NU636 Advanced Pharmacology
Unit 1 Assignment
Case Study
Polypharmacy
Instructions
Case Study
Mrs. A is a
71 year old widow with CCF and osteoarthritis who has recently been exhibiting
quite unusual behavior. Her daughter is concerned about her mother's ability to
remain independent and wishes to pursue nursing home admission arrangements.
She fears the development of a dementing illness. Over the last two to three
months Mrs. A has become confused, easily fatigued and very irritable. She has
developed disturbing obsessive/compulsive behavior constantly complaining that
her lace curtains were dirty and required frequent washing. Detailed
questioning revealed that she thought they were yellow-green and possibly
moldy. Her prescribed medications are:
Furosemide
40 mg daily in the morning
Digoxin 250
micrograms daily
Paracetamol
500 mg, 1-2 tablets 4-hourly PRN
Piroxicam
20 mg at night
Mylanta
suspension, 20 ml PRN
Coloxyl 120
mg, 1-2 tablets at night
Assignment
Questions
Critically
discuss this case study in terms of the problematic nature of this patient's
pharmacological management.
Outline
some pharmacokinetic changes in the geriatric population that may affect drug
disposition.
Outline how
changes in renal and hepatic function may affect treatment strategies.
In the drug
regimen presented above – discuss potential side effects and potential
interactions, if any?
Your
response should include a discussion of the problems of polypharmacy as it is
related to this case study and the assessment/management and educational
strategies which could have been implemented to improve the outcome of Mrs. A.
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to the Submit Assignments/Assessments area:
NU636 Advanced Pharmacology
Unit 2 Assignment
Cardiac
Impact
Instructions
Health Interview Survey (NHIS) were findings
that 38% of adults use CAM [complementary and alternative medical] health care
modalities.
Construct a
professional paper that outlines how the use of the following CAM health care
modalities impacts the cardiovascular system.
Ginseng
Hawthorn
L-Arginine
St. John’s
Wort
For each of
the modalities the discussion must include:
effect on
the cardiovascular system
anticipated
benefits
any
identified risks or adverse effects
relative
patient education
supporting
reference from scholarly literature.
Instructions
Prepare and
submit a minimum of a 6 page paper pages [excluding title and reference pages].
Format
consistent with APA style without an abstract page.
Answer all
the questions above.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to this assignment area:
NU636 Advanced Pharmacology
Unit 3 Assignment
Case Study
Diuretics
Instructions
A 70 year
old man with a history of myocardial infarction presents to the ER with
shortness of breath and chest pain. Over the past 2 weeks he has developed
increasing dyspnea with exertion and swelling in the limbs. Over the past 3
days he has found the need to elevate his head while sleeping to reduce the
incidence of coughing and shortness of breath. At the moment he uses 4 pillows.
In the ER
while sitting upright he seems to be in respiratory distress and is tachycardic
with a blood pressure of 195/112. JVD is predominant. Upon auscultation of the
lungs rales are heard bilaterally and he has pitting edema of both lower legs
up to his knees.
Chest x-ray
confirms pulmonary edema and he is immediately place on oxygen.
He is
currently on hydrochlorothiazide, metoprolol and enalapril.
Assignment
Questions
What would
be the anticipated diagnosis for a patient with the clinical presentation in the
case above? Correlate the symptoms noted with the pathophysiology of the
condition you identified.
What
pharmacologic agent would be anticipated as the first management step for this
patient and why?
Explore and
describe any potential interactions of the anticipated pharmacologic agent and
the patient’s existing pharmacologic management.
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to this assignment area:
NU636 Advanced Pharmacology
Unit 3 Assignment
Case Study
Antiarrhythmic
Instructions
Case Study
A 70 year
old male patient develops a large anterior wall myocardial infarction. He is
currently being managed with oxygen, aspirin, nitrates and a beta blocker.
He develops
recurrent episodes of ventricular tachycardia and remains conscious however has
dizzy spells and also becomes diaphoretic and hypotensive. An IV bolus of
lidocaine is given followed by IV lidocaine infusion.
Assignment
Questions
Which class
of antiarrhythmics does lidocaine fall under?
What is the
mechanism of action of lidocaine?
Why is
lidocaine indicated in this patient
What are
the side effects of lidocaine?
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to this assignment area:
NU636 Advanced Pharmacology
Unit 4 Assignment
Case Study
Gastrointestinal
A 60 year
old woman with a 10 year history of Type II diabetes presents with multiple
complications including retinopathy, peripheral neuropathy and declining renal
function.
She has not
had the urge to eat as of recently she feels “full” after a few bites. The
incidence of nausea and feeling bloated occurs at least twice a day and even
after a glass of water she feels bloated. She also complains of fatigue and not
been able to keep up with daily chores.
A
radiographic gastric emptying study shows a prolonged gastric emptying time.
Assignment
Questions
What is the
typical diagnosis for a patient who presents with this clinical picture?
What is the
likely pathophysiologic process responsible for the presenting symptom? Support
your response with a credible source.
What is the
class of the drug used to treat the pathophysiolog?. Discuss the pharmacologic
management plan for this patient.
Outline the
mechanism of action and any possible contraindications of the pharmacologic
management plan that you identified for the patient.
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to this assignment area:
NU636 Advanced Pharmacology
Unit 4 Assignment
Case Study:
Hyperlipidemia
A 70 year old
hypertensive and diabetic male is taking an ACE inhibitor and a thiazide for
his hypertension.
For his
type II diabetes he is taking metformin.
Both his
hypertension and blood glucose are within normal range.
Routine
blood work reveals normal renal function and liver enzymes. His total
cholesterol and low density lipoprotein (LDL) is elevated.
To reduce
the risk of coronary artery disease he is commenced on a HMG-CoA reductase
inhibitor.
Assignment
Questions
What drugs
fall under a HMG-CoA reductase inhibitor.
What is the
mechanism of action of this drug.
What effect
will this drug have on total LDL and cholesterol levels.
What are
the common adverse effects and drug interactions?
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to this assignment area:
NU636 Advanced Pharmacology
Unit 5 Assignment
Case Study
Acute Joint Inflammation
Mr. Y is a
47 year old, mixed race [Asian/African ethnicity], male patient who presented
to your office with severe right great toe pain. Onset of the pain was 2 days
ago. Mr. Y denies any known trauma to his right foot or his great toe on that
foot. His right great toe is red and became so swollen in the last day that he
cannot put on his shoe.
Mr. Y has a
history of hypertension for which he is taking HCTZ 25mg daily, Metopralol 50
mg twice daily, and Lisinopril 10 mg daily. He denies any other medical
problems.
Results of
the lab tests that were ordered:
Sed rate –
93; Glucose, random – 117 mg/dl; Hgb - 13.4 gm/dl; WBC – 8200/ccm with normal
diff; Serum uric acid – 10.9 mg/dl; Serum creatinine – 1.2 mg/dl
Assignment
Questions
Based on
presenting symptoms and lab findings, what is most likely diagnosis that will
be made for Mr. Y?
What is the
anticipated pharmacologic plan for managing Mr. Y’s acute pain? Provide a
justification for the plan including a citation from a peer-reviewed source.
What is the
anticipated pharmacologic plan for long-term management of Mr. Y’s diagnosis?
Provide a justification for the plan including a citation from a peer-reviewed
source.
Identify
the key elements of the education plan that would be appropriate for the
patient about the acute and chronic pharmacologic plans you identified above.
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to this assignment area:
NU636 Advanced Pharmacology
Unit 5 Assignment
Case Study:
Rheumatoid Arthritis
Case Study
A 50 year
old woman has had rheumatoid arthritis for 3 years and has been taking multiple
NSAID’s. She has taken corticosteroids a few times during flare ups.
The disease
seems to be progressing with stiffness and swelling in her hands and wrists.
Examination reveals rheumatoid nodules, synovitis of both wrists and
metacarpo-phalangeal joints. This is an indication of an acute exacerbation of
rheumatoid arthritis. She is prescribed methotrexate with sulfasalazine and a
short course of prednisone.
Assignment
Questions
What is the
mechanism of action of prednisone?
What is the
concern with chronic treatment with glucocorticoids?
What is the
mechanism of action of methotrexate and sulfasalazine.
What are
the side effects of methotrexate and sulfasalazine
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to the Submit Assignments/Assessments area:
NU636 Advanced Pharmacology
Unit 6 Assignment
Antibiotic
Stewardship
CDC
Antibiotic Stewardship Initiative Discussion Paper
Construct a
professional paper that outlines the advanced practice role – as a nurse
educator, a nurse leader, or a nurse practitioner – to advance the CDC’s antibiotic
resistance initiative.
Assignment
Requirements
Introduction
that identifies your advanced practice role and your view of how that role will
be able to impact the antibiotic resistance dilemma. Support your discussion
with at least two references from the literature.
