Solution – nurs6521 full course

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Week 1 discussion

Discussion: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics. Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body. When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharamcodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease. In this Discussion, you reflect on a case from your past clinical experiences and consider how a particular patient’s pharmacokinetic and pharmacodynamic processes altered his or her response to a drug.

To prepare:

Review this week’s media presentation with Dr. Terry Buttaro, as well as Chapter 2 of the Arcangelo and Peterson text, and the Scott article in the Learning Resources. Consider the principles of pharmacokinetics and pharmacodynamics.

Reflect on your experiences, observations, and/or clinical practices from the last five years. Select a case from the last five years that involves a patient whose individual differences in pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.

Think about a personalized plan of care based on these influencing factors and patient history in your case study.

With these thoughts in mind:

By Day 3

Post a description of the case you selected. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient from the case you selected. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmadynamic processes of the patients in their case studies. In addition, suggest how the personal care plan might change if the age of the patient were different and if the patient had a comorbid condition such as renal failure, heart failure, or liver failure.

Week 2 discussion

Discussion: Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient. As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives on a daily basis. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. In this Discussion, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

Scenario 1:

As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.

Scenario 2:

A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway.

Scenario 3:

You see another nurse practitioner writing a prescription for her husband who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident.

Scenario 4:

During your lunch break at the hospital, you read a journal article on pharmacoeconomics. You think of a couple of patients who have recently mentioned their financial difficulties. You wonder if some of the expensive drugs you have prescribed are sufficiently managing the patients’ health conditions and improving their quality of life.

To prepare:

Review Chapter 1 of the Arcangelo and Peterson text, as well as articles from the American Nurses Association, Anderson and Townsend, the Drug Enforcement Administration, and Philipsend and Soeken.

Select one of the four scenarios listed above.

Consider the ethical and legal implications of the scenario for all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family.

Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario.

With these thoughts in mind:

By Day 3

Post an explanation of the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family. Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different scenario than you did, in one or more of the following ways:

Suggest additional ethical and legal implications for all stakeholders in your colleagues’ scenarios.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Week 3 discussion

Discussion: Pharmacotherapy for Cardiovascular Disorders

As the leading cause of death in the United States for both men and women, cardiovascular disorders account for 7 million hospitalizations per year (NCSL, 2012). This is the result of the extensive treatment and care that is often required for patients with these disorders. While the incidences of hospitalizations and death are still high, the mortality rate of cardiovascular disorders has been declining since the 1960s (CDC, 2011). Improved treatment options have contributed to this decline, as well as more knowledge on patient risk factors. 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.

Consider the following case studies:

Case Study 1:

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:

Atenolol 12.5 mg daily

Doxazosin 8 mg daily

Hydralazine 10 mg qid

Sertraline 25 mg daily

Simvastatin 80 mg daily

Case Study 2:

Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following:

Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun

Aspirin 81 mg daily

Metformin 1000 mg po bid

Glyburide 10 mg bid

Atenolol 100 mg po daily

Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

Case Study 3:

Patient CB has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following:

Glipizide 10 mg po daily

HCTZ 25 mg daily

Atenolol 25 mg po daily

Hydralazine 25 mg qid

Simvastatin 80 mg daily

Verapamil 180 mg CD daily

To prepare:

Review this week’s media presentation on hypertension and hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson text.

Select one of the three case studies, as well as 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.

With these thoughts in mind:

By Day 3

Post an explanation of how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you selected. Then, describe how changes in the processes might impact the patient’s recommended drug therapy. Finally, explain how you might improve the patient’s drug therapy plan.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different case study than you did, in one or more of the following ways:

Provide alternative recommendations for drug treatments.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Week 4 discussion

Discussion: Pharmacotherapy for Respiratory Disorders

To the untrained ear, most coughs sound the same. However, as you might recall from past clinical experiences, a simple cough can lead to a patient diagnosis of a common cold, pneumonia, or even a chronic obstructive pulmonary disease (COPD). Although it can sometimes be challenging to diagnose a patient based on common respiratory symptoms such as congestion, coughing, and wheezing, it is important to be able to distinguish minor differences as even mild symptoms might require intervention with drug treatments. When recommending potential treatment options, advanced practice nurses must consider how individual patient factors might impact the effects of prescribed drugs.

