NURS 6521N Advanced Pharmacology Discussions and Assignment Papers

NURS 6521N Advanced Pharmacology Discussions and Assignment Papers

NURS 6521N Advanced Pharmacology Discussions and Assignment Papers

Week 2 Assignment

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. NURS 6521N Advanced Pharmacology Discussions and Assignment Papers.

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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.

Week 4 Assignment: Asthma and Stepwise Management

Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening symptoms. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To prepare:

Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients including adults and children.

Review Chapter 25 of the Arcangelo and Peterson text. Reflect on using the stepwise approach to asthma treatment and management.

Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

By Day 7

Write a 2- to 3- page paper that addresses the following:

Describe long-term control and quick relief treatment options for asthma patients, as well as the impact these drugs might have on patients.

Explain the stepwise approach to asthma treatment and management.

Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

Week 6 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. NURS 6521N Advanced Pharmacology Discussions and Assignment Papers

To prepare:

Review this week’s media presentation on the endocrine system and diabetes, as well as Chapter 45 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.

By Day 7

Write a 2- to 3- page paper that addresses the following:

Explain the differences between types of diabetes including type 1, type 2, gestational, and juvenile diabetes.

Describe one type of drug used to treat the type of diabetes you selected including proper preparation and administration of this drug. Include dietary considerations related to treatment.

Explain the short-term and long-term impact of this diabetes on patients including effects of drugs treatments.

Week 8 Assignment: Antimicrobial Agents

Antimicrobial agents are essential components in the treatment of various bacterial infections as they help to kill or prevent the growth of microbes such as bacteria, fungi, and protozoans. Prior to the discovery of antimicrobial agents, treatment options for patients with bacterial infections were limited. For many patients, treatment often resulted in the amputation of limbs or even death. Today, treatment options for bacterial infections typically have a more positive prognosis. Due to the various types of infections presented in patients, it is essential to be able to identify the underlying cause of the infection—whether bacterial or viral—before recommending drug treatments. This will help you identify whether or not an antimicrobial agent would be appropriate and which specific agent would target the infection. In this Assignment, you consider the appropriate use of antimicrobial agents for infections.

To prepare:

Review this week’s media presentation on principles of antimicrobial therapy, as well as Chapter 8 of the Arcangelo and Peterson text.

Consider the categories of antimicrobial agents.

Think about differences between viral and bacterial infections.

Reflect on why proper identification of the infection is key to selecting the proper antimicrobial agent.

By Day 7

Write a 2- to 3- page paper that addresses the following:

Describe the categories of antimicrobial agents.

Describe differences between viral and bacterial infections.

Explain why proper identification of viral and bacterial infections is key to selecting the proper antimicrobial agent. NURS 6521N Advanced Pharmacology Discussions and Assignment Papers

Week 10 Assignment: Cancer and Women’s and Men’s Health

The American Cancer Society estimates that by the end of 2012, more than 226,000 women will be diagnosed with breast cancer and more than 241,000 men will be diagnosed with prostate cancer (American Cancer Society, 2012a; American Cancer Society 2012b). With such prevalence of women’s and men’s cancers, patient education and preventive services are essential. In clinical settings, advanced practice nurses must assist physicians in educating patients on risk factors, preventive services, and for patients diagnosed with cancer, on potential drug treatments. The clinical implications of women’s and men’s cancer greatly depend on early detection, which is primarily achieved through preventive services. In this Assignment, you consider the short-term and long-term implications of cancer and drug treatments associated with women’s and men’s health, as well as appropriate preventive services.

To prepare:

Select a type of cancer associated with women’s or men’s health such as breast, cervical, or ovarian cancer in women and prostate cancer in men.

Locate and review articles examining the type of cancer you selected.

Review the U.S. Preventive Services Task Force article in the Learning Resources. Think about available preventive services that providers might recommend for patients at risk of this type of cancer.

Select two of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how these factors might impact decisions related to preventive services.

Consider drug treatment options for patients diagnosed with the type of cancer you selected including short-term and long-term implications of the treatments.

By Day 7

Write a 2- to 3- page paper that addresses the following:

Describe available preventive services that providers might recommend for patients at risk of the type of cancer you selected.

Explain how the factors you selected might impact decisions related to preventive services.

Describe drug treatment options for patients diagnosed with the type of cancer you selected. Explain the short-term and long-term implications of these treatments.

