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Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders – NURS 6521 Essays

Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders – NURS 6521 Essays

Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders – NURS 6521 Essays

Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders - NURS 6521 Essays

NURS 6521 Week 6: Neurologic and Musculoskeletal Disorders

Sabrina is a 26 year old female who has just been diagnosed with multiple sclerosis. She has scheduled an appointment for a follow up with her physician but has several questions about her diagnosis and is calling the Nurse Helpline for her hospital network. As she talks with the advanced practice nurse, she learns that her diagnosis also impacts her neurologic and musculoskeletal systems. Although multiple sclerosis is an autoimmune disorder, both the neurologic and musculoskeletal systems will be affected by adverse symptoms that Sabrina needs to be aware of and for which specific drug therapy plans and other treatment options need to be decided on.

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As an advanced practice nurse, what types of drugs will best address potential neurologic and musculoskeletal symptoms Sabrina might experience?’

This week, you will evaluate patients for the treatment of neurologic and musculoskeletal disorders by focusing on specific patient case studies through a decision tree exercise. You will analyze the decisions you will make in the decision tree exercise and reflect on your experiences in proposing the recommended actions to address the health needs in the patient case study.

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Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders – NURS 6521 Essays Learning Objectives

Students  will:

  • Evaluate patients for treatment of neurologic and musculoskeletal disorders
  • Analyze decisions made throughout the diagnosis and treatment of patients with neurologic and musculoskeletal disorders NURS 6521 Week 6 – Assignment: Decision Tree for Neurological and Musculoskeletal Disorders
  • Justify decisions made throughout the diagnosis and treatment of patients with neurologic and musculoskeletal disorders
Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders – NURS 6521 Essays Learning Resources
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

  • Chapter 11, “Basic Principles of Neuropharmacology” (pp. 67–71)
  • Chapter 12, “Physiology of the Peripheral Nervous System” (pp. 72–81)
  • Chapter 12, “Muscarinic Agonists and Cholinesterase Inhibitors” (pp. 82–89)
  • Chapter 14, “Muscarinic Antagonists” (pp. 90-98)
  • Chapter 15, “Adrenergic Agonists” (pp. 99–107)
  • Chapter 16, “Adrenergic Antagonists” (pp. 108–119)
  • Chapter 17, “Indirect-Acting Antiadrenergic Agents” (pp. 120–124)
  • Chapter 18, “Introduction to Central Nervous System Pharmacology” (pp. 125–126)
  • Chapter 19, “Drugs for Parkinson Disease” (pp. 127–142)
  • Chapter 20, “Drugs for Alzheimer Disease” (pp. 159–166)
  • Chapter 21, “Drugs for Seizure Disorders” (pp. 150–170)
  • Chapter 22, “Drugs for Muscle Spasm and Spasticity” (pp. 171–178)
  • Chapter 59, “Drug Therapy of Rheumatoid Arthritis” (pp. 513–527)
  • Chapter 60, “Drug Therapy of Gout” (pp. 528–536)
  • Chapter 61, “Drugs Affecting Calcium Levels and Bone Mineralization” (pp. 537–556)

American Academy of Family Physicians. (2019). Dementia. Retrieved from http://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=5

This website provides information relating to the diagnosis, treatment, and patient education of dementia. It also presents information on complications and special cases of dementia.

Document: Mid-Term Summary & Study Guide (PDF)

Laureate Education (Producer). (2019b). Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.

In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat Alzheimer’s disease.

Laureate Education (Producer). (2019e). Complex regional pain disorder [Interactive media file]. Baltimore, MD: Author.

In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat complex regional pain disorders.

Disorders of The Nervous System

Reflect on the comprehensive review of disorders of the nervous system and think about how you might recommend or prescribe pharmacotherapeutics to treat these disorders. (15m)

Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders – NURS 6521 Essays

For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders. NURS 6521 Week 6 – Assignment: Decision Tree for Neurological and Musculoskeletal Disorders.

 

To Prepare for Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders – NURS 6521 Essays

  • Review the interactive media piece assigned by your Instructor.
  • Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
  • Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
  • You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.
By Day 7 of Week 8

Write a 1- to 2-page summary paper that addresses the following:

  • Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
  • Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
  • What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
  • Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

You will submit this Week 6 Assignment: Decision Tree for Neurological and Musculoskeletal Disorders – NURS 6521 Essays in Week 8.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 8 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 8 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 8 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 8 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 8

AN ELDERLY IRANIAN MAN WITH ALZHEIMER’S DISEASE SAMPLE APPROACH

Alzheimer’s is characterized as a neurodegenerative disorder that starts slowly and worsens over time. This health issue is allied with 70% of dementia cases globally. The primary predominant initial symptom is the absence of memory related to current events (Alzheimer’s, 2015). As the disease progresses, other symptoms include mood swings, disorientation, lack of self-esteem, language barriers, and behavioral changes. Gradually, all physical functions are lost, eventually leading to death. Notably, Alzheimer’s disease cannot be cured; it could be managed to ensure the patient’s quality of life (Alzheimer’s, 2015).