To prepare:

Review Chapter 26 and Chapter 27 of the Arcangelo and Peterson text.

Select and research one of the following respiratory disorders: the common cold, pneumonia, or a chronic obstructive pulmonary disease (COPD) such as emphysema or chronic bronchitis. Consider types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.

Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the respiratory disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different respiratory disorder than you did. If the disorder you selected is primarily associated with the upper respiratory system, respond to colleagues who selected disorders primarily associated with the lower respiratory system. Provide alternative recommendations for drug treatments.

Week 5 discussion

Discussion: Pharmacotherapy for Cardiovascular Disorders

Neurological disorders, such as headaches, seizure disorders, sleep disorders, depression, and dementia can present several complications for patients of all ages. These disorders affect patients physically and emotionally, impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders may have drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to manage the diagnosis, treatment, and education of patients with neurological disorders.

To prepare:

Review this week’s media presentation on pharmacology for the nervous system.

Select one of the following neurological disorders: headaches, seizure disorders, sleep disorders, depression, or dementia. Consider the types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.

Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the neurological disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different neurological disorder than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.

Week 6 discussion

Discussion: Pharmacotherapy for Endocrine and Musculoskeletal Disorders

Patients with endocrine and musculoskeletal disorders often require long-term treatment and care resulting in the need for extensive patient education. By appropriately educating patients, advanced practice nurses can assist patients with the management of their disorders. In clinical settings, patients with endocrine and musculoskeletal disorders typically seek treatment for symptoms that pose problems to their everyday lives as ordinary tasks may become difficult to complete. For instance, patients might have difficulty walking short distances, preparing meals, or even running errands. To reduce these symptoms and additional health risks, it is essential to develop drug therapy plans with individual patient factors in mind.

To prepare:

Select one of the following endocrine or musculoskeletal disorders: thyroid disease, osteoarthritis, rheumatic arthritis, gout, multiple sclerosis, or fibromyalgia. Consider the types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.

Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the endocrine or musculoskeletal disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different endocrine or musculoskeletal disorder than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.

Week 7 discussion

Discussion: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

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 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 Discussion, 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.

Consider the following case study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

To prepare:

Review this week’s media presentation on pharmacology for the gastrointestinal system.

Review the provided case study. 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.

With these thoughts in mind:

By Day 3

Post an explanation of your diagnosis for the patient including your rationale for the diagnosis. Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who diagnosed the patient differently than you did, in one or more of the following ways:

Provide alternative recommendations for drug treatments.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Week 8 discussion

Discussion: Drug Treatments for HIV/AIDS

While HIV/AIDS is still currently incurable, the prognosis for patients with this infectious disease has improved due to advancements in drug treatments. Consider the case of Kristy Aney. Kristy was diagnosed with HIV in 1992 and was told she would survive, at most, 10 more years. Despite unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis, she has witnessed tremendous improvements in HIV/AIDS treatments which have helped patients live longer with fewer side effects. While she acknowledges that these drug treatments have kept her alive, she fears that improvements in drug therapy have led to more people becoming complacent about the disease (Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in the United States is higher than it has ever been (CDC, 2012). This poses the question: Is there a relationship between drug advancements, societal complacency, and infection?

To prepare:

Review Chapter 49 of the Arcangelo and Peterson text, as well as the Krummenacher et al. and Scourfield articles in the Learning Resources.

Reflect on whether or not the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options for HIV/AIDS.

Consider how health care professionals can help to change perceptions and make people more aware of the realities of the disease.

Think about strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

With these thoughts in mind:

By Day 3

Post an explanation of whether or not you think the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options.Then, explain how health care professionals can help to change perceptions and increase awareness of the realities of the disease. Finally, describe strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who provided a different rationale than you did, in one or more of the following ways:

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Week 9 discussion

Discussion: Pharmacotherapy for Hematologic Disorders

In the 1970s, the average lifespan for patients diagnosed with sickle cell disease was 14 years. Today, the average lifespan has increased to 50 years and beyond (TriHealth, 2012). The patient prognosis for many other hematologic disorders such as hemophilia and cancer continue to improve as well. This can be attributed to advancements in medical care—specifically drug therapy and treatment. When managing drug therapies for patients, it is essential to continuously examine current treatments and evaluate the impact of patient factors on drug effectiveness. To prepare for your role as an advanced practice nurse, you must become familiar with common drug treatments for various hematologic disorders seen in clinical settings.

To prepare:

Select one of the following hematologic disorders: anemia, hemophilia, cancer, sickle cell anemia, thalassemia, thrombolytic disorders, or white blood cell disorders. Consider the types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.

Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the hematologic disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different hematologic disorder than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.

Week 10 discussion

Discussion: Hormone Replacement Therapy

In recent years, hormone replacement therapy has become a controversial issue. When prescribing therapies, advanced practice nurses must weigh the strengths and limitations of the prescribed supplemental hormones. If advanced practice nurses determine that the limitations outweigh the strengths, then they might suggest alternative treatment options such as herbs or other natural remedies, changes in diet, and increase in exercise.

Consider the following scenario:

As an advanced practice nurse at a community health clinic, you often treat female (and sometimes male patients) with hormone deficiencies. One of your patients requests that you prescribe supplemental hormones. This poses the questions: How will you determine what kind of treatment to suggest? What patient factors should you consider? Are supplemental hormones the best option for the patient, or would they benefit from alternative treatments?

To prepare:

Review Chapter 56 of the Arcangelo and Peterson text, as well as the Holloway and Makinen and Huhtaniemi articles in the Learning Resources.

Review the provided scenario and reflect on whether or not you would support hormone replacement therapy.

Locate and review additional articles about research on hormone replacement therapy for women and/or men. Consider the strengths and limitations of hormone replacement therapy.

Based on your research of the strengths and limitations, again reflect on whether or not you would support hormone replacement therapy.

Consider whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies.

With these thoughts in mind:

By Day 3

Post a description of the strengths and limitations of hormone replacement therapy. Based on these strengths and limitations, explain why you would or why you would not support hormone replacement therapy. Explain whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies and why.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who provided a different rationale than you did, in one or more of the following ways:

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Week 11 discussion

Discussion: Off-Label Drug Use in Pediatrics

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable since very few drugs have been specifically researched and tested with children.

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion. Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

To prepare:

Review the Bazzano et al. and Mayhew articles in the Learning Resources. Reflect on situations in which children should be prescribed drugs for off-label use.

Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

With these thoughts in mind:

By Day 3

Post an explanation of circumstances under which children should be prescribed drugs for off-label use. Then, describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who provided a different rationale than you did, in one or more of the following ways:

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Week 2 assignment

The Ethics and Legalities of Medication Error Disclosure

American writer Nikki Giovanni once said: “Mistakes are a fact of life. It is the response to the error that counts” (Goodreads, 2012). Whenever you make an error when writing a prescription, you must consider the ethical and legal implications of your error—no matter how seemingly insignificant it might be. You may fear the possible consequences and feel pressured not to disclose the error. Regardless, you need to consider the potential implications of non-disclosure. How you respond to the prescription error will affect you, the patient, and the health care facility where you practice. In this Assignment, you examine ethical and legal implications of disclosure and nondisclosure of personal error.

Consider the following scenario:

You are working as an advanced practice nurse at a community health clinic. You make an error when prescribing a drug to a patient. You do not think the patient would know that you made the error, and it certainly was not intentional.

To prepare:

Consider the ethical implications of disclosure and nondisclosure.

Research federal and state laws for advanced practice nurses. Reflect on the legal implications of disclosure and nondisclosure for you and the health clinic.

Consider what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error.

Review the Institute for Safe Medication Practices website in the Learning Resources. Consider the process of writing prescriptions. Think about strategies to avoid medication errors.

By Day 7

Write a 2- to 3- page paper that addresses the following:

Explain the ethical and legal implications of disclosure and nondisclosure. Be sure to reference laws specific to your state.

Describe what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error. Provide your rationale.

Explain the process of writing prescriptions including strategies to minimize medication errors.

Week 4 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 symptoms. 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. 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:

Consider 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.

Review Chapter 25 of the Arcangelo and Peterson text. Reflect on using the stepwise approach to asthma treatment and management.

Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

By Day 7

Write a 2- to 3- page paper that addresses the following:

Describe long-term control and quick relief treatment options for asthma patients, as well as the impact these drugs might have on patients.

