asthma patient from their practice. 

The presentation clearly and accurately describes in detail the impact these drugs might have on their patient. NURS 6521 week 3 Assignment: Asthma and Stepwise Management
Points Range: 24 (24%) – 26 (26%)
The presentation accurately describes the long-term control and quick relief options for the asthma patient from their practice. 

The presentation accurately describes the impact these drugs might have on their patient.
Points Range: 21 (21%) – 23 (23%)
The presentation inaccurately or vaguely describes the long-term control and quick relief options for the asthma patient from their practice. 

The presentation inaccurately or vaguely describes the impact these drugs might have on their patient.
Points Range: 0 (0%) – 20 (20%)
The presentation inaccurately and vaguely describes the long-term and quick relief options for the asthma patient from their practice, or is missing. 

The presentation inaccurately and vaguely describes the impact these drugs might have on their patient, or is missing.
Explain the stepwise approach to asthma treatment and management for your patient.
Points Range: 27 (27%) – 30 (30%)
The presentation clearly and accurately explains in detail the stepwise approach to asthma treatment and management for their patient.
Points Range: 24 (24%) – 26 (26%)
The presentation accurately explains the stepwise approach to asthma treatment and management for their patient.
Points Range: 21 (21%) – 23 (23%)
The presentation inaccurately or vaguely explains the stepwise approach to asthma treatment and management for their patient.
Points Range: 0 (0%) – 20 (20%)
The presentation inaccurately and vaguely explains the stepwise approach to asthma treatment and management for their patient.
Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.
Points Range: 27 (27%) – 30 (30%)
The presentation clearly and accurately explains in detail how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. 

The presentation provides accurate and detailed examples to support the explanation provided.
Points Range: 24 (24%) – 26 (26%)
The presentation accurately explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. 

The presentation provides accurate examples to support the explanation provided.
Points Range: 21 (21%) – 23 (23%)
The presentation inaccurately or vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. 

The presentation provides inaccurate or vague examples to support the explanation provided.
Points Range: 0 (0%) – 20 (20%)
The presentation inaccurately and vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease, or is missing. 

The presentation provides inaccurate and vague examples to support the explanation provided, or is missing.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Total Points: 100

NURS 6521 week 4 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

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NURS 6521 week 4 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Case Study

Introduction

The symptoms present in patients experiencing gastrointestinal (GI) conditions are often non-specific, and it is important for care providers to conduct an extensive assessment to identify the underlying cause of the presentations. This process is further complicated by the fact that GI manifestations can occur on the background of diseases involving other systems. For example, patients with serious migraines frequently present with vomiting and nausea (Elliot et al., 2018). Hence, assessment of GI symptoms should be thoroughly performed on all system for both an accurate diagnosis and the appropriate therapeutic intervention. The paper will assess a case study involving GI manifestations, establish a diagnosis and rationale, and a treatment plan for the patient.

The case presents a patient with nausea, vomiting, and diarrhea, which are non-specific gastrointestinal symptoms. The patient has a confirmed history of drug abuse and suspected hepatitis C. However, the latter can only be placed as a diagnosis following a polymerase chain reaction (PCR) that identifies HCV RNA in the serum (Altaf et al., 2019; Ferri et al., 2016). Therefore, based on the medication history, the patient is suspected to be experiencing complications from the use of prednisone. NURS 6521 week 4 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

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The side effects of prednisone on the GI tract have been well documented in scholarly literature due to their use in the management of different conditions. For example, patients that have been prescribed this drug have been found to have an elevated production of gastric acid within one month (Resanen, 2016). Furthermore, corticosteroids adversely impact the gastric mucosa, which further increases the risk of gastritis or gastric ulcers. These phenomena can be better understood through the mechanism of action of prednisone. This involves inhibition of phospholipid conversion to arachidonic acid, which stops prostaglandin production and its gastro protective functions (Caplan et al., 2017). This makes the gastric wall susceptible to the physiologically acidic pH of the stomach, leading to the manifestations displayed by the patient.

The general principles applied to minimize the side effects from oral glucocorticoids include a reassessment of their use and necessity for the patient, reducing the duration of use, and providing mucosal protective agents such as bismuth subsalicylate or sulcrafate. These agents help in coating areas of ulcers or erosion and preventing further damage from gastric acid. In the case of this patient bismuth subsalicylate will be selected agent as it also contributes to stimulating the secretion of mucus, prostaglandin, and bicarbonate (O’Malley, 2020). Patient education will also be provided, and include information on diet and different products that should be avoided while taking prednisone. Spicy and fried foods are not recommended, and smoking and alcohol should also be avoided as they irritate the gastric mucosa. The patient has a history of drug abuse, which makes education on abstaining from alcohol important as this can lead to ulcers, and gastric perforation, which is life threatening.

Summary

The paper discusses a patient that reports with non-specific gastrointestinal manifestations, a history of drug abuse, and currently synthroid, nifedipine, and prednisone. The preliminary diagnosis of the patient is gastritis on the background of prednisone use. This is a glucocorticoid, which affects the gastric mucosa through inhibition of prostaglandins. The drug bismuth subsalicylate was prescribed due to its mucosal protective properties. Other recommendations such as patient dietary education were also stated as certain food products can also affect the state of the mucosa and cause the existing manifestations to persist or lead to more life threatening situations.

 

 

 

References

Altaf, S., Tarar, A., & Naeem, N. (2019). Current Status of Therapeutics and Diagnosis of

HCV. BioScientific Review (BSR), 1(2), 01-12.

Caplan, A., Fett, N., Rosenbach, M., Werth, V. P., & Micheletti, R. G. (2017). Prevention and

management of glucocorticoid-induced side effects: a comprehensive review: a review of glucocorticoid pharmacology and bone health. Journal of the American Academy of Dermatology, 76(1), 1-9.

Elliot, S. Y., SS, Y. P., & Venkatesan, T. (2018). Migraine, cyclic vomiting syndrome, and

other gastrointestinal disorders. Current treatment options in gastroenterology, 16(4), 511-527.

Ferri, C., Ramos-Casals, M., Zignego, A. L., Arcaini, L., Roccatello, D., Antonelli, A., … &

Lamprecht, P. (2016). International diagnostic guidelines for patients with HCV-related extrahepatic manifestations. A multidisciplinary expert statement. Autoimmunity reviews, 15(12), 1145-1160.

O’Malley, P. A. (2020). Pink Prescribing: Bismuth Subsalicylate; History, Actions, Risks,

and Future Use. Clinical Nurse Specialist, 34(2), 45-47.

Rasanen, T. O. I. M. I. (2016). Some aspects of the humoral mechanism of gastric

secretion. Gastric Secretion, Mechanism and Control, 255.

Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

 

Photo Credit: Getty Images/iStockphoto

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 a 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 Assignment, 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.

To Prepare
  • Review the case study assigned by your Instructor for this Assignment
  • 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.
By Day 7 of Week 4

Write a 1-page paper that addresses the following:

  • Explain your diagnosis for the patient, including your rationale for the diagnosis.
  • Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
  • Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

Reminder: The School 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. NURS 6521 week 4 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 4 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 “WK4Assgn+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.

NURS_6521_Week4_Assignment_Rubric

Excellent Good Fair Poor
Explain your diagnosis for the patient, including your rationale for the diagnosis.
Points Range: 23 (23%) – 25 (25%)
The response accurately and clearly explains in detail the diagnosis for the patient, including an accurate and thorough rationale for the diagnosis that supports clinical judgment.
Points Range: 20 (20%) – 22 (22%)
The response provides a basic explanation of 1-2 diagnoses for the patient, including an accurate rationale for the diagnosis that may support clinical judgment.
Points Range: 18 (18%) – 19 (19%)
The response inaccurately or vaguely explains the diagnosis for the patient, including an inaccurate or vague rationale for the diagnosis that may or may not support clinical judgment.
Points Range: 0 (0%) – 17 (17%)
The response inaccurately and vaguely explains the diagnosis for the patient, including an inaccurate and vague rationale for the diagnosis that does not support clinical judgment, or is missing.
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Points Range: 27 (27%) – 30 (30%)
The response accurately and completely describes in detail an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Points Range: 24 (24%) – 26 (26%)
The response describes a basic explanation of the appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Points Range: 21 (21%) – 23 (23%)
The response inaccurately or vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Points Range: 0 (0%) – 20 (20%)
The response inaccurately and vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.
Points Range: 27 (27%) – 30 (30%)
The response provides an accurate, clear, and detailed justification for the recommended drug therapy plan for this patient. 

The response includes specific, accurate, and detailed examples that fully support the justification provided.
Points Range: 24 (24%) – 26 (26%)
The response provides a basic justification for the recommended drug therapy plan for this patient. 

The response includes only 1-2 examples that fully support the justification provided.
Points Range: 21 (21%) – 23 (23%)
The response provides an inaccurate or vague justification for the recommended drug therapy plan for this patient. 

The response may include examples, which may inaccurately or vaguely support the justification provided.
Points Range: 0 (0%) – 20 (20%)
The response provides an inaccurate and vague justification for the recommended drug therapy plan for this patient, or is missing. 

The response does not include examples that support the justification provided, or is missing.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. NURS 6521 week 4 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors
Total Points: 100

NURS 6521 week 5 Discussion: Diabetes and Drug Treatments

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NURS 6521 week 5 Discussion: Diabetes and Drug Treatments

Diabetes and Drug Treatments

Diabetes mellitus (DM) is a disorder in the body’s metabolism characterized by altered glucose conversion into energy for cell use, defects in insulin secretion, or increased insulin resistance (Antonioli, Blandizzi, Csoka, Pacher, & Hasko, 2015). DM can occur in children and adults and is diagnosed by measuring glycosylated hemoglobin (HbA1C) levels, fasting plasma blood sugar (FPG) levels, 2-hour plasma blood sugar levels during oral glucose tolerance testing, or random blood sugar level; however HbA1C provides a more accurate and long-term measure of blood sugar control (Huether & McCance, 2017).

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Types of Diabetes

Type 1 diabetes mellitus (T1DM), presents during childhood approximately before age 10, with a classic clinical onset of high blood sugar, excessive thirst, excessive urination, and weight loss resulting from an autoimmune dysfunction activating the CD4, CD8 T cell, and macrophages infiltrating the pancreas leading to chronic inflammation, pancreatic B-cell dysfunction, destruction, and death (Antonioli et al., 2015). Genetic susceptibility increases the risk of close relatives to a T1DM patient as a result of gene polymorphisms, whereas environmental exposure can trigger an immune response to genetically susceptible individuals destroying the insulin-producing B-cells in the pancreas (Levitsky & Misra, 2019). NURS 6521 week 5 Discussion: Diabetes and Drug Treatments

Type 2 diabetes mellitus (T2DM) develops in genetically predisposed individuals as a result of advancing age, inactivity, and obesity resulting in high levels of blood sugar due to the body’s inability to produce insulin, use enough insulin, or use glucose for energy with signs and symptoms of fatigue, weight gain, slow healing wounds, frequent infections, visual changes, and altered sensation (Blair, 2016). Chronic-low grade inflammation, immune system activation, and infiltration in the pancreas results in B-cell dysfunction and progressively increased insulin resistance (Antonioli et al., 2015).

Gestational diabetes mellitus is high blood sugar levels with the onset or first detected during pregnancy; however according to the American Diabetes Association (ADA) (as cited by

Heather & McCance, 2017), women with gestational diabetes may have had undiagnosed pre-existing diabetes, so the ADA recommends that these women should receive a T1DM or T2DM diagnosis instead of gestational diabetes.

Metformin Administration in Type 2 Diabetes

Biguanides such as Metformin is the first line of therapy for T2DM unless contraindicated because it inhibits the liver’s glucose production and increases muscle tissue insulin sensitivity (Blair, 2016). Metformin comes in two oral preparations: a) initial adult dose for the immediate-release tablet is 500 mg orally once or twice daily or 850 mg daily; should be administered with a meal to decrease gastrointestinal (GI) upset; and gradual dosage increases usually every seven days to minimize adverse GI effects; and b) initial adult dose for the extended-release Metformin is 500 mg to 1 gram once daily with the evening meal and gradual dose titration to minimize adverse GI effects (UpToDate, n.d.). Contraindications to Metformin use are hypersensitivity to Metformin or any of its components, patients with eGFR < 30 mL/minute as it can result in lactic acidosis, acute, or chronic metabolic acidosis, and death (UpToDate, n.d.).

Short-Term and Long-Term Impact of Type 2 Diabetes and Effects of Drug Treatment

Short-term impact of T2DM are : a) hypoglycemia in individuals taking secretagogues such as sulfonylurea agents or exogenous insulin that requires immediate glucose replacement by mouth or intravenously; b) hyperosmolar hyperglycemic nonketotic syndrome (HHNKS), is less common but can result in high mortality rate particularly in the elderly who have comorbidities such as infections, cardiovascular, or renal disease which is characterized by very high blood sugar level resulting in severe dehydration, electrolyte imbalance, and neurologic impairment (Huether & McCance, 2017). NURS 6521 week 5 Discussion: Diabetes and Drug Treatments

The long-term impact of T2DM are categorized into: a) microvascular complications which are damages to small blood vessels leading to renal failure, retinopathy leading to blindness, and neuropathy leading to impotence and foot disorders; and b) macrovascular complications are damage to larger blood vessels leading to cardiovascular diseases (Blair, 2016).

Monitoring recommendation for Metformin use are : a) Vitamin B12 levels every two to three years especially in individuals with peripheral neuropathy or anemia because long-term Metformin use can result in Vitamin B12 deficiency; b) initial and yearly hematologic and renal function studies; and c) Bi-annual urine glucose, fasting blood sugar, and hemoglobin A1C in patients with stable glucose control and every four months for individuals not meeting glycemic control (UpToDate, n.d.).

References

Antonioli, L., Blandizzi, C., Csoka, B., Pacher, P., & Hasko, G. (2015). Adenosine signaling in diabetes mellitus—Pathophysiology and therapeutic considerations. Nature Reviews Endocrinology, 11(4), 228-. Gale OneFile: Science.

Blair, M. (2016). Diabetes mellitus review. Urologic Nursing, 1, 27. https://doi.org/10.7257/1053-816X.2016.36.1.27

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby

Levitsky, L.L., & Misra, M. (2019, June 27). Epidemiology, presentation, and diagnosis of type 1 diabetes mellitus in children and adolescents. In A.G. Hoppin (Ed.), UpToDate. Retrieved March 25, 2020, from https://www.uptodate.com/

Metformin: Drug information—UpToDate. (n.d.). Retrieved March 25, 2020, from https://www.uptodate.com/

 

Discussion: Diabetes and Drug Treatments

Photo Credit: [Mark Hatfield]/[iStock / Getty Images Plus]/Getty Images

Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations.

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. NURS 6521 week 5 Discussion: Diabetes and Drug Treatments
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
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!

NURS_6521_Week5_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
Points Range: 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources. NURS 6521 week 5 Discussion: Diabetes and Drug Treatments

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Points Range: 0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3
First Response
Points Range: 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

Points Range: 15 (15%) – 16 (16%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

Points Range: 13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Points Range: 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response
Points Range: 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

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Points Range: 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English. NURS 6521 week 5 Discussion: Diabetes and Drug Treatments

Points Range: 12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed. .

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Points Range: 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days
Total Points: 100
Type 1 Diabetes

Type 1 diabetes generally develops during childhood or adolescence, however type 1 can develop during adulthood (Rosenthal & Burchum, 2018). Previously called insulin dependent or juvenile diabetes, type 1 diabetes is caused by an autoimmune reaction that destroys pancreatic beta cells, which are the cells responsible for insulin synthesis and release into bloodstream.

Type 2 Diabetes

Type 2 diabetes accounts for 90-95% of diagnosed diabetes cases and approximately 22 million Americans have this disease (Rosenthal & Burchum, 2018). Type 2 diabetes is non-insulin dependent diabetes or also known as adult-onset diabetes mellitus. Insulin is still produced for patients with Type 2, the secretion is no longer tightly coupled to plasma glucose, which makes the release of insulin delayed and peak output is subnormal. A patient will have fasting labs and also check a hemoglobin A1C.

Juvenile Diabetes

An autoimmune disease where the pancreas stops producing insulin. Also, known as type 1 diabetes or insulin dependent. This is not related to lifestyle or diet. Early signs to watch for, include thirst and urination. If having symptoms, the provider will test blood levels.

Gestational Diabetes

Diabetes that appears during pregnancy and then subsides after delivery is gestational diabetes (Rosenthal & Burchum, 2018). You want to monitor blood glucose and make sure it is well controlled with diet and insulin if prescribed. Gestational diabetes usually shows up in the middle of pregnancy, and providers test between 24-28 weeks of pregnancy (CDC, n.d.).

The medication I chose is Metformin (Glucophage). Metformin is an oral agent that decreases glucose production by the liver and increases tissue response to insulin (Rosenthal & Burchum, 2018). Metformin is started once diagnosis of type 2 diabetes is made unless contraindicated. Metformin is safe and has beneficial effects on A1C, weight management, and cardiovascular mortality (American Diabetes Association, 2018). Metformin can be used as monotherapy, unless A1C is greater than 9%, then consider dual therapy. Keeping a healthy weight is important along with diet and lifestyle changes.

Drug Class: Biguanides

Pharmacokinetics: Metformin is slowly absorbed from the small intestine and is not metabolized, but excreted unchanged by the kidneys (Rosenthal & Burchum, 2018). Metformin can accumulate to toxic levels. Metformin can be used in patients with mild impairment in kidney function and in some patients with moderate kidney impairment (U.S. Food & Drug, 2017). Before started, obtain patients eGFR. Not recommended in patients with a eGFR <30. NURS 6521 week 5 Discussion: Diabetes and Drug Treatments

Side effects: decreased appetite, nausea, and diarrhea.

Severe metabolic acidosis can occur with accumulation of Metformin and patients with significant renal impairment. If a patient had any recent infection or illness they need to be aware to let the provider know and the medication might have to be stopped until feeling better. Patients admitted in the hospital are usually stopped on their Metformin and resumed after discharge. Caution patients if drink alcohol, whether its acute or chronic, because alcohol potentiates the effects of Metformin on lactate metabolism. Metformin can cause low blood sugar if patients do not eat enough, if they drink alcohol or if they take other medications that can lower blood sugar (U.S. Food & Drug, 2017). Monitoring blood glucose levels are very important when educating patients.

Sarah

References

American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes-2018. Diabetes Care, 41(supplement 1), S73-S85. Retrieved from: https://care.diabetesjournals.org/content/diacare/41/Supplement_1/S73.full.pdf

Centers for Disease Control and Prevention. (n.d.). Gestational Diabetes and Pregnancy.Retrieved from: https://www.cdc.gov/pregnancy/diabetes-gestational.html

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

U.S. Food & Drug. (2017). FDA Drug Safety Communication: FDA revises warnings regarding use of the diabetes medicine metformin in certain patients with reduced kidney function. Retrieved from: https://www.fda.gov/drugs/drug- safety- and-availability/fda-drug-safety-communication-fda-revises-warnings-regarding-use-diabetes-medicine-metformin-certain

 

response

Great job on your discussion regarding Metformin and diabetes management! I did some additional research on Metformin so I could contribute and bring additional information to your chosen topic. I did my discussion post on sulfonylureas which is also an oral agent medication that can be used in the treatment of Type II Diabetes. Biguanides mechanism of action and potential side effects are different from those of sulfonylureas in that they do not usually result in hypoglycemia (when used alone) nor dot hey promote hyperinosemia or weight gain. Biguanides can be used as a first line of treatment in addition to diet and exercise or they can be combined with other oral agents or insulin. It is imperative that providers start patient’s out with a lose dose and gradually increase the dose every 1-2 weeks depending upon therapeutic goals. Metformin should be started at 500mg or 850mg daily or twice daily with a maximum dose of 2550mg. Dosing is most effective when taken before meals in the mornings and evenings (Arcangelo, Peterson, Wilbur & Reinhold, 2017, p. 792).

In review of dietary recommendations and the use of Metformin I was unable to find any solid evidence on whether any dietary intakes affect the use of Metformin. It is noted that while taking the medication one should refrain from high fat diets and those that include a lot of sugar as a diet that consists of high fat and sugar are defeating the purpose of the medication being taken. Metformin taken with cimetidine increases the risk for hypoglycemic events and combination therapy with the use of metformin and glucocorticoids or alcohol can increase the risk of lactic acidosis.

Studies have shown that metformin treatment when combined with healthy lifestyles has a long-term effect on the management of diabetes. According to Rojas & Gomes (2013), “Diabetes incidence 10 years since DPP randomization was reduced by 34% and 18% in the lifestyle and metformin group, respectively (Rojas & Gomes, 2013).

Arcangelo, V. P. (2017). Pharmacotherapeutics for Advanced Practice. Philadelphia: Wolters Kluwer.

Rojas, L. &. (2013). Metformin: an old but still the best treatment for type 2 diabetes. Diabetology & Metabolic Syndrome. NURS 6521 week 5 Discussion: Diabetes and Drug Treatments

NURS 6521 week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

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NURS 6521 week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

BACKGROUND

Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.” NURS 6521 week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

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SUBJECTIVE

During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so you perform a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

MENTAL STATUS EXAM

Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When you asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation. NURS 6521 week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

RESOURCES

§ Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources.

Decision Point One 

Select what you should do:
Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks
: Begin Aricept (donepezil) 5 mg orally at BEDTIME
Begin Razadyne (galantamine) 4 mg orally BID
http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_10/index.html

The case study is on a 76-year-old Iranian male patient that is suspected to have Alzheimer’s disease. The conclusion is based on the reports provided by his eldest son and there were no organic disease processes that were identified during the examination. The behavioral changes started two years ago, and included personality changes, apathy, which was followed by memory loss and challenges in finding the appropriate words during conversation. Confabulation is also noticed during the clinical interview, speech, and self-reported euthymic mood. The patient also has an impairment in his judgment and insight as well as absence of impulse control. There is no suicide ideation reported and the patient is diagnosed with neurocognitive disorder as a result of Alzheimer’s disease.

The first approach that will be taken will include Donepezil 5mg at bedtime. The use of donepezil among patients that have Alzheimer’s disease has been examined for decades. The medication is an acetylcholinesterase inhibitor, which increases the acetylcholine levels in the brain and compensates the reduced function of cholinergic neurons (Birks and Harvey, 2018). An assessment of randomized clinical trials analyzed the impact that donepezil has on patients with Alzheimer’s using randomized control trials. The findings showed that there is strong evidence that donepezil is effective in three major areas in the management of this condition, which include behavior, functional ability, and cognition (Li et al., 2018). These are the major areas that were affected in the patient and the goal was to limit their impact on his quality of life. As indicated in the case, he had significant personality changes that negatively impacted his engagement in activities of interest. However, there is a need to state that the National Institute of Aging has noted that there is still a poor comparison between different agents that are used as the first line of treatment for the patient (NIH, 2020). NURS 6521 week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

The outcomes from donepezil differ as there can be development of complications along with limited clinical benefits. The patient complained of side effects such as loss of weight and appetite, vomiting, nausea, and diarrhea, which have been reported among patients using this medication (Kumar and Sharma, 2019).