The case study presented in the media file describes the examination and treatment of an elderly Iranian male of 76 years old named Mr. Akkad. His eldest son explained that he displays strange behaviors and does not show interest in religious activities with his family. Moreover, Mr Akkad also forgot things and after various memory tests, confabulation has been reported in the case of Mr Akkad.

Mr. Akkad reported impaired impulse and judgment. Later , a mini-mental state test was performed, revealing that Mr. Akkad suffers from a major neurocognitive disease that occurred probably due to Alzheimer’s. This disorder cannot be cured; only it can be treated and managed by pharmacological intrusions that lie on various dynamics like appropriate drug selection, the appropriate dose of the drug, time of use, and route of administration.

Decision Point One:

For this decision, three options were listed, the first option was to begin Exelon 1.5mg orally BID with an increase to 3 mg orally BID in 2 weeks, the second option was to begin Aricept 5mg orally at bedtime and the third option was to begin Razadyne 4mg orally BID. The option which I have selected is to begin 1.5mg of Exelon by increasing the dose to 3mg in two weeks as it serves as the first line of treatment and effective for normal brain functioning involving processing, memory and language areas (tartrate & Exelon, 2019). It is a cholinesterase inhibitor and helps improve nerve cells’ functioning in the brain. By administering rivastigmine (Exelon), acetylcholine concentration elevates and is available for synaptic transmission by inhibiting the hydrolysis of Ach with the help of cholinesterase (Birks & Evans, 2015).

Decision Point Two:

This decision also listed three options. The first was to increase Aricept to 10mg, the second option was to discontinue Aricept and begin Razadyne, and the third option was to discontinue Aricept and begin Namenda. I was hoping that point one decision will little effect on the patient’s symptoms and start to mimic them. However, the results that came from the first decision were that the client returned to the clinic after four weeks and his family explained that no change occured in the behavior and interest of Mr Akkad. The mini-mental state examination also scores the same as previously.

Decision point two was to increase the dose of Exelon to 4.5mg orally BID. This dose will help restore neurotransmitter balance in the brain, improve memory and awareness, and engage in interesting activities (Sadowsky et al., 2014).

Decision Point Three:

This decision tree also listed three options, after decision point two, the patient started to respond and tolerate the treatment, and the family explained that Mr. Akkad is attending religious activities, but some behaviors were still reported the same. The third option was to add 5mg of Namenda orally per day. I have chosen this medical intervention to augment the Exelon during intolerance. Namenda helps improve mood, ability to perform daily tasks, and cognition (Glinz et al., 2019).

Combination therapy resulted in greater symptomatic improvements in both cognitive and behavioral efficacy measures suggest that the complementary mechanisms of action of ChEIs and memantine have additive or synergistic potential in delaying symptomatic decline in AD (Glinz et al., 2019). I have also advised the son of Mr. Akkad about the trajectory of Alzheimer’s, that it cannot be cured and could be managed by pharmacological interventions over a significant time.

References:

Alzheimer’s, A. (2015). 2015 Alzheimer’s disease facts and figures. Alzheimer’s & dementia: the journal of the Alzheimer’s Association, 11(3), 332.

Birks, J. S., & Evans, J. G. (2015). Rivastigmine for Alzheimer’s disease. Cochrane Database of Systematic Reviews, (4).

Glinz, D., Gloy, V. L., Monsch, A. U., Kressig, R. W., Patel, C., McCord, K. A., … & Raatz, H. (2019). Acetylcholinesterase inhibitors combined with memantine for moderate to severe Alzheimer’s disease: a meta-analysis. Swiss medical weekly, 149(2526).

Sadowsky, C. H., Micca, J. L., Grossberg, G. T., & Velting, D. M. (2014). Rivastigmine from capsules to patch: therapeutic advances in the management of Alzheimer’s disease and Parkinson’s disease dementia. The primary care companion for CNS disorders, 16(5).

Tartrate, G., & Exelon, B. (2019). Exelon (Rivastigmine Tartrate): Side Effects, Interactions, Warning, Dosage & Uses. Retrieved 4 October 2019, from https://www.rxlist.com/exelon-drug.htm#indications