NURS 6521 Weekly Discussions and Assignment Papers

Week 1: Basic Pharmacotherapeutic Concepts/Ethical and Legal Aspects of Prescribing

How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow?

Questions like these are related to the underlying pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics. As an advanced practice nurse, understanding these fundamental pharmacotherapeutic concepts is important to ensure that the prescription drugs you recommend for your patients will be safe and effective to treat and/or manage their symptoms. Additionally, as the advanced practice nurse, it is your responsibility to ensure that when prescribing prescription drugs, you adhere to the ethical and legal principles set forth for prescribing drugs as an added layer of protection and safety for the patients you will treat. NURS 6521 Weekly Discussions and Assignment Papers

This week, you will analyze factors that may influence pharmacokinetic and pharmacodynamics processes of a patient and assess the details of a personalized plan of care that you develop based on influencing factors and patient history. You will also evaluate and analyze ethical and legal implications and practices related to pre scribing drugs, including disclosure and nondisclosure, and analyze the process of writing prescriptions to avoid medication errors. NURS 6521 Weekly Discussions and Assignment Papers

Learning Objectives

Students will:

• Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients
• Assess patient factors and history to develop personalized plans of care
• Evaluate ethical and legal implications related to prescribing drugs
• Analyze ethical and legal practices of prescribing drugs
• Analyze strategies to address disclosure and nondisclosure
• Justify advanced practice nurse strategies to guide prescription drug decision-making
• Analyze the process of writing prescriptions to avoid medication errors

Learning Resources

Required Readings

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2^nd ed.) St. Louis, MO: Elsevier.

• Chapter 1, “Prescriptive Authority” (pp. 1–3) NURS 6521 Weekly Discussions and Assignment Papers
• Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
• Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
• Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
• Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
• Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767

American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

This website details key aspects of drug registration.

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator. NURS 6521 Weekly Discussions and Assignment Papers

Required Media

Introduction to Advanced Pharmacology

Meet Dr. Terry Buttaro, associate professor of practice at Simmons College of Nursing and Health Sciences as she discusses the importance of pharmacology for the advanced practice nurse. (8m)

Discussion: Pharmacokinetics and Pharmacodynamics

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic 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.

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare

• Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
• Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
• 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.

By Day 3 of Week 1

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples. NURS 6521 Weekly Discussions and Assignment Papers

By Day 6 of Week 1

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 pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NURS 6521 Weekly Discussions and Assignment Papers

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion

Sample Discussion

Patient Case: Opioids and Addiction

          Every day, roughly 128 persons in the United States die as a result of an opioid overdose (NIH, 2020). This suggests that between 21 and 29 percent of patients who use opioids for chronic pain are abusing them (NIH, 2020). In 2018, I looked after a woman in her thirties. I spent some time getting to know this woman because I had to care for her for several days. Her stories about her drug addiction and how embarrassed she was to have put her family through what she did were widely circulated. She said that she never intended to get addicted and that she began taking opioids to relieve pain from a vehicle accident.

Pharmacokinetics and Pharmacodynamics

            Methadone is widely used for the treatment of opioid dependence. When speaking of pharmacokinetics, methadone is a liposoluble drug (Neto & Garcia, 2015). It is a synthetic long-lasting opioid (Neto & Garcia, 2015). When administered orally, this medication has a fast and almost complete absorption (Neto & Garcia, 2015). Therefore, it can be detected in the plasma thirty minutes after oral dosage it completed (Neto & Garcia, 2015). The half-life of methadone is approximately 24 hours and it contains 80-90% plasma binding (Neto & Garcia, 2015). This is especially helpful when it comes to addicts because it is less susceptible to tolerance than other drugs (Neto & Garcia, 2015). Methadone is metabolized by the liver and excreted by the kidneys (Neto & Garcia, 2015). Therefore, the weight of the patient could be an influencing factor on pharmacokinetics. NURS 6521 Weekly Discussions and Assignment Papers

