PHARMACOTHERAPY FOR CARDIOVASCULAR DISORDERS
Order Instructions
Writer please follow all instructions my professor mark according to the rubric.
This week there is no discussion board. You will have a written paper due Sunday. Below is the patient case that you will use to complete this assignment. For this case, you will choose a pharmacokinetic factor from the ones listed in the instructions in the module, and answer the corresponding questions. When evaluating this case, you will review the treatment regimen for appropriateness of indication, dosing, contraindications and drug interactions. Begin by studying the different hypertension guidelines, ACA/AHA and JNC.
Assignments
Read chapters: 33, and 37-46
Submit written assignment by Sunday
Patient case for Week 2 Assignment
BN is a 74-year-old African American male who is seeing his PCP because he noticed when he woke up that his “heart was not beating right; it feels like it is going to slow.” He denies chest pain, SOB, N/V. He notes feeling dizzy earlier in the day. 6 weeks earlier his PCP started him on Diltiazem CD to further lower his BP to goal. His Metoprolol was lowered at that time as well from 75 mg to 50 mg BID. His PCP recommends he be admitted to the hospital.
Upon presentation to the hospital:
PMH:
HTN x 7 years
Type II DM
CAD s/p angioplasty 2 years ago
MI 3 years ago
EF = 60%
PVD s/p left femoral to posterior bypass
Hx of A Fib x 4 years
Medications:
Digoxin 0.25 mg QD KCl 40 mEq QD Vitamin C 500 mg QD
Diltiazem CD 180 mg QD ASA EC 325 mg QD Vitamin E 400 IU QD
Metoprolol 5- mg BID Warfarin 5 mg QD Ibuprofen 200 mg 2 tabs prn headache
Lisinopril 20 mg QD Famotidine 20 mg QHS Multivitamin QD
Imdur 30 mg QD Lantus 26u QHS Ca++/Vit D 500mg/200 IU BID
HCTZ 12.5 mg QD Humalog 8u with meals
PE:
BP 110/50 Pulse 38 bpm Resp 14/min
Rest of physical exam unremarkable
Labs:
K+ 6.9 WBC 5,800/mm3
Na+ 135 Hct 35%
Cr 1.9 Dig 2.78
BUN 35 INR 2.3
Gluc 102
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.
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
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare
Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
Review the case study assigned by your Instructor for this Assignment.
Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
BY DAY 7 OF WEEK 2
Write a 2- to 3-page paper that addresses the following:
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632Links to an external site.). All papers submitted must use this formatting.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
To submit your completed assignment, save your Assignment as WK2Assgn_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6521_Week2_Assignment_Rubric
NURS_6521_Week2_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeExplain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
25 to >22.5 pts
Excellent
The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
22.5 to >19.75 pts
Good
The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
19.75 to >17.25 pts
Fair
The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
17.25 to >0 pts
Poor
The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.
25 pts
This criterion is linked to a Learning OutcomeDescribe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
30 to >26.7 pts
Excellent
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.
26.7 to >23.7 pts
Good
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.
23.7 to >20.7 pts
Fair
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.
20.7 to >0 pts
Poor
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.
30 pts
This criterion is linked to a Learning OutcomeExplain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.
30 to >26.7 pts
Excellent
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.
26.7 to >23.7 pts
Good
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.
23.7 to >20.7 pts
Fair
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.
20.7 to >0 pts
Poor
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.
30 pts
This criterion is linked to a Learning OutcomeWritten 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.
5 to >4.45 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
4.45 to >3.95 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
3.95 to >3.45 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
3.45 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
5 to >4.45 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors
4.45 to >3.95 pts
Good
Contains a few (1–2) grammar, spelling, and punctuation errors
3.95 to >3.45 pts
Fair
Contains several (3–4) grammar, spelling, and punctuation errors
3.45 to >0 pts
Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts
This criterion is linked to a Learning OutcomeWritten 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.
5 to >4.45 pts
Excellent
Uses correct APA format with no errors
4.45 to >3.95 pts
Good
Contains a few (1–2) APA format errors
3.95 to >3.45 pts
Fair
Contains several (3–4) APA format errors
3.45 to >0 pts
Poor
Contains many (≥ 5) APA format errors
5 pts
Total Points: 100
LEARNING RESOURCES
Required Readings
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 33, “Review of Hemodynamics” (pp. 285–289)
Chapter 37, “Diuretics” (pp. 290–296)
Chapter 38, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 297–307)
Chapter 39, “Calcium Channel Blockers” (pp. 308–312)
Chapter 40, “Vasodilators” (pp. 313–317)
Chapter 41, “Drugs for Hypertension” (pp. 316–324)
Chapter 42, “Drugs for Heart Failure” (pp. 325–336)
Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348)
Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 349–363)
Chapter 45, “Drugs for Angina Pectoris” (pp. 364–371)
Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388)
Required Media
Cardiovascular Disorders
Meet Dr. Norbert Myslinski as he discusses ACE inhibitors, angiotensin inhibitors, beta-blockers, calcium channel blockers, and diuretics as different categories of hypertension drugs. What potential drugs might be best recommended for patients suffering from hypertension? (8m)
Walden University. (n.d.). Instructor feedbackLinks to an external site.. https://cdn-media.waldenu.edu/2dett4d/Walden/WWOW/1001/pulse_check/instructor_feedback/index.html#/
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