Explain the stepwise approach to asthma treatment and management.

Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

Week 6 assignment

Diabetes and Drug Treatments

Diabetes is an endocrine system disorder that affects millions of children and adults (ADA, 2011). 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. In this Assignment, you compare types of diabetes including drug treatments for type 1, type 2, gestational, and juvenile diabetes.

To prepare:

Review this week’s media presentation on the endocrine system and diabetes, as well as Chapter 46 of the Arcangelo and Peterson text and the Peterson et al. article in the Learning Resources.

Reflect on differences between types of diabetes including type 1, type 2, gestational, and juvenile diabetes.

Select one type of diabetes.

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 7

Write a 2- to 3- page paper that addresses the following:

Explain the differences between 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. Include dietary considerations related to treatment.

Explain the short-term and long-term impact of this diabetes on patients including effects of drugs treatments.

Week 8 assignment

Antimicrobial Agents

Antimicrobial agents are essential components in the treatment of various bacterial infections as they help to kill or prevent the growth of microbes such as bacteria, fungi, and protozoans. Prior to the discovery of antimicrobial agents, treatment options for patients with bacterial infections were limited. For many patients, treatment often resulted in the amputation of limbs or even death. Today, treatment options for bacterial infections typically have a more positive prognosis. Due to the various types of infections presented in patients, it is essential to be able to identify the underlying cause of the infection—whether bacterial or viral—before recommending drug treatments. This will help you identify whether or not an antimicrobial agent would be appropriate and which specific agent would target the infection. In this Assignment, you consider the appropriate use of antimicrobial agents for infections.

To prepare:

Review this week’s media presentation on principles of antimicrobial therapy, as well as Chapter 8 of the Arcangelo and Peterson text.

Consider the categories of antimicrobial agents.

Think about differences between viral and bacterial infections.

Reflect on why proper identification of the infection is key to selecting the proper antimicrobial agent.

By Day 7

Write a 2- to 3- page paper that addresses the following:

Describe the categories of antimicrobial agents.

Describe differences between viral and bacterial infections.

Explain why proper identification of viral and bacterial infections is key to selecting the proper antimicrobial agent.

Week 10 assignment

Cancer and Women’s and Men’s Health

The American Cancer Society estimates that by the end of 2012, more than 226,000 women will be diagnosed with breast cancer and more than 241,000 men will be diagnosed with prostate cancer (American Cancer Society, 2012a; American Cancer Society 2012b). With such prevalence of women’s and men’s cancers, patient education and preventive services are essential. In clinical settings, advanced practice nurses must assist physicians in educating patients on risk factors, preventive services, and for patients diagnosed with cancer, on potential drug treatments. The clinical implications of women’s and men’s cancer greatly depend on early detection, which is primarily achieved through preventive services. In this Assignment, you consider the short-term and long-term implications of cancer and drug treatments associated with women’s and men’s health, as well as appropriate preventive services.

To prepare:

Select a type of cancer associated with women’s or men’s health such as breast, cervical, or ovarian cancer in women and prostate cancer in men.

Locate and review articles examining the type of cancer you selected.

Review the U.S. Preventive Services Task Force article in the Learning Resources. Think about available preventive services that providers might recommend for patients at risk of this type of cancer.

Select two of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how these factors might impact decisions related to preventive services.

Consider drug treatment options for patients diagnosed with the type of cancer you selected including short-term and long-term implications of the treatments.

By Day 7

Write a 2- to 3- page paper that addresses the following:

Describe available preventive services that providers might recommend for patients at risk of the type of cancer you selected.

Explain how the factors you selected might impact decisions related to preventive services.

Describe drug treatment options for patients diagnosed with the type of cancer you selected. Explain the short-term and long-term implications of these treatments.

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Week 1 quiz

Question 1

A patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note the

Question 2

A nurse is caring for a postsurgical patient who has small tortuous veins and had a difficult IV insertion. The patient is now receiving IV medications on a regular basis. What is the best nursing intervention to minimize the adverse effects of this drug therapy?

Question 3

A nurse who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.)

Question 4

In response to a patient’s nausea, the nurse has mixed a dose of an antiemetic with 50 mL of sterile normal saline and will administer the dose by IV piggyback. What is the rationale for the use of IV piggyback?