            When speaking of pharmacodynamics, Methadone is considered an opioid-agonist (Neto & Garcia, 2015). Its pharmacodynamic properties include analgesia, respiratory depression, dependence, and even tolerance (Neto & Garcia, 2015). However, studies have shown that this opioid is less sensitive to tolerance since it was not altered after exposure to morphine (Neto & Garcia, 2015). In addition to this, Methadone promote strong serotonin and norepinephrine uptake in the central nervous system (Neto & Garcia, 2015). Considering the combination of these properties, this makes methadone a useful tool to manage pain, tolerance, and addiction to opioids (Neto & Garcia, 2015). The processes of pharmacodynamics in this situation can be influenced by the other drugs that the patient was using prior to Methadone and other drugs she is taking along with Methadone. However, Methadone is a cross-tolerance opioid, which means it blocks the effects of other opioids (CAMH, 2018).

Personalized Plan of Care

            Since Methadone is an opioid and will need to be prescribed long term, frequent and ongoing management would be needed for this patient. The patient would need to either be present in the clinic or available for a telehealth conference at least once a week. Twice a month, the patient would need to be present in the clinic for an appointment. These appointments would be important to make sure the patient is taking the methadone and has the correct dosage prescribed. When methadone reaches a sufficient level in the blood, it will alleviate the patient’s cravings, suppress opioid withdrawal symptoms, reduce the euphoric effects of other opioids, and would not induce sedation (CAMH, 2018). Other medications that the patient is prescribed would be updated at each appointment along with health history to reduce the influence on pharmacodynamic and pharmacokinetic processes. The patient would also be expected to attend therapy sessions along with PCP follow ups to get the prescription of methadone refilled.NURS 6521 Weekly Discussions and Assignment Papers

Conclusion

            Methadone can be a great tool to treat those who are struggling with addiction to opioids. This can be addiction to heroin or opioid prescription pills such and oxycodone. Methadone has a very high plasma binding percentage and half-life. This means the medication can build in the body to create a stabilized environment that suppresses withdrawal symptoms, reduces cravings, and reduces the euphoric effects of other opioids (CAMH, 2018). However, a personalized patient plan would need to be created and continually modified to fit each patient in order for the treatment to be successful. NURS 6521 Weekly Discussions and Assignment Papers

References

• Canadian Mental Health and Addiction Network (2018). Overview of methadone maintenance treatment. Portico. Retrieved from https://www.porticonetwork.ca/web/knowledgex-archive/amh-specialists/overview-mmt
• National Institute of Drug Abuse (2020). Opioid overdose crisis. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
• Neto, J., & Garcia, M. (2015) Revisiting methadone: Pharmacokinetics, pharmacodynamics, and clinical indication. DOI: 10.5935/1806-0013.20150012

Assignment: Ethical and Legal Implications of Prescribing Drugs

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. 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. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

• Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor for this Assignment.
• Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
• Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and 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, including whether you would disclose any medication errors. NURS 6521 Weekly Discussions and Assignment Papers

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following: NURS 6521 Weekly Discussions and Assignment Papers

• Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
• Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
• Explain the process of writing prescriptions, including strategies to minimize medication errors.

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-20293632). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
• Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 1

To participate in this Assignment:

Week 1 Assignment

NURS 6521 Weekly Discussions and Assignment Papers Week 2: Cardiovascular System

Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options.

This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs. NURS 6521 Weekly Discussions and Assignment Papers

Learning Objectives

Students will:

• Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes
• Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies
• Evaluate drug therapy plans for cardiovascular disorders

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

• Chapter 34, “Review of Hemodynamics” (pp. 335–340)
• Chapter 35, “Diuretics” (pp. 341–349)
• Chapter 36, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 351–362)
• Chapter 37, “Calcium Channel Blockers” (pp. 363–369)
• Chapter 38, “Vasodilators” (pp. 371–373)
• Chapter 39, “Drugs for Hypertension” (pp. 375–388)
• Chapter 40, “Drugs for Heart Failure” (pp. 389–402)
• Chapter 41, “Antidysrhythmic Drugs” (pp. 403–418)
• Chapter 42, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 419–439)
• Chapter 43, “Drugs for Angina Pectoris” (pp. 441–450)
• Chapter 44, “Anticoagulant and Antiplatelet Drugs” (pp. 451–472)

Required Media (click to expand/reduce)

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)

Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript NURS 6521 Weekly Discussions and Assignment Papers

Assignment: 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.