Case study 1 HH is a 68 yo M who was admitted with Community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3)and azithromycin 500mg IV qday(day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of n/v. Ht: 5\’8\” Wt: kg. Allergies: Penicillin(rash) Post a description of pt. health needs,be specific, explain type of treatment regimen you will recommend, include the choice or pharmacotherapeutics you will recommend and explain why, justify response. Explain a pt. education strategy you will recommend for assisting patient with management of his health. Be specific and provide examples….. NURS 6521 N Advanced Pharmacology Discussions and Assignments

Description

NURS 6521 Week 1 Quiz 1 – Question and Answers

In which of the following patients would a nurse expect to experience alterations in drug metabolism?
The nurse’s assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? NURS 6521 N Advanced Pharmacology Discussions and Assignments
A patient who has ongoing pain issues has been prescribed meperidine (Demerol) IM. How should the nurse best administer this medication?
A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient’s medication regimen. Which of the patient’s medications should prompt the nurse to teach her to avoid drinking grapefruit juice?
A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?
A home health nurse notes that there have been changes to a patient’s oral drug regimen. The nurse will closely monitor the new drug regimen to
5 ml = _______________tsp
A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the patient’s care, the nurse should consider a possible alteration in which of the following aspects of pharmacokinetics?
A patient has a blood serum drug level of 50 units/mL. The drug’s half-life is 1 hour. If concentrations above 25 units/mL are toxic and no more of the drug is given, how long will it take for the blood level to reach the nontoxic range?
A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient’s compromised renal function will likely
A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The nurse suspects that the change in the effectiveness of the drug is related to
A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction?
In order to promote therapeutic drug effects, the nurse should always encourage patients to
Talwin given in combination with Vistaril diminishes the adverse effects of nausea caused by the Talwin. This drug interaction affecting the pharmacodynamics of the Talwin is
An older adult patient with a history of Alzheimer’s disease and numerous chronic health problems has been ….several medications during his current admission to hospital and recent declines in the patient’s cognition have impaired his ability to swallow pills. Which of the following medications may the nurse crush before administering them to this patient?
A patient is ….with an antibiotic for an infection in his leg. After 2 days of taking the antibiotic, the patient calls the clinic and reports that he has a rash all over his body. The nurse is aware that a rash can be an adverse effect of an antibiotic and can be either a biologic, chemical, or physiologic action of the drug, which is an example of
A patient has been ….several drugs and fluids to be …intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note the
For which of the following patients would a nasogastric tube most likely be ….to aid in the administration of medications?
An elderly postsurgical patient has …..postoperative pneumonia in the days following abdominal surgery and is being ….with a number of medications. Which of the following medications that the nurse will administer has the slowest absorption?
An unconscious patient has been …..to the hospital, and the physician has ….a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication?
Which of the following statements best defines how a chemical becomes ….a drug?
A nurse is instructing a patient concerning a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety?
A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate?
During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives nurs 6521 week 1 quiz
The nurse is caring for a patient receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity?
A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 p.m. The nurse finds the patient drowsy and confused at 10 a.m. the next day. The nurse is aware that this behavior is most likely due to NURS 6521N Advanced Pharmacology Discussions and Assignment Papers
A 70-year-old man with diabetes mellitus is taking metoprolol (Lopressor) to manage his hypertension. The nurse would be sure to instruct the patient to
A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient’s daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that nurs 6521 week 1 quiz
A nurse is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term?
A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is nurs 6521 week 1 quiz
A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man’s most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man’s serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?
A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for
A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient’s subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been ….digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication?
A nurse who is working with an older adult patient who takes eight medications a day wants to promote medication adherence. Which of the following nursing interventions would best promote medication adherence?
Mr. Penny, age 67, was ….with chronic angina several months ago and has been unable to experience adequate relief of his symptoms. As a result, his physician has prescribed ranolazine (Ranexa). Which of the following statements is true regarding the use of ranolazine for the treatment of this patient’s angina?
A nurse who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the nurse should encourage them to nurs 6521 week 1 quiz
Medication reconciliation of an 82-year-old man who has recently moved to a long-term care facility reveals that the man takes 1 to 2 mg of lorazepam bid prn. The nurse should recognize what consequence of this aspect of the resident’s drug regimen? NURS 6521N Advanced Pharmacology Discussions and Assignment Papers
An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident’s medication regimen make create a risk for
Frequent episodes of exercise-…..chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient’s age will have what effect on her use of nitroglycerin?
An elderly man has been …..to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease?

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Legal and Ethical Implications of Closure and Disclosure

In general, writing errors during prescription may bring forth deviations or inconsistencies in the intended order by dispensing the incorrect drug, dosage form, dose, wrong quality or even inadequate or inadequate labeling. The error can adversely affect the health professional, his organization and the health of the patient. With that in mind, it is then essential to consider the implications of either disclosing or not disclosing the error. According to the Institute for Safe Medication Practices (2012), it is not only ethical but legal practice to always disclose prescription errors soonest possible as this will prompt the necessary actions thus avert further harm to the patient.

The Arizona Pharmacy Association, (2013) clearly outlines the need to observe not only the ethical but the legal concerns pertaining dispensing of medications to patients. Accordingly, the state demands that the medicines dispensing professionals has to be well trained and, while carrying out their duties, they have to be extra careful so as to achieve the highest attainable percentage of accuracy. If anything goes wrong in the course of their dispensing duties, they are required to disclose immediately failure to which the association or any other individuals can file a lawsuit against the misdemeanor (Legal Information Institute, 2017). NURS 6521N Advanced Pharmacology Discussions and Assignment Papers

What to Do As an Advanced Practice Nurse

Being the advanced practice nurse who has realized that I made a mistake while prescribing drugs, I would disclose the error immediately to those working with me so that they can help trace the patient and recall the prescription. Then if necessary, I will explain to the patient about the error and the ongoing steps to correct the mistake. However, if I realize that the patient is not likely to understand owing to his health condition or age, I will just recall the medications and issue the right ones, correcting the error. My decision to disclose is based on the fact that both the legal and ethical laws call for disclosure. Generally, the nursing practice upholds work ethics and disclosing my personal errors is part of that. Following the ethics, it is not right for me to realize my mistake and just cover it with nondisclosure knowing well that the mistake has a potential to ruin the lives of others. To eliminate the guilt and prevent further damage, I will disclose my prescription error. Then on the legal aspect, the both the federal and state laws demands for disclosure of prescription errors so as to prevent loses and have statics right.  The legal requirement demands disclosure even though the customer may not have realized for which I must comply (Arizona Medical Association, n.d). Further, disclosing the error will “raise an alarm” to my colleagues and I hence warn us to be more accurate and effective in the future to prevent reoccurring of the error.

Procedure of Writing Prescriptions and Strategies to Minimize Error

Medication errors have been causing death to many and this has caused major concern to many organizations since it relates to ethics and legal aspects (Anderson & Townsend, 2010). To curb the errors while writing prescription, it is advisable that the concerned health officer be attentive, pay attention to all available related details on prescription, ensure that he writes the type of medicine, dosage and form of the dose correctly and avoid using terms or abbreviations that are not well understood or even those that can end up being confused with other drugs. The officer should also go through the prescription he has just written to ascertain that the order truly reflects whatever he intended to write down (Institute for Safe Medication Practices, 2012).

Understandably, there are various strategies that could help to minimize the prescription errors. Part of these is ensuring the correct entry of prescription always. On this, it is clear that transcription errors account for a significant percentage of the dispensing errors. By consistently applying reliable ways of verifying the patient’s identity while feeding the information into the computer or a hard copy, one ends up reducing the prescription errors relating to similar names or sound-alike names. Then one has to be aware of the sound-alike and look-alike drugs. Drugs with similar names or similar abbreviation could be interchanged bringing errors. To minimize this, one should confirm and compare the prescription. On this note, one should also confirm if the dosage prescribed is appropriate for that particular disease and age of the patient. Further, writing prescription entails avoidance of misplacing figures and letters as they could result in misinterpretation and consequent errors. If it is in labeling the drugs and dosage in the various packaging, the writings should be clear and legible. Other useful strategies are; having a well-organized workplace, reduce destructions as much as possible and reduce any stress while at work. Without a doubt, all these factors increase concentration on prescribing medications hence errors reduction. NURS 6521N Advanced Pharmacology Discussions and Assignment Papers

References

Anderson, P., & Townsend, T. (2010). Medication errors: Don’t let them happen to you. American Nurse Today, 5(3), 23–28. Retrieved from https://americannursetoday.com/medication-errors-dont-let-them-happen-to-you/

Arizona Medical Association, (n.d). Physician led. Patient focused. Available at: <https://www.azmed.org/page/opioidrxsafety

Arizona Pharmacy Association, (2013). Arizona guidelines for dispensing controlled substances. Available at:< https://pharmacypmp.az.gov/sites/default/files/pharmacist%20best%20practices.pdf

Institute for Safe Medication Practices. (2012). ISMP’s list of error-prone abbreviations, symbols, and dose designations. Retrieved from http://www.ismp.org/Tools/errorproneabbreviations.pdf

Legal Information Institute, (2017). Arizona Legal Ethics. Available at: < https://www.law.cornell.edu/ethics/az/narr/AZ_NARR_1_06.HTM.