NURS 6521: Advanced Pharmacology Entire Course

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NURS 6521: Advanced Pharmacology Entire Course Discussions And Assignments

NURS 6521 Entire Course Weekly Discussions And Assignments

NURS 6521 Week 1: Basic Pharmacotherapeutic Concepts

In 2011, more than 3.7 billion drug prescriptions were filled at pharmacies in the United States (The Kaiser Family Foundation, 2011). With billions of drugs prescribed each year for the treatment and management of various disorders, it is essential for advanced practice nurses to familiarize themselves with common drug treatments and effects of these treatments on patients. When prescribing drugs, ensuring patient safety is the major concern. In many clinical settings, nurses work more closely with patients than any other health care provider, making it their responsibility to assist physicians with this task. As an advanced practice nurse maintaining patient safety, you must consider the many patient factors that impact pharmacotherapeutics.

This week you explore factors that influence pharmacokinetic and pharmacodynamic processes in patients. You also examine patient factors that advanced practice nurses must consider when developing drug therapy plans.

Learning Objectives

By the end of this week, students will:

  • Analyze factors that influence pharmacokinetic and pharmacodynamics processes in patients
  • Assess patient factors and history to develop personalized plans of care
  • Understand and apply key terms, concepts, and principles related to pharmacotherapeutics
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat geriatric patients

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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 Weitzel et al (2014) 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.

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NURS 6521 Week 2: Ethical and Legal Aspects of Prescribing

Responsibilities are given to him on whom trust rests. Responsibility is always a sign of trust.
—James Cash Penney

Nurses have been rated the most trusted professionals in the United States (CDC, 2012). With this trust comes a critical responsibility to maintain ethical and legal practices in order to preserve patient safety when treating patients and prescribing drugs. Since the scope of practice for advanced practice nurses is broadening, you will likely encounter new and complex ethical challenges in your clinical settings.

This week, you explore ethical and legal implications of prescribing drugs including disclosure, nondisclosure, and prescriptive authority. You also examine the process of writing prescriptions to avoid prescription drug errors.

Learning Objectives

By the end of this week, students will:

  • Evaluate ethical and legal implications related to prescribing drugs
  • Analyze ethical and legal practices of prescribing drugs
  • Evaluate ethical and legal implications of disclosure and nondisclosure
  • Analyze the process of writing prescriptions to avoid medication errors
  • Understand and apply key terms, concepts, and principles related to ethical and legal aspects of prescribing

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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, Ladd and Hoyt (2016), the Drug Enforcement Administration, and Sabatino et al (2017).
  • 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.

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: Advanced Pharmacology Entire Course

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.

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NURS 6521 Week 3: 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. Consider hypertension. An estimated 68 million people in the United States have this disorder (CDC, 2012). However, about 30 percent of these patients are not treated at all, and of those who are treated, less than 50 percent have properly controlled blood pressure levels (University of Maryland Medical Center, 2009). In clinical settings, patients often present with symptoms of hypertension and other 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 changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for these disorders.

Learning Objectives

By the end of this week, students will:

  • Evaluate the influence of patient factors on pharmacokinetic and pharmacodynamics processes
  • Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy
  • Evaluate drug therapy plans for cardiovascular disorders
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat cardiovascular disorders

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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.

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NURS 6521 Week 4: Respiratory System

In the United States, 12 million people suffer from chronic obstructive pulmonary disease (National Heart Lung and Blood Institute, n.d.), and about 25 million people suffer from asthma (CDC, 2011). Since various symptoms are associated with chronic obstructive pulmonary disease, asthma, and other common respiratory disorders, a single patient might be prescribed multiple drugs for treatment. Consider an 8-year-old asthmatic patient who frequently presents with acute asthma exacerbations that are triggered by seasonal allergies. As a result of his disorder, he might be prescribed albuterol to treat asthma attacks and Clarinex to treat allergic reactions. This requires you, as the advanced practice nurse, to be aware of risks of polypharmacy and patient factors that impact the effects of drugs.

This week you examine types of drugs prescribed to patients with respiratory disorders, as well as the impact of patient factors on the effects of drugs. You also explore ways to improve patient treatment plans including suggested drug therapies. Finally, you examine asthma treatment and management.

Learning Objectives

By the end of this week, students will:

  • Analyze types of drugs prescribed to treat respiratory disorders
  • Evaluate the impact of patient factors on the effects of prescribed drugs for respiratory disorders
  • Evaluate drug therapy plans for respiratory disorders
  • Assess the impact of asthma treatments on patients
  • Analyze the stepwise approach to asthma treatment and management
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat respiratory disorders

NURS 6521: Advanced Pharmacology Entire Course

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.

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NURS 6521 Week 5: Neurological System

According to an article published in the Los Angeles Times, drug misuse is the leading cause of accidental death in the United States. Some of the most common drugs found in association with drug-related deaths are drugs prescribed to treat neurological disorders. These prescription drug-related deaths are often attributed to painkillers such as OxyContin and Vicodin, as well anti-anxiety drugs such as Valium and Xanax (Girion, Glover, & Smith, 2011). This issue emphasizes the importance of the regulation and management of prescription drugs. You must be aware of this when prescribing controlled drugs commonly used to treat neurological disorders such as headaches, sleep disorders, anxiety, and depression. As an advanced practice nurse, you have the responsibility to carefully diagnose and prescribe treatment, as well as to closely monitor the effects of drug therapies on the physical and mental health of your patients.

In the previous weeks of this course, you began to explore disorders and treatments as they relate to specific body systems. This week, you continue this exploration with the nervous system, but with special considerations in mind. Treatments for nervous system disorders present unique issues not just because of the scope and breadth of the disorders, but also because the types of drugs that are often used for treatment. You examine types of drugs prescribed to treat neurological disorders, as well as the impact of patient factors on the effects of the drugs.

Learning Objectives

By the end of this week, students will:

  • Analyze types of drugs prescribed to treat neurological disorders
  • Evaluate the impact of patient factors on the effects of prescribed drugs for neurological disorders
  • Evaluate drug therapy plans for neurological disorders
  • Analyze patient education strategies for treatment and management of neurological disorders
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat neurological 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.

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NURS 6521 Week 6: Endocrine and Musculoskeletal System

The endocrine and musculoskeletal systems play important roles in the regulation and coordination of activities throughout the body. When alterations of these systems occur, many patients require long-term drug therapies. In addition to drugs prescribed by their health care providers, patients with these disorders also often take herbal and dietary supplements. According to the American Diabetes Association, 22 percent of diabetic patients use herbal therapy and 31 percent use dietary supplements (American Diabetes Association, 2009). This may impact the effects of prescribed drugs, as well as pose a concern of adverse drug reactions in patients. When treating patients with endocrine and musculoskeletal disorders, it is important to educate patients on associated risks. As an advanced practice nurse prescribing drugs, you must carefully consider all drug, herbal, and dietary therapies prior to finalizing treatment plans.

This week you examine types of drugs prescribed to patients with endocrine and musculoskeletal disorders, as well as the impact of patient factors on the effects of drugs. You also explore ways to improve patient treatment plans including suggested drug therapies. Finally, you examine types of diabetes and the impact of diabetes drugs on patients.

Learning Objectives

By the end of this week, students will:

  • Analyze types of drugs prescribed to treat endocrine and musculoskeletal disorders
  • Evaluate the impact of patient factors on the effects of prescribed drugs for endocrine and musculoskeletal disorders
  • Evaluate drug therapy plans to treat endocrine and musculoskeletal disorders
  • Analyze patient education strategies for treatment and management of endocrine and musculoskeletal disorders
  • Differentiate types of diabetes
  • Evaluate the impact of diabetes drugs on patients
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat 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

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.

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NURS 6521 Week 7: Gastrointestinal and Hepatobiliary System

Symptoms of various gastrointestinal (GI) and hepatobiliary disorders often overlap making diagnosis and treatment challenging. Consider the case of a 21-year-old female who is rushed to the hospital by her roommate. The patient is not conscious enough to describe her symptoms or medical history to the health care provider. However, the roommate is able to share that the patient has experienced abdominal pain for the past three days, as well as vomiting, constipation, and bloating. After unsuccessful attempts at contacting the patient’s family, the roommate decided to bring her in for care. At this point, medical history and currently prescribed drugs are unknown. However, this patient requires treatment for symptoms that could be the result of various underlying disorders. As an advanced practice nurse, you could potentially be responsible for this patient’s care. How would you proceed to care for this patient? What type of drug therapy would you recommend not knowing if she is currently taking other prescribed drugs? Are there certain drugs you should avoid in order to prevent a drug-drug interaction?

This week you examine diagnoses for patients with potential GI and hepatobiliary disorders. You also develop a drug therapy plan based on patient history and diagnosis.

Learning Objectives

By the end of this week, students will:

  • Assess patients with gastrointestinal and hepatobiliary disorders
  • Develop drug therapy plans based on patient history and diagnosis
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat 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.