Photo Credit: Getty Images/Science Photo Library RF

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. NURS 6521 Weekly Discussions and Assignment Papers

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-20293632). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
• Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 2 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 2 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 2

To participate in this Assignment:

Week 2 Assignment

NURS 6521 Weekly Discussions and Assignment Papers Week 8: Pharmacology for Psychological Disorders

How does an advanced practice nurse determine the best treatment option or pharmacotherapeutic to recommend for patients with psychological disorders?

Much like assessing or recommending pharmacotherapeutics for other conditions or disorders, as an advanced practice nurse, you may encounter a patient who presents with a psychological disorder. Understanding the guiding principles related to treating patients with psychological disorders as well as the effects of pharmacotherapeutics on a patient’s overall health and well-being is critical for the safe and effective delivery of care.

This week, you examine types of drugs prescribed to patients with psychological disorders. You also examine potential impacts of pharmacotherapeutics used to treat psychological disorders on a patient’s pathophysiology. NURS 6521 Weekly Discussions and Assignment Papers

Learning Objectives

Students will:

• Evaluate patients for treatment of psychological disorders
• Analyze decisions made throughout the diagnosis and treatment of patients with psychological disorders
• Analyze impacts of pharmacotherapeutics for psychological disorders on patient pathophysiology
• Evaluate patients for treatment of neurological and musculoskeletal disorders
• Analyze decisions made throughout the diagnosis and treatment of patients with neurological and musculoskeletal disorders
• Justify decisions made throughout the diagnosis and treatment of patients with neurological and musculoskeletal disorders. NURS 6521 Weekly Discussions and Assignment Papers

Learning Resources

Required Readings (click to expand/reduce) NURS 6521 Weekly Discussions and Assignment Papers

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

• Chapter 24, “Antipsychotic Agents and Their Use in Schizophrenia” (pp. 231–246)
• Chapter 25, “Antidepressants” (pp. 247–265)
• Chapter 26, “Drugs for Bipolar Disorder” (pp. 267–274)
• Chapter 27, “Sedative-Hypnotic Drugs” (pp. 275–285)
• Chapter 28, “Management of Anxiety Disorders” (pp. 287–292)
• Chapter 29, “Central Nervous System Stimulants and Attention-Deficit/Hyperactivity Disorder” (pp. 293–299)

Required Media (click to expand/reduce) NURS 6521 Weekly Discussions and Assignment Papers

Laureate Education (Producer). (2019a). Adult geriatric depression [Interactive media file]. Baltimore, MD: Author.

In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat adult geriatric depression.

Laureate Education (Producer). (2019c). Attention deficit hyperactivity disorder [Interactive media file]. Baltimore, MD: Author.

In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat attention deficit hyperactivity disorder.

Laureate Education (Producer). (2019d). Bipolar therapy [Interactive media file]. Baltimore, MD: Author.

In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics for bipolar therapy.

Laureate Education (Producer). (2019g). Generalized anxiety disorder [Interactive media file]. Baltimore, MD: Author.

In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat generalized anxiety disorder.

Discussion: Decision Making When Treating Psychological Disorders

For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology.

To Prepare

• Review this week’s interactive media pieces and select one to focus on for this Discussion.
• Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology. NURS 6521 Weekly Discussions and Assignment Papers

By Day 3 of Week 8

Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.

By Day 6 of Week 8

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NURS 6521 Weekly Discussions and Assignment Papers

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 of Week 8 and Respond by Day 6 of Week 8

To Participate in this Discussion:

Week 8 Discussion

Assignment: Decision Tree for Neurological and Musculoskeletal

ORDER NOW FOR CUSTOMIZED AND ORIGINAL NURSING PAPERS

By Day 7 of Week 8

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.
• Click the Week 8 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 8 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission. NURS 6521 Weekly Discussions and Assignment Papers

Grading Criteria

To access your rubric:

Week 8 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity: NURS 6521 Weekly Discussions and Assignment Papers

Submit your Week 8 Assignment draft and review the origina lity report.

Submit Your Assignment by Day 7 of Week 8

To participate in this Assignment: NURS 6521 Weekly Discussions and Assignment Papers

Week 8 Assignment

NURS 6521 Weekly Discussions and Assignment Papers Week 9: Women’s and Men’s Health/Infections and Hematologic Systems, Part I

As an advanced practice nurse, you will likely encounter many disorders associated with women’s and men’s health, such as hormone deficiencies, cancers, and other functional and structural abnormalities. Disorders such as these not only result in physiological consequences but also psychological consequences, such as embarrassment, guilt, or profound disappointment for patients. For these reasons, the provider-patient relationship must be carefully managed. During evaluations, patients must feel comfortable answering questions so that you, as a key health-care provider, will be able to diagnose and recommend appropriate treatment options. Advanced practice nurses must be able to educate patients on these disorders and help relieve associated stigmas and concerns. NURS 6521 Weekly Discussions and Assignment Papers

This week, you examine women’s and men’s health concerns as well as the types of drugs used to treat disorders that affect women’s and men’s health. You also explore how to treat aspects of these disorders on other health systems. NURS 6521 Weekly Discussions and Assignment Papers

Learning Objectives

Students will:

• Evaluate patients for treatment of complex health issues
• Evaluate patients for treatment of infections
• Evaluate patients for treatment of hematologic disorders
• Analyze patient education strategies for the management and treatment of complex comorbidities

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advacned practice providers. St. Louis, MO: Elsevier.

• Chapter 44, “Anticoagulant and Antiplatelet Drugs” (pp. 451–472)
• Chapter 45, “Drugs for Deficiency Anemias” (pp. 473–483)
• Chapter 48, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 521–533)
• Chapter 49, “Birth Control” (pp. 535–547)
• Chapter 50, “Androgens” (pp. 549–556) NURS 6521 Weekly Discussions and Assignment Papers
• Chapter 51, “Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia” (pp. 557–569)
• Chapter 68, “Basic Principles of Antimicrobial Therapy” (pp. 769–781)
• Chapter 69, “Drugs That Weaken the Bacterial Cell Wall I: Penicillins” (pp. 783–790)
• Chapter 73, “Sulfonamides and Trimethoprim” (pp. 619–826)
• Chapter 74, “Drug Therapy of Urinary Tract Infections” (pp. 827–831)
• Chapter 75, “Antimycobacterial Agents” (pp. 833–847)
• Chapter 76, “Miscellaneous Antibacterial Drugs” (pp. 849–853)
• Chapter 77, “Antifungal Agents” (pp. 855–866)
• Chapter 78, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 867–886)
• Chapter 80, “Drug Therapy of Sexually Transmitted Diseases” (pp. 905–911)

Lunenfeld, B., Mskhalaya, G., Zitzmann, M., Arver, S., Kalinchenko, S., Tishova, Y., & Morgentaler, A. (2015). Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male, 18(1), 5–15. doi:10.3109/13685538.2015.1004049

This article presents recommendations on the diagnosis, treatment, and monitoring of hypogonadism in men. Reflect on the concepts presented and consider how this might impact your role as an advanced practice nurse in treating men’s health disorders.

Montaner, J. S. G., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., … Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS ONE, 9(2), e87872. Retrieved from https://doi.org/10.1371/journal.pone.0087872

This study examines HAART therapy and its sustainability and profound population-level decrease in morbidity, mortality, and HIV transmission. NURS 6521 Weekly Discussions and Assignment Papers

Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53–58. .https://doi.org/10.1016/j.maturitas.2016.01.007 NURS 6521 Weekly Discussions and Assignment Papers

This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition.

Agency for Healthcare Research and Quality. (2014). Guide to clinical preventive services, 2014: Section 2. Recommendations for adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, and counseling. NURS 6521 Weekly Discussions and Assignment Papers

Required Media (click to expand/reduce)

Laureate Education (Producer). (2019h). Pathopharmacology: Pharmacology and immunological disorders: Improvements in medications and drug administration [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 8 minutes.
Nurse Manager, Bette Nunn discusses how technology has improved the practice of administering drugs and created new and improved drug therapies. The importance of using technology as well as a patient’s knowledge of their own drug history is also discussed.

Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

To Prepare

• Review the Resources for this module and reflect on the different health needs and body systems presented.
• Your Instructor will assign you a complex case study to focus on for this Discussion. NURS 6521 Weekly Discussions and Assignment Papers
• Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.

By Day 3 of Week 9

Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples. NURS 6521 Weekly Discussions and Assignment Papers

You will respond to your colleagues’ posts in Week 10.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NURS 6521 Weekly Discussions and Assignment Papers

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 9 Discussion Rubric

Post by Day 3 of Week 9 and Respond by Day 6 of Week 10

To Participate in this Discussion:

Week 9 Discussion

NURS 6521 Weekly Discussions and Assignment Papers Week 10: Women’s and Men’s Health/Infections and Hematologic Systems, Part II

Bacterial and viral infections may spread through the direct contact of bodily fluids such as blood or through vectors, who help to spread infections via the blood. When you think of infections and the hematologic system, what comes to mind? NURS 6521 Weekly Discussions and Assignment Papers

Infectious diseases, such as malaria, dengue, or other hemorrhagic fevers are some examples of infections that impact the hematologic system. However, disorders of the hematologic system, such as anemia or blood clotting factor disorders, can also have a deleterious effect on a patient’s health and well-being. As an advanced practice nurse, you will need to understand the different types of pharmacotherapeutics used to treat infections and disorders of the hematologic system as you work to enhance patient-centered approaches for safe, quality, and effective care.

This week, you will examine infections and hematologic disorders, as well as the types of drugs used to treat aspects of these disorders or health systems.

Learning Objectives

Students will:

• Evaluate patients for treatment of complex health issues
• Evaluate patients for treatment of infections
• Evaluate patients for treatment of hematologic disorders
• Analyze patient education strategies for the management and treatment of complex comorbidities

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advacned practice providers. St. Louis, MO: Elsevier.

• Chapter 44, “Anticoagulant and Antiplatelet Drugs” (pp. 451–472)
• Chapter 45, “Drugs for Deficiency Anemias” (pp. 473–483)
• Chapter 48, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 521–533)
• Chapter 49, “Birth Control” (pp. 535–547)
• Chapter 50, “Androgens” (pp. 549–556)
• Chapter 51, “Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia” (pp. 557–569)
• Chapter 68, “Basic Principles of Antimicrobial Therapy” (pp. 769–781)
• Chapter 69, “Drugs That Weaken the Bacterial Cell Wall I: Penicillins” (pp. 783–790)
• Chapter 73, “Sulfonamides and Trimethoprim” (pp. 619–826)
• Chapter 74, “Drug Therapy of Urinary Tract Infections” (pp. 827–831)
• Chapter 75, “Antimycobacterial Agents” (pp. 833–847)
• Chapter 76, “Miscellaneous Antibacterial Drugs” (pp. 849–853)
• Chapter 77, “Antifungal Agents” (pp. 855–866)
• Chapter 78, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 867–886)
• Chapter 80, “Drug Therapy of Sexually Transmitted Diseases” (pp. 905–911) NURS 6521 Weekly Discussions and Assignment Papers

Lunenfeld, B., Mskhalaya, G., Zitzmann, M., Arver, S., Kalinchenko, S., Tishova, Y., & Morgentaler, A. (2015). Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male, 18(1), 5–15. doi:10.3109/13685538.2015.1004049

This article presents recommendations on the diagnosis, treatment, and monitoring of hypogonadism in men. Reflect on the concepts presented and consider how this might impact your role as an advanced practice nurse in treating men’s health disorders. NURS 6521 Weekly Discussions and Assignment Papers

Montaner, J. S. G., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., … Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS ONE, 9(2), e87872. Retrieved from https://doi.org/10.1371/journal.pone.0087872

This study examines HAART therapy and its sustainability and profound population-level decrease in morbidity, mortality, and HIV transmission.

Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53–58. .https://doi.org/10.1016/j.maturitas.2016.01.007

This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition.

