hw21223456

Overview

ASSIGNMENT 1In Week 2, we will continue our pharmacology journey and apply the concepts to the cardiovascular system. Pharmacodynamics and pharmacokinetics are the two branches of pharmacology. Remember, pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion (ADME), 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 pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (ie diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease. ASSIGNMENT Directions: For each of the scenarios below, answer the questions using your required learning resources, Medscape, and clinical practice guidelines (ie AHA, ACC, ADA, GINA). When recommending medications, write out a complete prescription for each medication. What order would you send to a pharmacy? Include drug, dose, route, frequency, # dispensed (days supply), refills, special instructions etc. Also state if you would continue, discontinue or taper the patient’s current medications (if applicable). Use at least 3 sources for each scenario and cite sources using APA format. LIST REFERENCES AFTER EACH SCENARIO. SCENARIO 1 What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medication’s classification and mechanism of action (MOA)? · Repatha 140 mg IV every 2 weeks #1 1 RF · Hyzaar (losartan/hydrochlorothiazide) 50/25 mg PO daily #30 3 RF · digoxin 1.25 mg PO daily #30 1 RF · hydralazine/isosorbide mononitrate (BiDil) 37.5 mg/20 mg PO every 8 hours #90 1 RF · clonidine 0.3 mg patch PO once weekly #4 1 RF SCENARIO 2 A patient with stable angina is prescribed nitroglycerin. The provider avoids oral tablets and instead chooses a sublingual or transdermal formulation. Why is oral nitroglycerin not clinically useful? Discuss how first-pass metabolism affects nitroglycerin’s bioavailability and define both terms. Identify the route of administration with 100% bioavailability and explain how alternative routes overcome the first pass effect. Include a sample prescription for nitroglycerin. SCENARIO 3 Where are the majority of cytochrome P450 (CYP) enzymes located? Using the Drugs.com pill identifier, enter the following characteristics to identify the medication AND strength. What CYP enzyme metabolizes this medication? How can this information be applied to medication therapy management? Write a sample prescription for the identified medication and strength. Imprint (E 137) Shape (Round) Color (Pink) Form (Tablet) Scoring (None) SCENARIO 4 KU is a 47-year-old male following up on his labs that were drawn last week. He smokes 1 pack per day. He is currently on lisinopril 40 mg po daily, liraglutide (Victoza) 0.6 mg subcutaneously once daily and St. John’s Wort. Fasting lipid profile shows total cholesterol 260 mg/dL, LDL 180 mg/dL, HDL 43 mg/dL, and TG 185 mg/dL. He is 5’9” and weighs 204 lbs. What treatment plan would you implement for KU? What are GOAL Total Cholesterol (TC), HDL, LDL, and Triglyceride levels for KU? What is his BMI per Medscape calculator? What patient monitoring and education would you provide? How many risk factors for coronary artery disease does this patient have? Identify them specifically ASSIGNMENT 2 In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker. Do not include notes. You should cite your work on the slides with in-text citations and include the references at the end of the ppt on a reference slide. Remember you are to use APA 7th edition formatting even in this assignment. The Assignment:

• Explain the concept of a knowledge worker.
• Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.
• Include one slide that visually represents the role of a nurse leader as knowledge worker.
• Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.

*Hypothetical Scenario from Discussion Forum* Discussion question

• Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience? Response In my years of practicing as a nurse, I have noticed many patients that we term as “frequent flyers” whose readmission rate earns them that title. This is not always due to the fault of the patients but some gaps and limitations in care. To be able to address this issue, nurse leaders need to form a “follow-up committee” that incorporates an interdisciplinary care model to address issues that arise both during admission and after discharge, especially for patients with chronic conditions. Nurses are at the forefront of healthcare and sometimes spend more time with patients which leads to developing a better rapport with these patients. Patients are more likely to confide in their nurses when they trust them and, having a post-discharge or follow-up committee to report to will help address these issues faster and reduce hospital readmissions. This interdisciplinary team may include physicians, therapists, nurses, pharmacists, social workers, physical/occupational therapists, mental health professionals, dietitians, case managers and community health workers. Data may be collected by accessing patient records and assessing the rate of readmission for these patients, their demographics, reason for readmission and resources available to them after discharge. This information will help healthcare workers and nurse leaders recognize the gaps in care and where to target and allocate resources to ensure a smooth transition after a hospital admission. Interdisciplinary teams integrate their perspectives to create a coordinated, patient-centered plan. This will also help to know how to allocate resources to the specific needs of the patients to avoid wasting resources. Ko and Walston (2013), defined interdisciplinary care as “a patient-centered approach involving a collaborative team of healthcare professionals, including physicians, nurses, social workers, and therapists, aimed at managing symptoms and preventing complications in various settings”. Creating an interdisciplinary care team brings together physicians, therapists, nurses and other caregivers in a coordinated approach to the patient’s treatment which leads to improved efficiency and quality of care and minimizes the risk of miscommunication between all parties (Warren & Warren, 2023). Also, encouraging patients to take a proactive approach to health ensures greater satisfaction and improved outcomes. Being involved in their health and decision making concerning their care makes patients feel in control of their own health rather than taking a passive approach and having others make decisions for them. This increases the chance of adherence to care and medical regimen, ensuring the overall success of patient care. References Ko, F. C., & Walston, J. D. (2013). What Are the Special Needs of Patients With Frailty? Elsevier EBooks, 371–376. https://doi.org/10.1016/b978-1-4377-3796-7.00064-1 Warren, J., & Warren, J. (2023). The Case for Understanding Interdisciplinary Relationships in Health Care. Ochsner Journal, 23(2), 94–97. https://doi.org/10.31486/toj.22.0111