WC NURS676 Discussions Latest 2022 July (Full)

NURS676 Advanced Pharmacology

Week 1 Discussion

Discussion Prompt 1 (Complete the Do No Harm interactive in Week 1 first.)

Reflect on your experience as Dr. Manning in the?Do No Harm?interactive exercise. How did this exercise affect your understanding of how to identify and prevent prescription medication misuse??What tools and techniques did you learn? Can you see yourself realistically using any of them in your practice? Why or why not?

Additionally, choose two of the following to address:

Which patient(s) from the video do you feel you worked well with, and which patient situation could you have handled differently? Explain.

Which patient from the video was the most challenging for you to work with? Why? Do you think you would work with them in “real life” the same way that you worked with them in this simulation?

How realistic did you find the portrayal of the?relationship between Dr. Manning and Dr. Edwards? In your experience, do doctors interact in this way? Why do you think their interaction was included in this scenario??

How realistic did you find the portrayal of?the relationship between the nurse practitioner and the doctor??In your experience, do doctors and NPs interact in this way??Why do you think their interaction was included in this scenario??

How realistic do you think these patient situations are? In your experience, have you seen a need for increased vigilance in PMM? Explain.

How does PMM awareness and prevention support the Hippocratic Oath? Use one of the patient scenarios to support your answer.

Discussion Prompt 2 

Select one of the following case studies to address. In the subject line of your post, please identify which prompt you are responding to, for example, choice #2 using Schedule II substances.

There are a variety of requirements or restrictions states may impose on advanced practice registered nurses (APRNs) who prescribe controlled substances. In your state, discuss the role of the APRN in administering and dispensing drugs under the federal drug classification and schedules. Discuss your state requirements and restrictions and identify practice barriers to the nurse practitioner role including the administration of controlled substances.

You have determined after a thorough history and examination that your patient’s injury requires treatment using a Schedule II substance. What are the policies for writing a prescription for a Schedule II CS? Can you offer the patient refills? What is the DEA policy on post-dated prescriptions for Schedule II drugs? How can you avoid tampering with prescriptions for controlled substances? This may vary by state. Make sure to research both the federal and state requirements where you practice.

Controlled substances are categorized using a classification system. Define the five different schedules for controlled drugs and provide examples of drugs in each schedule. Explain the reason why controlled substances need to be categorized. What are the associated controls required in your state for prescribing in each schedule?

 

 

NURS676 Advanced Pharmacology

Week 2 Discussion

In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.

Jennifer is a 25-year-old female who has the complaint of worrying excessively, feeling restless, difficulty concentrating and feeling fatigued for the last 6 months. She is under considerable stress trying to juggle work, taking college classes, and raising her 2 young children. After running some lab tests including a TSH (which were all normal), you diagnose her with generalized anxiety disorder. What pharmacological and non-pharmacological interventions could you recommend to help treat her anxiety? Are there any medications that you would avoid for this patient? Are there any tools that can help you screen your patients for anxiety in case they don’t feel comfortable admitting to you that they are anxious? How would you follow up with this patient?

Emily?is a 44-year-old woman who presents with a 6-week history of initial insomnia and a 10-pound weight loss. She admits to feeling sad almost every day since she lost her job 6 weeks ago. She has no interest in engaging in previously enjoyable activities. She denies suicidality (ideation or plan). She has never been treated for depression. Her physical examination is negative, vital signs and blood work including a thyroid profile is all within normal limits, and her body mass index is 22. Her mother has a history of depression, and she was treated successfully with Sertraline. What medication should be considered for Emily and why? Does her age and childbearing potential influence your treatment decision? Is medication therapy enough? Please include medication education in your discussion.

James?is a 51-year-old male truck driver with a long history of diabetes and hypertension. His current medication regimen is Lisinopril 20mg QD, metformin 1000mg QD, Lipitor 40mg QHS, and ASA 81mg QD. His A1C is 7, BP is 144/80, total cholesterol is 266, HDL 44, LDL 177, and Trig 199. What other information should you know about this patient to feel confident that his care is well optimized? What parameters would you like to see improved? To what clinical guidelines should you adhere when managing this patient? Are there any changes to treatment you should consider? Support your decisions with evidence.

 

NURS676 Advanced Pharmacology

Week 3 Discussion

In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.

Jana,?a 36-year-old single mother of three children, has a 15-year history of asthma. For the past month, she has been using?albuterol?every day. Previously, she had been using the inhaler every 3 to 4 months. She is in the office for a refill. What further information is needed to treat this patient and why? What clinical guidelines should you refer to for her medication management and why?

Dave is a 47-year-old male patient in for a follow-up visit to discuss his chronic allergic rhinitis and nasal congestion. He takes Claritin 10mg daily which seems to help his clear runny nose and itchy eyes. However, he complains of chronic nasal congestion and difficulty breathing through his nose. You find out he has been using over-the-counter nasal spray twice a day for several months. What do you think is contributing to his chronic nasal congestion? How would you manage this patient going forward?  

Lester?is a 67-year-old male who is prescribed Warfarin for his new onset atrial fibrillation. He is concerned about starting this medication and admits he is forgetful about taking meds and doesn’t understand why he must have follow-up blood tests. Discuss the patient education you would offer about Warfarin (include side effects). How would you address his concerns and questions? How can you ensure your patient education information is accurate and up to date? Are there other medications that you could consider for Lester?

 

NURS676 Advanced Pharmacology

Week 4 Discussion

In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.

Clara?is a 35-year-old female who has a five week history of?epigastric?pain that is worse after she eats. The pain is minimally relieved by?Mylanta?or burping. She has come to your office for evaluation and your initial impression is gastritis. What is your recommendation and treatment plan? What clinical guidelines support your decision and why?