Agency for Healthcare Research and Quality. (2014). Guide to clinical preventive services, 2014: Section 2. Recommendations for adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, and counseling. NURS 6521 Weekly Discussions and Assignment Papers

Document: Final Exam Study Guide (PDF)

Required Media (click to expand/reduce)

Laureate Education (Producer). (2019h). Pathopharmacology: Pharmacology and immunological disorders: Improvements in medications and drug administration [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 8 minutes.
Nurse Manager, Bette Nunn discusses how technology has improved the practice of administering drugs and created new and improved drug therapies. The importance of using technology as well as a patient’s knowledge of their own drug history is also discussed.

Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

To Prepare

By Day 6 of Week 10

Read a selection of your colleagues’ responses from Week 9 and respond to at least two of your colleagues on two different days who were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

ORDER NOW FOR CUSTOMIZED AND ORIGINAL NURSING PAPERS

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 9 Discussion Rubric

Post by Day 3 of Week 9 and Respond by Day 6 of Week 10

To Participate in this Discussion:

Week 9 Discussion

Week 11: Pediatrics

Children, like adults, deal with variety of health issues, but they also have issues that are more prevalent within their population. One issue that significantly impacts children is the prescription of drugs for off-label use. As an advanced practice nurse, how do you determine the appropriate use of off-label drugs in pediatrics? Are there certain drugs that should be avoided with pediatric patients?

This week, you examine the practice of prescribing off-label drugs to children. You also explore strategies for making off-label drug use safer for children from infancy to adolescence, as it is essential that you are prepared to make drug-related decisions for pediatric patients in clinical settings. NURS 6521 Weekly Discussions and Assignment Papers

Learning Objectives

Students will:

• Evaluate the practice of prescribing off-label drugs to children
• Analyze strategies to make the off-label use of drugs safer for children
• Identify key terms, concepts, and principles related to prescribing drugs to treat patient disorders
• NURS 6521 Weekly Discussions and Assignment Papers

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

• Chapter 8, “Drug Therapy in Pediatric Patients” (pp. 65—67)

Corny, J., Lebel, D., Bailey, B., & Bussieres, J. (2015). Unlicensed and off-label drug use in children before and after pediatric governmental initiatives. The Journal of Pediatric Pharmacology and Therapeutics, 20(4), 316–328. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557722/ NURS 6521 Weekly Discussions and Assignment Papers

 

This article highlights pediatric governmental initiatives to prevent unlicensed and off-label drug use in children. Review these initiatives and guidelines and how they might impact your practice as an advanced practice nurse.

Panther, S. G., Knotts, A. M., Odom-Maryon, T., Daratha, K., Woo, T., & Klein, T. A. (2017). Off-label prescribing trends for ADHD medications in very young children. The Journal of Pediatric Pharmacology and Therapeutics, 22(6), 423–429. doi:10.5863/1551-6776-22.6.423 NURS 6521 Weekly Discussions and Assignment Papers

This study examines the frequency of off-label prescribing to children and explores factors that impact off-label prescribing. This study also examines off-label prescribing to children with ADHD.

Document: Final Exam Study Guide (PDF)

Required Media (click to expand/reduce)

Laureate Education (Producer). (2019i). Therapy for pediatric clients with mood disorders [Interactive media file]. Baltimore, MD: Author.

Assignment: Off-Label Drug Use in Pediatrics

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. NURS 6521 Weekly Discussions and Assignment Papers

To Prepare

• Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
• 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. NURS 6521 Weekly Discussions and Assignment Papers

By Day 5 of Week 11

Write a 1-page narrative in APA format that addresses the following: NURS 6521 Weekly Discussions and Assignment Papers

• Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
• 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.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.
• Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 11 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 11 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 11

To participate in this Assignment:

Week 11 Assignment

NURS 6521 Weekly Discussions and Assignment Papers Final Exam

By Day 7 of Week 11

Complete the Final Exam. You have 120 minutes to complete the exam. You may only attempt this exam once.

Submission and Grading Information NURS 6521 Weekly Discussions and Assignment Papers

Complete the Exam by Day 7 of Week 11

To Complete this Exam: