Mrs. A is a 71 year old widow with CHF and osteoarthritis who has recently been exhibiting quite unusual behavior. Her daughter is concerned about her mother’s ability to remain independent and wishes to pursue nursing home admission arrangements.
Mrs. A is a 71 year old widow with CHF and osteoarthritis who has recently been exhibiting quite unusual behavior. Her daughter is concerned about her mother’s ability to remain independent and wishes to pursue nursing home admission arrangements. She fears the development of a dementing illness. Over the last two to three months Mrs. A has become confused, easily fatigued and very irritable. She has developed disturbing obsessive/compulsive behavior constantly complaining that her lace curtains were dirty and required frequent washing. Detailed questioning revealed that she thought they were yellow-green and possibly moldy. Her prescribed medications are:
Furosemide 40 mg daily in the morning
Digoxin 250 micrograms daily
Paracetamol 500 mg, 1-2 tablets 4-hourly PRN
Piroxicam 20 mg at night
Mylanta suspension, 20 ml PRN
Coloxyl 120 mg, 1-2 tablets at night
Assignment Questions
Critically discuss this case study in terms of the problematic nature of this patient’s pharmacological management.
Outline some pharmacokinetic changes in the geriatric population that may affect drug disposition.
Outline how changes in renal and hepatic function may affect treatment strategies.
In the drug regimen presented above – discuss potential side effects and potential interactions, if any?
Your response should include a discussion of the problems of polypharmacy as it is related to this case study and the assessment/management and educational strategies which could have been implemented to improve the outcome of Mrs. A.
Instructions
Prepare and submit a 3-4 page paper [total] in length (not including APA format).
Answer all the questions above.
Support your position with examples.
Please review the rubric to ensure that your assignment meets criteria.
Submit the following documents to the Submit Assignments/Assessments area:
NU636 Advanced Pharmacology
Unit 2 Assignment
Instructions
Health Interview Survey (NHIS) were findings that 38% of adults use CAM [complementary and alternative medical] health care modalities.
Construct a professional paper that outlines how the use of the following CAM health care modalities impacts the cardiovascular system.
Ginseng
Hawthorn
L-Arginine
St. John’s Wort
For each of the modalities the discussion must include:
effect on the cardiovascular system
anticipated benefits
any identified risks or adverse effects
relative patient education
supporting reference from scholarly literature.
Instructions
Prepare and submit a minimum of a 6 page paper pages [excluding title and reference pages].
Format consistent with APA style without an abstract page.
Answer all the questions above.
Please review the rubric to ensure that your assignment meets criteria.
Submit the following documents to this assignment area:
Assignment: Cardiac Impact
Estimated time to complete: 2 hours
NU636 Advanced Pharmacology
Unit 5 Assignment
Case Study: Inflammatory Bowel Disease
Case Study
Mrs. Z is a 34-year-old female who come in with a complaint of diarrhea accompanied by abdominal pain. Onset of the symptom was about 4 days ago. She reports thinking she is running a fever but has not taken her temperature. She concerned that she is starting to feel weak.
When asked how about the characteristics and the number of bowel movements a day, she reports increased number of BMs over the last few months. In the last few days she reports averaging about 10 small volume watery stools with varying amounts of blood daily.
She denies recent travel and reportedly has not been on any antibiotics in the past few weeks.
In reviewing her record, you notice that her health history is positive for history of ulcerative colitis. She has not been on any medications for this over the last few years as she had not been symptomatic.
Mrs. Z is on an oral contraceptive. She takes slippery elm capsules and has for the last several years. She reports that she has been taking 2 to 3 doses of Benefiber prebiotic fiber for the last couple days.
Objective data:
BP 116/70 sitting, 100/66 standing; P 92; Temp 100.1
Abdomen – active bowel sounds all 4 quadrants, mild tenderness with palpation
Otherwise her exam is unremarkable for pertinent positives or negatives.
Labs – WBC 14,000; Hgb 11.9; Hct 35.7; Sodium 133; Potassium 3.3
What pharmacologic therapy would you prescribe for Mrs. Z?
How will you evaluate the effectiveness of this therapy?
What patient education would you provide for Mrs. Z relative to the pharmacologic agent you prescribed?
Are there any pharmacogenetic considerations related to what you prescribed for the patient?
Are there any alternative therapies or over-the-counter agents that might be of value to Mrs. Z?
What, if any, lifestyle changes would you recommend?
Instructions: Please prepare and submit a paper 3-4 pages [total] in length (not including APA format) answering the questions below. Please support your position with examples.
NU636 Advanced Pharmacology
Unit 6 Assignment
Antibiotic Stewardship
CDC Antibiotic Stewardship Initiative Discussion Paper
Construct a professional paper that outlines the advanced practice role – as a nurse educator, a nurse leader, or a nurse practitioner – to advance the CDC’s antibiotic resistance initiative. The paper needs to be a minimum of six (6) pages [excluding title and reference pages] consistent with APA style without an abstract page. The paper is worth 40 points.
Please include the following:
Introduction that identifies your advanced practice role and your view of how that role will be able to impact the antibiotic resistance dilemma. Support your discussion with at least two references from the literature.
Review the CDC’s goals and identify one of the CDC’s key strategies that you will be able to promote/support in your advanced practice role. Support your discussion with at least two references from the literature.
Discuss three activities/actions that you will develop to support the promotion of the key strategy that you identified in item 2 above. Each action/activity needs to be well designed and supported with at least one reference from the literature. [For example, if you are a nurse educator student – in what course(s) will you be able to promote your identified key strategies, be specific about what that would look like using example lesson plan(s), identify any active learning strategies you will utilize, etc., and provide justification for your strategies, etc.; if you are a nurse leader student – what program(s) and activities will you engage with relative to your organization, be that existing programs or creation of new programs, reporting mechanisms, development of collaborative committees, etc., and provide justification for your strategies, etc.; if you are a nurse practitioner student – what prescribing practices, patient education practices, monitoring programs, etc., will you engage with, and provide justification for your strategies, etc.
The paper is to be formatted according to APA style
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