Lilly is a 6-year-old girl who presents with a 2 week history of worsening redness, dryness, and rash to the volar aspects of the wrists and dorsum of the hands. The area is moderately pruritic. On assessment, you note her rash is consistent with mild eczema. You would like to prescribe a topical corticosteroid. What potency should be considered for this patient? Include the frequency of application and length of recommended treatment. What can be done about her pruritus? Are there any OTC ointments that should be considered for this patient? Include medication and general patient education in your discussion.

Marty is a 66-year-old male chef who has been experiencing severe reflux symptoms for the past several weeks that seem to be worsening at night. He had similar symptoms two to three years ago that went away when he stopped drinking alcohol. He claims to remain abstinent, but his symptoms have returned. What additional information should you obtain? What medications should you consider for his symptoms? Discuss your assessment and plan of care including clinical guidelines that support your decision.

 

NURS676 Advanced Pharmacology

Week 5 Discussion

In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.

Melina?is a 36-year-old female with complaints of excessive fatigue, muscle aches, difficulty sleeping, weight gain, and hair loss. She has been experiencing these symptoms for the past six months. She recently lost her job as a clerk and is under a lot of stress. She denies taking any medication and denies any medical history. She is crying at the clinic today and tells you that she does not feel right. Her labs demonstrate that her TSH is significantly elevated at 8. How will you approach and manage her complaints? What discussion will you have with the patient regarding her therapy going forward?

John is a 40-year-old male who has come to the clinic to review his recent lab results. He has a history of hypertension and has been on Lisinopril 20mg daily for a couple of years. He was diagnosed with “pre-diabetes” about four years ago. He states he has been trying to “eat right, exercise, and lose weight” and he has lost 5 pounds during the previous year. He hasn’t had a follow-up appointment in over a year because he was afraid to come into the office due to COVID-19. Today, his BMI is 30 and his blood pressure is 150/90. His labs show that his CBC, complete metabolic panel, and TSH are all within normal limits. His HbA1c is 8.5. What other information would you want to know about this patient? What would you recommend as your treatment plan and which clinical guidelines would you use to help develop your plan?

Janie is a 55-yer-old female who presents to the clinic today asking for a prescription for Synthroid to help her lose weight. She said her friend was diagnosed with “low thyroid” recently and lost a lot of weight after starting Synthroid. Janie denies complaints of fatigue, dry skin, hair loss, or constipation. Janie’s labs (CBC, complete metabolic panel, TSH, free T4) are all within normal limits. What other information would you want to know about Janie? How would you address Janie’s request?

 

NURS676 Advanced Pharmacology

Week 6 Discussion

In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.

Melissa?is a 31-year-old recently married female who presents to your office for an annual visit.?She has three children ages 2, 5, and 8. Her new husband wants to wait at least a year before they try to have a child of their own. She has used combined oral contraceptives (COCs) for more than 10 years. Since the birth of her last child, she has been using?COCs?intermittently. She finds it too difficult to remember to take the pills regularly and wants an easier method. Menses are regular, although her periods seem heavier than usual, and she gets more irritable when she is not taking the?COCs. She rarely exercises and admits to smoking and drinking occasionally. She is overweight. She has no medical history. What additional information do you need to obtain? Discuss her options and provide evidence for your rationale. Include patient education in your discussion. ?

Bridget?is 16-year-old female who comes to the clinic for a sports physical with her mom. When her mom leaves the room during the examination, Bridget asks for a prescription for birth control. She requests that you do not tell her mother. Bridget is healthy with no allergies. She is at the 50th percentile for body mass index (BMI). Her blood pressure is 112/68 mmHg, and her examination is normal except for mild acne on her face and upper chest. What is Bridget’s initial treatment plan? What is the legal age in your state when adolescents can self-consent for contraception? What education does she need?

Javier is a 54-year-old male who comes to the clinic with his fifth gout flare this year. He presents with a red, warm, swollen big toe to his right foot. His only other medical history is that he has hypertension that has been controlled by hydrochlorothiazide 25 mg daily. He states the pain is a 5 out of 10. How would you treat his gout exacerbation? Is there anything you can do to help prevent future occurrences? What education does this patient need? Discuss your treatment plan and which clinical guidelines you used to help develop you plan.

 

NURS676 Advanced Pharmacology

Week 7 Discussion

In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #2.

Nolan?is a 55-year-old male with a 5-day history of nasal congestion, rhinorrhea, malaise, and irritated sore throat. His nasal discharge has gone from clear to yellow in color. He took OTC acetaminophen at onset of symptoms with minimal relief. He has no health history and his examination in your office today is unremarkable. He has already missed 2 days of work and insists he needs an antibiotic. He adds that he “always gets an antibiotic” when he sees the other clinician in your clinic. When looking at his chart, you confirm this to be true. You have diagnosed Nolan with a viral URI. What medication treatment plan do you recommend, if any? Discuss your patient education and outcome evaluation for this patient. What does the literature say about the over prescribing of antibiotics?

Jessica is a 35-year-old female who presents to the clinic with a 2-day history of fever (temp 101.4), purulent nasal discharge, and erythema/warmth/tenderness to palpation to her left maxillary sinus area. She also states that her “teeth ache” on the left side and that her face hurts worse when she bends down to tie her shoes. She had started with a mild cold a couple of weeks ago and thought she was getting better but then 2 days ago she started feeling much worse. You diagnose Jessica with bacterial sinusitis. She states that she has always gotten a Z-pack prescription for her sinusitis in the past. What would your treatment plan be for this patient? How will you decide which antibiotic to prescribe and how long she will need to take it? What non-pharmacological treatments can you offer her to help her feel better?

Explanation & Answer

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Order Now and we will direct you to our Order Page at Litessays. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.