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NURS 6521 Week 8: Infections

Prior to the H1N1 influenza pandemic in 2009, it had been more than 40 years since an infectious virus had resulted in such substantial illness, hospitalizations, and deaths on a global scale (CDC, 2010). This can be attributed to improved prevention such as proper hygiene, as well as vaccinations and other drug therapies. However, as the H1N1 pandemic illustrates, infections are sometimes unavoidable even when appropriate prevention methods are implemented. In clinical settings, patients present with various infections including common disorders such as flus and colds, as well as disorders that require more extensive treatment and care such as the human immunodeficiency virus (HIV) or tuberculosis (TB). As an advanced practice nurse, you must evaluate patients presenting with symptoms of infections and recommend appropriate drug treatments.

This week you begin to explore infections by considering issues surrounding the prevalence, management, and education about HIV/AIDS. You also examine viral and bacterial infections, as well as the appropriate use of antimicrobial agents.

Learning Objectives

By the end of this week, students will:

  • Analyze reasons for the prevalence of HIV/AIDS
  • Analyze ways health care professionals can change society’s perceptions of HIV/AIDS
  • Analyze strategies to educate HIV positive patients on treatment and management
  • Analyze categories of antimicrobial agents
  • Differentiate between viral and bacterial infections
  • Analyze the relationship between infections and antimicrobial agents
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat infections and infestations

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 Montaner et al (2014) 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.

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NURS 6521 Week 9: Hematologic System

Once properly diagnosed, many hematologic disorders are very manageable with the appropriate treatment plan (Cancer Institute of Florida, n.d.). As an advanced practice nurse, it will be your responsibility to diagnose, treat, and/or recognize when to refer patients with these disorders. Many patients, however, struggle with diagnoses related to hematologic disorders that require extensive treatment and long-term care such as cancer or hemophilia prompting them to seek second opinions or alternative care. In your role as advanced practice nurse, you must be able to ease these concerns by answering patient questions about the disorders, related drug therapies, and effects of drug therapies based on individual patient factors.

This week you examine drugs prescribed to treat hematologic disorders, as well as the impact of patient factors on the effects of the drugs. You also explore ways to improve patient treatment plans including suggested drug therapies.

Learning Objectives

By the end of this week, students will:

  • Analyze types of drugs prescribed to treat hematologic disorders
  • Evaluate the impact of patient factors on the effects of prescribed drugs for disorders of the hematologic system
  • Evaluate drug therapy plans to treat disorders of the hematologic system
  • Analyze patient education strategies for treatment and management of hematologic disorders
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat 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.

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NURS 6521 Week 10: Women’s and Men’s Health

Breast cancer is not just a disease that strikes at women. It strikes at the very heart of who we are as women: how others perceive us, how we perceive ourselves, how we live, work, and raise our families—or whether we do these things at all.

–Debbie Wasserman Schultz

This sentiment that Schultz expressed is true for 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.

This week, as you examine women’s and men’s health issues, you focus on treatments for hormone deficiencies and cancer. You also explore preventive services for women’s and men’s health.

Learning Objectives

By the end of this week, students will:

  • Evaluate the strengths and limitations of hormone replacement therapy
  • Evaluate treatments for hormone deficiencies
  • Analyze preventive services for women’s and men’s health
  • Analyze drug treatments for cancer patients
  • Evaluate implications of cancer drug treatments on patients
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat disorders associated with women’s and men’s health

NURS 6521: Advanced Pharmacology Entire Course

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 Roberts and Hickey (2016), Lunenfeld et al (2015), and Makinen and Huhtaniemi (2011) 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.

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NURS 6521 Week 11: Pediatrics

Children deal with variety of health issues similar to adults, 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. Consider the case of Rebecca Riley. When she was two years old, Riley was diagnosed with ADHD, and by age three, she was diagnosed with bipolar disorder. In the span of two years, Riley’s doctor prescribed four drugs off-label: Clonidine, Depakote, Zyprexa, and Seroquel. Riley’s doctor also approved 13 increases in drug dosages. Then, at age four, Riley died from pneumonia combined with a toxic level of prescription drugs (Lambert, 2010). Cases such as this have brought attention to the off-label use of drugs in pediatric patients, as well as the importance of monitoring patient reactions to prescribed drugs and evaluating the effects of drug-drug interactions. 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.

Learning Objectives

By the end of this week, 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
  • Understand and apply key terms, concepts, and principles related to prescribing drugs to treat pediatric patients

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 Panther et al (2017) and Corney, Lebel, Bailey, and Bussieres (2015) 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.

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