Review the
CDC’s goals and identify one of the CDC’s key strategies that you will be able
to promote/support in your advanced practice role. Support your discussion with
at least two references from the literature.
Discuss
three activities/actions that you will develop to support the promotion of the
key strategy that you identified in item 2 above. Each action/activity needs to
be well designed and supported with at least one reference from the literature.
For example, if you are a:
nurse
educator student – in what course(s) will you be able to promote your
identified key strategies, be specific about what that would look like using
example lesson plan(s), identify any active learning strategies you will
utilize, etc., and provide justification for your strategies, etc.
nurse
leader student – what program(s) and activities will you engage with relative
to your organization, be that existing programs or creation of new programs,
reporting mechanisms, development of collaborative committees, etc., and
provide justification for your strategies, etc.
nurse
practitioner student – what prescribing practices, patient education practices,
monitoring programs, etc., will you engage with, and provide justification for
your strategies, etc.
Instructions
Prepare and
submit a minimum of a 6 page paper pages [excluding title and reference pages].
Format
consistent with APA style without an abstract page.
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to this assignment area:
NU636 Advanced Pharmacology
Unit 6 Assignment
Case Study:
HIV
Linda is a
28-year-old female in a discordant relationship with her boyfriend of 1 year.
Linda is 12 weeks pregnant based on her last menstrual period. She is engaged
in HIV-care and is naïve to antiretroviral therapy (ART) because her CD4 cell
count is 538 per mm3 and viral load is 8,300. No tobacco, alcohol, or illegal
or illicit drug use.
Physical
examination: Normal, healthy 28-year-old gravid female. She is overweight with
a body mass index of 28.2.
Laboratory
and other tests: Genotype is pan-sensitive without HIV mutations. Ultrasound at
her 2-day follow-up estimates she is 15 weeks pregnant.
Assignment
Questions
What are
the Public Health Service Panel on Antiretroviral Guidelines for Adults and
Adolescents guidelines for HIV-positive pregnant females regarding starting
ART? What antiretroviral medications are recommended as first line? Which drugs
should be avoided? Provide a rationale for all answers.
What
education does Linda need regarding her medication?
Are there
any risks to the baby during labor?
What should
be done for the baby at birth if he/she tests positive for HIV? What will the
providers need to do in terms of monitoring the baby?
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all the
questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to the Submit Assignments/Assessments area:
NU636 Advanced Pharmacology
Unit 7 Assignment
Case Study Breast
Cancer
Mrs. V is a
47 year old white female who noted a lump near the lower, outer edge of her
right breast. After undergoing work up, Mrs. V. was diagnosed with breast
cancer. She underwent a right mastectomy without surgical reconstruction.
The
pathology report relative to the patient’s tumor revealed the tumor was
estrogen receptor positive.
Assignment
Questions
What
chemotherapeutic agent would be anticipated for this patient’s treatment plan?
Support your discussion with a reference from a scholarly source.
Discuss the
mechanism of action for the anticipated chemotherapeutic agent. Support your
discussion with a reference from a scholarly source.
Discuss
what the anticipated side effects of the chemotherapeutic agent are. Support
your discussion with a reference from a scholarly source.
Anticipating
the potential side effects of the treatment plan, what are the key elements to
include in the patient education plan? Support your discussion with a reference
from a scholarly source.
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to the Submit Assignments/Assessments area:
NU636 Advanced Pharmacology
Unit 8 Assignment
Case Study:
Antidepressants Assignment and Discussion Response
A 40 year
old woman presents with fatigue. She reports feeling ‘very run down’ for the
past three months. She has no interest in participating in her usual activities
and sporting events. She reports sleeping problems and low appetite. She is
constantly feeling low and has frequent crying spells.
Her
physical examination is normal and thyroid function is normal.
She is
diagnosed with major depression and is referred for counseling and started on
fluoxetine.
Assignment
Questions
What is the
mechanism of action of fluoxetine?
Why is
fluoxetine the drug of choice?
What are
the side effects of fluoxetine? (include both the side effects and the
potential adverse effects of excessive doses of SSRIs.)
What are
the risks of abruptly discontinuing fluoxetine?
Instructions
Prepare and
submit a 3-4 page paper [total] in length (not including APA format).
Answer all
the questions above.
Support
your position with examples.
Please
review the rubric to ensure that your assignment meets criteria.
Submit the
following documents to this assignment area:
