N521- Advanced Pharmacology Assignment 2

R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years. He reports to his CNP in his family practice clinic. He presents with progressive difficulty getting his breath while doing simple tasks. He is having difficulty doing any manual work, but he has no symptoms when working behind his desk. He also reports a cough, fatigue, and weight loss. He has been treated for three respiratory infections a year for the past 3 years and feels like another one is developing now. On physical examination, you notice clubbing of his fingers, use of accessory muscles for respiration, wheezing in the lungs, and hyperresonance on percussion of the lungs. Pulmonary function studies show an FEV1 of 58%. R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years.

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In a paper not to exceed six pages, excluding title and reference pages, please answer the following:

1. What is R. W.’s likely diagnosis?
2. What stage of disease does RW have?
3. List specific pharmacotherapeutic treatment goals for R. W.
4. What drug therapy would the CNP likely prescribe? Why?
5. What are the parameters for monitoring the success of the therapy?
6. Describe specific patient education based on the prescribed therapy.
7. List one or two adverse reactions for the selected agent that would cause the CNP to change therapy.
8. What would be the choice for second-line therapy?
9. What health promotion activities should be recommended for this patient?
10. If RW was currently taking metoprolol for “headaches” would a change be recommended?
11. R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years

Please use the Case Study Analysis rubric provided to guide you in completing this assignment. It will be used to evaluate your submitted work.

Competency	40	36	33	0	Points Earned
Case Study questions completely and thoroughly answered with accurate evidence-based supported rationales	Accurate and well defined discussion of all 10 questions for the case study using current evidence-based resources.	Accurate discussion of nine case study questions  presented with use of  current evidence-based resources.	Accurate discussion of 8 questions using current evidence-based resources	Missing response to questions or inappropriate answers to questions. No use of evidence-based resources.	/40 R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years
	40	36	33	0
Evidence of critical thinking therapeutic decision-making in drug selection and evaluation of patient care pathophysiology and current pharmacological research assessment of the effectiveness of drug therapy formulation of clinical care and teaching plans for persons from diverse populations	Well-defined evidence of critical thinking therapeutic decision-making in drug selection and evaluation of patient care pathophysiology and current pharmacological research assessment of the effectiveness of drug therapy formulation of clinical care and teaching plans for persons from diverse populations	Evidence of critical thinking in prescriptive therapy, monitoring and adverse events.  May have lacked a teaching plan or pathophysiologic discussion.	Evidence of critical thinking but incompletely described therapeutic decision making and omitted teaching plan and pathophysiology.	Multiple bulleted points are absent or poorly defined in the assignment. There is no demonstration of critical thinking. R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years	/40
	10	9	8	0	Points Earned
Grammar, spelling, and punctuation	There are no errors in grammar, spelling, and punctuation	There are a few minor errors in grammar, spelling, and punctuation that do not detract from the meaning (1-3 errors)	There are major errors in grammar, spelling, and punctuation .(4-5 errors)	No content or more than 5 errors	/10
	10	9	8	0
APA Compliance	The paper meets APA formatting guidelines	There are a few minor errors (1-3 errors)	There are significant errors in the format of the paper (4-5 errors)	No content or more than 5 errors	/10
Total Points		R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years