Question 5

A home health nurse notes that there have been changes to a patient’s oral drug regimen. The nurse will closely monitor the new drug regimen to

Week 2 quiz

Question 1

A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive

Question 2

A nurse is caring for a 46-year-old patient of Chinese origin who has bipolar disorder. The physician has prescribed lithium carbonate (Eskalith) to treat the disorder. The nurse is aware that the lithium dose will likely be given in a

Question 3

A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a

Question 4

A nurse is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured her hip. How should the woman’s nurse best exemplify cultural competence in the care of this patient?

Question 5

A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states

Week 3 quiz

Question 1

A nurse is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the nurse assess before beginning drug therapy?

Question 2

A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin?

Question 3

A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention?

Question 4

A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?

Question 5

A nurse is caring for a patient who is admitted into the cardiac care unit with acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When preparing for administration of the drug, the nurse will

Week 4 quiz

Question 1

A patient is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which of the following statements will the nurse include when providing patient education concerning this drug?

Question 2

After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient?

Question 3

A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient?

Question 4

A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following?

Question 5

Children age 6 to 11 are recommended to start with what dosage of Allegra?

Week 5 quiz

Question 1

Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency?

Question 2

A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by

Question 3

An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman’s pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient’s pain?

Question 4

A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome?

Question 5

A nurse will be prepared to administer naloxone (Narcan) to a patient who has had an overdose of morphine. Repeated doses of Narcan will be necessary because Narcan

Week 6 quiz

Question 1

A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?

Question 2

A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?

Question 3

A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?

Question 4

A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention?

Question 5

A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically?

Week 7 quiz

Question 1

A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse?

Question 2

A patient is taking cholestyramine. The nurse will assess for which of the following common adverse effects of the drug?

Question 3

A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the patient to

Question 4

A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is

Question 5

A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the nurse take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?

Week 8 quiz

Question 1

A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take

Question 2

A patient has been prescribed daptomycin for a complicated skin infection. Which of the following will the nurse advise the patient to report immediately?

Question 3

Which of the following is critical to helping prevent development of resistant strains of microbes in patients?

Question 4

A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug?

Question 5

An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with

Week 9 quiz

Question 1

Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse’s response to Mr. Lepp?

Question 2

A nurse is discussing oprelvekin therapy with a male patient. Which of the following will the nurse tell the patient is the most common adverse effect of the drug?

Question 3

A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patient’s drug regimen. What patient education should the nurse provide to this patient?

Question 4

A patient with non-Hodgkin’s lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient’s care, what nursing diagnosis should the nurse prioritize?

Question 5

An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?

Week 10 quiz

Question 1 A patient is being discharged from the hospital and will be taking oxybutynin (Ditropan) for overactive bladder. The nurse will instruct the patient that she will be taking a medication

Question 2 A nurse is working in a women’s hospital where she is caring for a new mother who is experiencing postpartum urinary retention. Bethanechol (Urecholine) has been ordered. The nurse will observe for which of the following?

Question 3 A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?

Question 4 A nurse is performing patient education for a woman who has just been prescribed a bisphosphonate. Which of the following diagnostic and history findings would have prompted the woman’s care provider to prescribe a bisphosphonate?

Question 5 A nurse is providing patient education to a 50-year-old woman who is taking methotrexate (MTX) for breast cancer. The nurse will instruct the patient to avoid which of the following drugs?

Week 11 quiz

Question 1

A nurse working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using

Question 2

A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the

Question 3

A 2-year-old child is diagnosed with a minor ailment and is to be administered medications at home for 2 weeks. The child lives with his mother, grandmother, and four other children between the ages of 14 months and 7 years. The home health nurse is asked to assess the home environment to determine if it is appropriate for the child to take his medication at home. Which of the following will have the greatest impact on the nurse’s assessment?

Question 4

A 19-year-old patient reports to a clinic with vaginal discharge with a foul odor. A microscopic exam reveals trichomonas vaginalis. The nurse practitioner is aware that

Question 5

A 29-year-old woman who is morbidly obese has recently begun a comprehensive, medically-supervised program of weight reduction. Prior to adding dextroamphetamine (Dexedrine) to her regimen, the patient should be questioned about her intake of

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