The second decision was the use of cognitive behavioral treatment, which has been found studies to have a positive impact among patients with early stages of Alzheimer’s disease. Evidence supporting psychosocial interventions for patients with dementia has been identified in isolated cases (Forstmeier et al., 2015). However, there is still limited empirical data on these approaches. Some scholars have labelled behavioral interventions as appropriate among patients that have neuropsychiatric symptoms. Therefore, these will be used on the patient to improve behavior, and particularly targeted at reducing apathy and improving the self-control by the patient. Improvement of mood will positively impact the quality of life and the ability for the patient to engage in activities that will improve his cognitive status.

The third decision will be to include family members in the therapeutic process as this will help reinforce behaviors that will assist the patient. Studies illustrate that there is a high lack of adherence to care among elderly patients (Smith et al., 2017). This reduces the ability to evaluate the effectiveness of the interventions, as outcomes may be due to poor drug use. The goal is to increase the support system of the patient, and daily interactions as this has been found to positively impact the cognitive and emotional well-being of patients with dementia.

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References

Birks, J. S., & Harvey, R. J. (2018). Donepezil for dementia due to Alzheimer’s

disease. Cochrane Database of systematic reviews, (6).

Forstmeier, S., Maercker, A., Savaskan, E., & Roth, T. (2015). Cognitive behavioural

treatment for mild Alzheimer’s patients and their caregivers (CBTAC): study protocol for a randomized controlled trial. Trials, 16(1), 526.

How is Alzheimer’s Disease Treated? (2020). NIH

Kumar, A., & Sharma, S. (2019). Donepezil. In StatPearls [Internet]. StatPearls Publishing.

Li, Q., He, S., Chen, Y., Feng, F., Qu, W., & Sun, H. (2018). Donepezil-based multi

functional cholinesterase inhibitors for treatment of Alzheimer’s disease. European journal of medicinal chemistry, 158, 463-477.

Smith, D., Lovell, J., Weller, C., Kennedy, B., Winbolt, M., Young, C., & Ibrahim, J. (2017).

A systematic review of medication non-adherence in persons with dementia or cognitive impairment. PloS one, 12(2).

Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.

 

Photo Credit: Getty Images/Science Photo Library RF

To Prepare
  • Review the interactive media piece assigned by your Instructor.
  • Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
  • Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
  • You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment. NURS 6521 week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders
By Day 7 of Week 8

Write a 1- to 2-page summary paper that addresses the following:

  • Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
  • Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
  • What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
  • Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

You will submit this Assignment in Week 8.

Submission and Grading Information

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

  • Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 8 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 8 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 “WK8Assgn+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. NURS 6521 week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

NURS_6521_Week8_Assignment_Rubric

Excellent Good Fair Poor
Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. Be specific.
Points Range: 18 (18%) – 20 (20%)
The response accurately and thoroughly summarizes in detail the patient case study assigned, including specific and complete details on each of the three decisions made for the patient presented.
Points Range: 16 (16%) – 17 (17%)
The response accurately summarizes the patient case study assigned, including details on each of the three decisions made for the patient presented.
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely summarizes the patient case study assigned, including details on each of the three decisions made for the patient presented.
Points Range: 0 (0%) – 13 (13%)
The response inaccurately and vaguely summarizes the patient case study assigned, including details on each of the three decisions made for the patient presented, or is missing.
Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
Points Range: 23 (23%) – 25 (25%)
The response accurately and thoroughly explains in detail how the decisions recommended for the patient case study are supported by the evidence-based literature. 

The response includes specific and relevant outside reference examples that fully support the explanation provided.
Points Range: 20 (20%) – 22 (22%)
The response accurately explains how the decisions recommended for the patient case study are supported by the evidence-based literature. 

The response includes relevant outside reference examples that lend support for the explanation provided that are accurate.
Points Range: 18 (18%) – 19 (19%)
The response inaccurately or vaguely explains how the decisions recommended for the patient case study are supported by the evidence-based literature. 

The response includes inaccurate or vague outside reference examples that may or may not lend support for the explanation provided or are misaligned to the explanation provided.
Points Range: 0 (0%) – 17 (17%)
The response inaccurately and vaguely explains how the decisions recommended for the patient case study are supported by the evidence-based literature, or is missing. 

The response includes inaccurate and vague outside reference examples that do not lend support for the explanation provided, or is missing.
What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
Points Range: 18 (18%) – 20 (20%)
The response accurately and thorough explains in detail what they were hoping to achieve with the decisions recommend for the patient case study assigned. 

The response includes specific and relevant outside reference examples that fully support the explanation provided.
Points Range: 16 (16%) – 17 (17%)
The response accurately explains what they were hoping to achieve with the decisions recommended for the patient case study assigned. 

The response includes relevant outside reference examples that lend support for the explanation provided that are accurate.
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely explains what they were hoping to achieve with the decisions recommended for the patient case study assigned. 

The response includes inaccurate or vague outside reference examples that may or may not lend support for the explanation provided or are misaligned to the explanation provided.
Points Range: 0 (0%) – 13 (13%)
The response inaccurately and vaguely explains what they were hoping to achieve with the decisions recommended for the patient case study assigned, or is missing. 

The response includes inaccurate and vague outside reference examples that do not lend support for the explanation provided, or is missing.
Explain any difference between what you expected to achieve with each of the decisions and the results of the decisions in the exercise. Describe whether they were different. Be specific and provide examples.
Points Range: 18 (18%) – 20 (20%)
The response accurately and clearly explains in detail any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise. 

The response provides specific, accurate, and relevant examples that fully support whether there were differences between the decisions made and the decisions available in the exercise.
Points Range: 16 (16%) – 17 (17%)
The response accurately explains any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise. 

The response provides accurate examples that support whether there were differences between the decisions made and the decisions available in the exercise.
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely explains any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise. 

The response provides inaccurate or vague examples that may or may not support whether there were differences between the decisions made and the decisions available in the exercise.
Points Range: 0 (0%) – 13 (13%)
vaguely explains in detail any differences between what they expected to achieve with each of the decisions and the results of the decisions in the exercise, or is missing. 

The response provides inaccurate and vague examples that do not support whether there were differences between the decisions made and the decisions available in the exercise, or is missing.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors. NURS 6521 week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

NURS 6501 Module 1 assignment Case Study Analysis

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NURS 6501 Module 1 assignment Case Study Analysis

Case Study Analysis

A 42-year old male comes into the emergency presenting with the following symptoms: a fever of 100.6˚ F, chills and a swollen leg with redness. The patient describes that he was working in his yard when his string trimmer slipped and cut his leg. The patient cleaned the wound with water from his garden hose and covered the wound with a Band-aid. The purpose of this review is to explore why the patient might have the symptoms described, which genes are associated with the development of the disease and provide a description of the immunosuppression process, including its effect on normal body function and systems. NURS 6501 Module 1 assignment Case Study Analysis

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The patient may be presenting the symptoms due to the development of an infection on the cut. An infected cut normally develops after germs get into the sensitive tissue beneath the skin via a damaged area of the skin. An infection may develop at any point between 2-3 days until the cut visibly heals (Healthline.com Editor, 2019). An uninfected cut will normally improve until it is completely healed, whereas an infected cut is likely to become more painful. Moreover, infected cuts usually have red surrounding skin and the patient may feel hot. Additionally, the patient may notice swelling around the infected area and progressed infections usually begin to ooze pus (Healthline.com Editor, 2019). A patient presenting these symptoms is advised to seek immediate medical attention because they demonstrate that the infection has spread. NURS 6501 Module 1 assignment Case Study Analysis

Research has found that the wound healing process is dependent on genetic makeup (Gross, 1996). This is because higher organisms can respond to tissue injury by either wound repair or regeneration (Gross, 1996). Research to identify the genetic loci in the wound closure process found that the traits were contained in chromosomes 8, 12 and 15 as well as two separate locations on the chromosome 13 (McBrearty, Clark, Zhang, Blankenhorn, & Heber-Katz, 1998). On the other hand, genetic control for the healing process was a function of the chromosome 7 (McBrearty, Clark, Zhang, Blankenhorn, & Heber-Katz, 1998). Thus, the mammalian genes controlled the healing and regeneration process in mammals.

Immunosuppression describes the ability to induce a lower level of immune system activation and efficacy (Pellegrino & Mancini, 2016). Immunosuppression may occur as a system function or as an adverse reaction to the treatment of another condition. For instance, immunosuppression may be performed to reduce the body’s possibility for rejecting an organ transplant (Pellegrino & Mancini, 2016). Immunosuppression may also be used to treat conditions where the immune system is overreacting, in the case of allergies and autoimmune diseases such as infections. Immunosuppression from pre-existing diseases such as HIV or ongoing cancer treatment could lead to higher risks of getting an infection from a cut. A weakened immune system is one of the environmental and health risk factors for getting an infection from a cut. Whether an individual is undergoing deliberate immunosuppression due to an organ transplant or are undergoing radiation therapy or non-deliberate immunosuppression due to chronic illness, then an individual is more susceptible to autoimmune diseases such as infections.

In conclusion, the case study has demonstrated that the patient may have experienced an infected cut from his incident during gardening. The infected cut will normally present similar symptoms. Moreover, the genetic aspect of wound healing and regeneration is derived from literature and the influence of immunosuppression on healing responses is also explored. By considering these factors, the healthcare practitioner will be able to diagnose and treat the infection. NURS 6501 Module 1 assignment Case Study Analysis

 

 

References

Gross, J. (1996). Getting to mammalian wound repair and amphibian limb regeneration: a mechanistic link in the early events. Wound repair and regeneration, 4(2), 190-202.

Healthline.com Editor. (2019). How to Identify and Treat an Infected Cut. Retrieved March 6, 2020, from Healthline.com: https://www.healthline.com/health/infected-cut

McBrearty, B. A., Clark, L. D., Zhang, X. M., Blankenhorn, E. P., & Heber-Katz, E. (1998). Genetic analysis of a mammalian wound-healing trait. Proceedings of the National Academy of Sciences, 95(20), 11792-11797.

Pellegrino, B., & Mancini, M. C. (2016). Immunosuppression. Retrieved from emedicine.medscape.com: https://emedicine.medscape.com/article/432316-overview NURS 6501 Module 1 assignment Case Study Analysis

 

Module 1 Assignment: Case Study Analysis
An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

 

Photo Credit: Getty Images/Hero Images

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)
Develop a 1- to 2-page case study analysis in which you:

Explain why you think the patient presented the symptoms described.
Identify the genes that may be associated with the development of the disease.
NURS 6501 Module 1 assignment Case Study Analysis
Explain the process of immunosuppression and the effect it has on body systems.
By Day 7 of Week 2
Submit your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). 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 “M1Assgn+last name+first initial.(extension)” as the name.
Click the Module 1 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Module 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 “M1Assgn+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. NURS 6501 Module 1 assignment Case Study Analysis

NURS_6501_Module1_Case Study_Assignment_Rubric
Grid View
List View
Excellent Good Fair Poor
Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:
Explain why you think the patient presented the symptoms described.

Points Range: 28 (28%) – 30 (30%)
The response accurately and thoroughly describes the patient symptoms.

The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

Points Range: 25 (25%) – 27 (27%)
The response describes the patient symptoms.

The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

Points Range: 23 (23%) – 24 (24%)
The response describes the patient symptoms in a manner that is vague or inaccurate. NURS 6501 Module 1 assignment Case Study Analysis

The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/research.

Points Range: 0 (0%) – 22 (22%)
The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing.

The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/research.

Identify the genes that may be associated with the development of the disease.
Points Range: 23 (23%) – 25 (25%)
The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease.
Points Range: 20 (20%) – 22 (22%)
The response includes an accurate analysis of the genes that may be associated with the development of the disease.
Points Range: 18 (18%) – 19 (19%)
The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.
Points Range: 0 (0%) – 17 (17%)
The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.
Explain the process of immunosuppression and the effect it has on body systems.
Points Range: 28 (28%) – 30 (30%)
The response includes an accurate, complete, detailed, and specific explanation of the pathophysiological processes that may be associated with the development of the diagnosed condition.
Points Range: 25 (25%) – 27 (27%)
The response includes an accurate explanation of the pathophysiological processes that may be associated with the development of the diagnosed condition. NURS 6501 Module 1 assignment Case Study Analysis
Points Range: 23 (23%) – 24 (24%)
The response includes a vague or inaccurate explanation of the pathophysiological processes that may be associated with the development of the diagnosed condition.
Points Range: 0 (0%) – 17 (17%)
The response includes a vague or inaccurate explanation of the pathophysiological processes that may be associated with the development of the diagnosed condition, or the analysis is missing.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

Points Range: 3 (3%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment are vague or off topic.

Points Range: 0 (0%) – 2 (2%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided. NURS 6501 Module 1 assignment Case Study Analysis

Written Expression and Formatting – English Writing Standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
Points Range: 3 (3%) – 3 (3%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.
Points Range: 0 (0%) – 2 (2%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) APA format errors.
Points Range: 3 (3%) – 3 (3%)
Contains several (3 or 4) APA format errors.
Points Range: 0 (0%) – 2 (2%)
Contains many (≥ 5) APA format errors. NURS 6501 Module 1 assignment Case Study Analysis

Corporation Merger

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The hospital you work for has merged with an organization that currently has two hospitals as part of the organization. The facility you work in uses X medical records, the other two hospitals use Y medical records. All three hospitals will use Y medical records once the merger is complete. Change is needed at your hospital for continuity in the larger organization and for the best patient care possible. You will be responsible for getting your team up to speed on the new medical recording system.
In 750-1,000 words, provide the following:

Brief rationale as to why the change is important for the organization.
The steps you would take the begin implementing the change.
Examine what change management approach you believe would be most appropriate for your suggested implementation.
Provide three to five scholarly resources, in addition to information from your textbook.

ethics

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I added the directions in a word document attached.

Topic 2 DQ2

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Topic 2 DQ2

Describe how the nursing profession is viewed by the general public. Discuss factors that influence the public’s perception of nursing? Describe ways to educate the general public on the professional nurse’s role and scope of nursing within a changing health care system.

 

 

******** Please answer question with a paragraph, add citation and references. Thanks !

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Topic 4 DQ1

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Topic 4 DQ1

Please write paragraphs responding the discussion below. Add citations and references in alphabetic order.

 

What are the methods a nurse can use to gather cultural information from patients? How does cultural competence relate to better patient care? Discuss the ways in which a nurse demonstrates cultural competency in nursing practice.

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