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NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
NURS6521 Week 2 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. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
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
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. NURS6521 Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
- 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
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Week 2 Assignment Rubric
Check Your Assignment Draft for Authenticity
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Submit your Week 2 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 2
NURS 6521 Week 2 Assignment Sample Approach Submitted by a Student
Pharmacotherapy for Cardiovascular Disorders
Case Study Details: 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 12.5mg daily
Doxazosin 8mg daily
Hydralazine 10mg QID
Sertraline 25mg daily
Simvastatin 80mg daily
Provide an explanation of how the factor you selected may influence the pharmacokinetic and pharmacodynamic process in the patient from the case study provided.
Patient Factor – Obesity
Obesity is a risk factor which can directly impact both hypertension and hyperlipidemia, as well as increasing the risk of diabetes, and impacting the potential of successful treatment of various cardiovascular disorders (Arcangelo & Peterson, 2013). Focusing attention on the behavioral factors that impact the patient’s obesity, can help to ensure that one has a higher chance of success as the other conditions are treated.
Two factors identified in this patient that can impact the pharmacokinetics for this patient are both poor nutrition, and reduced blood circulation (Arcangelo & Peterson, 2013). Assumptions can be made surrounding the poor nutrition component as this is related to documented cases of obesity. Obesity also results in limited physical activity, which impacts circulation levels seen in the patient. Hypertension is accompanied by vasoconstriction, and the potential for plaque build-up because of hyperlipidemia (CDC, 2020).
An assessment of these risk factors, as well as their impact on the effectiveness to prescribed medication regimen is an essential component to the proper assessment and subsequent treatment of the patient. With an assessment and consideration of the risk factor related to obesity it would be most beneficial to suggest that patient focus on modification of diet and activity/exercise behaviors. One such adjustment that could result in successful change is the use of the DASH diet plan (Arcangelo & Peterson, 2013). This would help to minimize pharmacokinetics impacts seen in this patient.
Drug Therapy Plan
Upon review of the patient’s medications there are several areas of improvement available in the drug therapy plan. First, and most important is consideration that beta-blockers have been shown to directly contribute to the development of hyperlipidemia (Arcangelo & Peterson, 2013). Even though beta-blockers are most used as the first line of defense in treatment of hypertension, with the additional concerns involving hyperlipidemia the Atenolol should be discontinued.
With this change in discontinuing Atenolol, the Hydralazine should also be discontinued since most often this is only prescribed when patient is prescribed a beta-blocker and diuretic in their drug therapy plan (Arcangelo & Peterson, 2013). With these changes it would be beneficial to prescribe a dose of 12.5mg Hydrochlorothiazide daily as a starting point in the treatment of hypertension through the use of stand along diuretic.
Hydrochlorothiazide is safe for use in patients who have diagnosed diabetes and have been linked to its ability to reduce heart disease and stroke mortality rates (Arcangelo & Peterson, 2013). The obesity levels of the patient indicate a higher risk of diabetes so this approach takes a more proactive method assuming that diabetes is a risk factor that may soon be documented in this patient (National Institute…, 2018). Simvastatin based on the information provided is an appropriate treatment for hyperlipidemia. While cholesterol levels were not provided in the scenario information this first line of defense against this condition appears to be appropriate.
Conclusion
Assessment of factors which can impact the pharmacokinetics in patients drug therapy plan is essential to finding the most effective and efficient way in which one can find success in the treatment of patients. For many these factors can often be simple to address and yet the impact is great. Drug therapy opens numerous methods in which to treat certain conditions but factors that impact that success must also be addressed to see highest level of success. It is important to note as well that these factors must often be reassessed as changes occur. This allows for one to often eliminate drugs from regimen and focus on drug free treatment plans.
References
Arcangelo, V.P., & Peterson, A.M., 2013. Pharmacotherapeutics for advanced practice: A practical approach (3rd Edition). Ambler, P.A.: Lippincott Williams & Wilkins
Centers for Disease Control and Prevention. (2020, April 11). The health effects of overweight and obesity. https://www.cdc.gov/healthyweight/effects/index.html
National Institute of Diabetes and Digestive and Kidney Diseases. (2018, February 28). Health risks of overweight & obesity. https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity/health-risks
Module 2: Cardiovascular and Respiratory Systems
MODULE 2: AT A GLANCE
CARDIOVASCULAR AND RESPIRATORY SYSTEMS
WEEK 2
WEEK 3
WHAT’S HAPPENING THIS MODULE?
Module 2: Cardiovascular and Respiratory Systems is a 2-week module, Weeks 2 and 3 of the course. In this module, you will examine how patient factors may influence pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics used in the treatment of cardiovascular and respiratory disorders. You will also explore and suggest drug therapy plans for asthma and analyze the stepwise approach for asthma treatment and management.
INTRODUCTION
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.
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
PHARMACOTHERAPY FOR CARDIOVASCULAR DISORDERS
…heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…
—Murphy et al., 2018
Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.
As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To Prepare
- Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
- Review the case study assigned by your Instructor for this Assignment.
- Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
- Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
- Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
- Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
BY DAY 7 OF WEEK 2
Write a 2- to 3-page paper that addresses the following:
- Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
- Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
- Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632Links to an external site.). All papers submitted must use this formatting.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
- To submit your completed assignment, save your Assignment as WK2Assgn_LastName_Firstinitial
- Then, click on Start Assignmentnear the top of the page.
- Next, click on Upload Fileand select Submit Assignment for review.
NURS_6521_Week2_Assignment_Rubric
| NURS_6521_Week2_Assignment_Rubric | ||||||
| Criteria | Ratings | Pts | ||||
| This criterion is linked to a Learning OutcomeExplain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. |
|
25 pts | ||||
| This criterion is linked to a Learning OutcomeDescribe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. |
|
30 pts | ||||
| This criterion is linked to a Learning OutcomeExplain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements. |
|
30 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. |
|
5 pts | ||||
| Total Points: 100 | ||||||
LEARNING RESOURCES
- Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants(2nd ed.) St. Louis, MO: Elsevier.
- Chapter 33, “Review of Hemodynamics” (pp. 285–289)
- Chapter 37, “Diuretics” (pp. 290–296)
- Chapter 38, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 297–307)
- Chapter 39, “Calcium Channel Blockers” (pp. 308–312)
- Chapter 40, “Vasodilators” (pp. 313–317)
- Chapter 41, “Drugs for Hypertension” (pp. 316–324)
- Chapter 42, “Drugs for Heart Failure” (pp. 325–336)
- Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348)
- Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 349–363)
- Chapter 45, “Drugs for Angina Pectoris” (pp. 364–371)
- Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388)
Cardiovascular Disorders
- Meet Dr. Norbert Myslinski as he discusses ACE inhibitors, angiotensin inhibitors, beta-blockers, calcium channel blockers, and diuretics as different categories of hypertension drugs. What potential drugs might be best recommended for patients suffering from hypertension? (8m)
- Walden University. (n.d.). Instructor feedbackLinks to an external site.. https://cdn-media.waldenu.edu/2dett4d/Walden/WWOW/1001/pulse_check/instructor_feedback/index.html#/
[Music] One of the missions of this course is to straddle the basic sciences and the clinical sciences. Many years ago, Sir William Osler said, “One cannot become a competent clinician “without the full knowledge of human physiology “and pathology. “Without it, one flounders along “in an aimless fashion, never able to gain “an accurate conception of disease, “practicing a sort of popgun pharmacy, “hitting now the malady and again the patient, he himself not knowing which.”
This week, Dr. Norbert Myslinski examines how categories of drugs working through different mechanisms can provide a synergistic effect creating more treatment options. So often in hospitals and the doctors’ offices and also in medical schools and nursing schools and dental schools, here is this dichotomy between the two. I mean, you first learn
the basic sciences, then you forget about those
and you go to the clinics, I think you learn
the real stuff, but we want to do
with this course is to produce a bridge between the two. And make the understanding
of the clinical portions more relevant by knowing
the basic science– knowing the basic science
that we have. Another way in which groups
are important is synergism. In pharmacology,
we have a concept where the effect
of two different drugs is greater than the sum
of the individual drugs and which is very important
when you combine different drugs and especially when you have
groups of drugs or categories that work via
different mechanisms of action. You may have a same end result
of different categories of drugs, but they work
via different mechanisms. And if you do that,
you’re more likely to get a synergistic effect
than if they all worked via the same mechanism. Some drugs work
via same mechanism no matter what
their effects are, okay? For instance, aspirin. Aspirin has many effects,
all right? Aspirin is an analgesic
that alleviates pain. Aspirin is anti-inflammatory,
alleviates inflammation. Aspirin is an anticoagulant
for the blood. Aspirin also is antipyretic. It decreases
body temperature, okay? But how does it do it? It has many effects. By the way, all drugs
have multiple effects. No drug only has one effect. All drugs have
more than one effect. But how does aspirin do
all these different effects? Via the same mechanism. And that’s
through the inhibition of a certain compound
in the body called prostaglandins. So inhibition of the synthesis
of prostaglandins produces all of them. Okay? There are many different types
of prostaglandins and therefore we have
different effects in there, Okay? So if we have
two different drugs, they work via the inhibition
of prostaglandins. Say, aspirin and Tylenol, right? They’re not going to have
a synergistic effect. They’ll have an additive effect,
right? But if you have, for instance,
a narcotic like morphine, okay? And then you also have Tylenol,
you can have a synergistic effect
with those two. Although with Tylenol
and aspirin, there is a ceiling. You can take
two or three tablets and that’s the maximum
pain relief you’re going to get. No matter if you take five
or 10 after that, you may have gastric distress,
but it’s more of an effect, it’s a ceiling. With morphine though
there is no ceiling. You just keep going,
going, going, you get more
and more pain relief, you know, until your respiration
shuts down and you die. So if we look at hypertension,
that silent killer. That’s one disorder
that we have a wealth of groups and categories of drugs working
via many different mechanisms. So we can have
a very nice synergistic effect. We can tailor-make
their pharmacotherapy, you know, so they can control
their blood pressure with the least amount
of side effects and they can function
in society. For example, you have
your ACE inhibitors, you have
your angiotensin inhibitors, you have your beta-blockers,
you have your calcium-channel blockers,
you have your diuretics, all of them can
reduce blood pressure, all of them work
via different mechanisms. There are two types
of blood vessels that go up, which is the carotids
and the vertebrals and then they go into
a little area here and distributed throughout
the brain and one of the most
common causes of disability that we have is stroke. Now, stroke is when you have
a deprivation of oxygen going to a part of the brain. And that’s usually
due to one of three things. Either there is a buildup
of a clot in that blood vessel, a primary site,
so the blood stops going to that area
or you have a clot that breaks off
from a different part of your body, more likely
from the left side of heart because you may have
atherosclerosis, build up of fatty tissues
and clots there and if one breaks off,
it can go into your brain and to clog a blood vessel,
that will be quick or you can have
a weak blood vessel wall so that it blows up
like a balloon, a balloon is aneurysm
and eventually it bursts and when it bursts
then you have a stroke in that part
of the area of brain. Now, the symptoms of a stroke
on many patients that nurses treat
for chronic time periods, the symptoms of a stroke
can be quite varied. You know, as many functions
that are functions of the brain depending upon
where the stroke is, depending upon
where the stroke is, okay? For instance, if it happens here
at the back of the brain, you’ll have a lot
of visual symptoms because this is where
the brain processes visual information,
occipital lobes. If you have one over here
in the temporal lobes, that process is hearing, okay? So you’d have
hearing problems, okay? If you have a stroke
that affects this part over here,
this is somatosensory cortex, you may have a problem
with the feeling, touch, and pressure
in different parts of your body. Over here is the motor cortex
and that has to do with movement. So you may have problems
with movement of your body. Okay, so it all depends upon
where that injury is and it’s very interesting
because when there is a stroke, the main part dies and then
the other parts around it shut down and unless
treatment is given quickly and drugs can be given that can
dissolve a clot real quickly, okay, the part
that sort of are not dead yet, but they are affected
around there if not treated quickly
then that part may also die. And so when you first
have a stroke your symptoms involve
not only the dead part, but also the part back here
sort of shut down, all right? If you’re treated quickly,
if you have the signs of a stroke you have
what we call a brain attack then you get right there
to the emergency center, you can dissolve the clot,
and then you can have reversal of some of the symptoms. Like dysfunction of all
these ones around, the dysfunctional ones can come
back and we can have reversal of the symptoms, but if you
don’t get the treatment, these will eventually die too
and the others– those symptoms will stay around
for a very long time. And so it all depends upon
where the dysfunction is and that determines
what kind of symptoms we have. Captioning performed by
Aegis Communications