N521-19B_21 Advanced Pharmacology Module 7 Assignment 3

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Assignment 3

L. P., age 23, is a Hispanic woman who graduated from college last year. She reports to the CNP in her local community mental health center. She began working as an accountant 1 month after graduating. Approximately 2 months ago, she moved into a two-bedroom apartment with another woman who works at the same accounting firm. She states that her roommate recommended that she see a doctor to find out if she has anemia or “some sort of fatigue syndrome.” She states that she has felt “restless” and “on edge” for most of the past 9 months. She becomes easily fatigued and irritable and has difficulty concentrating and falling asleep. She states that sometimes her mind “just goes blank,” and she is worried that her work performance is no longer excellent. She reports that all her life she had good grades in school and was very successful in everything she attempted. Although she has been “a worrier from the day I was born,” now she worries more than she ever has and feels nervous “all the time.” L. P. reports that she has a good relationship with her boyfriend but they do not get to see each other very often because he is attending graduate school 100 miles away. N521-19B_21 Advanced Pharmacology Module 7 Assignment 3. She reports having a satisfying sexual relationship with him. She denies having any problems with relationships with her parents, roommate, or peers. She denies having any financial worries unless she is fired from her job for poor work performance. She reports that she has always been healthy and has taken good care of herself. The only medication she takes is birth control pills, which she has taken for the past 4 years without any adverse effects.

In a paper not to exceed six pages, excluding title and reference pages, submit your answers to the following in an MS Word document:

What is L. P.’s likely diagnosis?
List specific pharmacotherapeutic treatment goals for L. P.
Should the CNP order any labs for L. P. at this time? Why?
What drug therapy would the CNP likely prescribe? Why?
What are the parameters for monitoring the success of the therapy?
Describe specific patient monitoring based on the prescribed therapy.
List one or two adverse reactions for the selected agent that would cause the CNP to change therapy.
L. P. returns to see the CNP after six weeks, complaining of still feeling anxious and had heard of a medication called Klonopin that she would like to try; how should the CNP respond to her request?
What health promotion activities should be recommended for this patient?
What is L. P.’s long-term prognosis?

Please use the Case Study Analysis rubric provided to guide you in completing this assignment. It will be used to evaluate your submitted work.

Rubric – N521-19B_21 Advanced Pharmacology Module 7 Assignment 3

Competency	40	36	33	0	Points Earned
Case Study questions completely and thoroughly answered with accurate evidence-based supported rationales. N521-19B_21 Advanced Pharmacology Module 7 Assignment 3	Accurate and well defined discussion of all 10 questions for the case study using current evidence-based resources.	Accurate discussion of nine case study questions presented with use of current evidence-based resources.	Accurate discussion of 8 questions using current evidence-based resources	Missing response to questions or inappropriate answers to questions. No use of evidence-based resources.	/40
	40	36	33	0
Evidence of critical thinking therapeutic decision-making in drug selection and evaluation of patient care pathophysiology and current pharmacological research assessment of the effectiveness of drug therapy formulation of clinical care and teaching plans for persons from diverse populations	Well-defined evidence of critical thinking therapeutic decision-making in drug selection and evaluation of patient care pathophysiology and current pharmacological research assessment of the effectiveness of drug therapy formulation of clinical care and teaching plans for persons from diverse populations	Evidence of critical thinking in prescriptive therapy, monitoring and adverse events. May have lacked a teaching plan or pathophysiologic discussion.	Evidence of critical thinking but incompletely described therapeutic decision making and omitted teaching plan and pathophysiology.	Multiple bulleted points are absent or poorly defined in the assignment. There is no demonstration of critical thinking.	/40
Competency	10	9	8	0	Points Earned
Grammar, spelling, and punctuation	There are no errors in grammar, spelling, and punctuation	There are a few minor errors in grammar, spelling, and punctuation that do not detract from the meaning (1-3 errors)	There are major errors in grammar, spelling, and punctuation .(4-5 errors)	No content or more than 5 errors	/10
Competency	10	9	8	0
APA Compliance	The paper meets APA formatting guidelines	There are a few minor errors (1-3 errors) N521-19B_21 Advanced Pharmacology Module 7 Assignment 3	There are significant errors in the format of the paper (4-5 errors)	No content or more than 5 errors	/10
Total Points					/100

Competency

Points Earned

Case Study questions completely and thoroughly answered with accurate evidence-based supported rationales

Accurate and well defined discussion of all 10 questions for the case study using current evidence-based resources.

Accurate discussion of nine case study questions presented with use of current evidence-based resources.

Accurate discussion of 8 questions using current evidence-based resources

Missing response to questions or inappropriate answers to questions. No use of evidence-based resources.

/40

Evidence of

critical thinking
therapeutic decision-making in drug selection and evaluation of patient care
pathophysiology and current pharmacological research
assessment of the effectiveness of drug therapy
formulation of clinical care and teaching plans for persons from diverse populations

Well-defined evidence of

Evidence of critical thinking in prescriptive therapy, monitoring and adverse events. May have lacked a teaching plan or pathophysiologic discussion. N521-19B_21 Advanced Pharmacology Module 7 Assignment 3

Evidence of critical thinking but incompletely described therapeutic decision making and omitted teaching plan and pathophysiology.

Multiple bulleted points are absent or poorly defined in the assignment. There is no demonstration of critical thinking.

/40

Competency

Points Earned

Grammar, spelling, and punctuation

There are no errors in grammar, spelling, and punctuation

There are a few minor errors in grammar, spelling, and punctuation that do not detract from the meaning (1-3 errors)

There are major errors in grammar, spelling, and punctuation .(4-5 errors)

No content or more than 5 errors

/10

Competency

APA Compliance

The paper meets APA formatting guidelines

There are a few minor errors (1-3 errors)

There are significant errors in the format of the paper (4-5 errors)

No content or more than 5 errors

/10

Total Points

/100

Discussion 3

M. L. is a 15-year-old Hispanic female who plays soccer for her school team. She has noticed that when running, she sometimes has trouble catching her breath. She also reports an increased runny nose and itchy eyes. She has a frequent dry cough and is awakened with coughing spells at least four times a week. Her mother and father have seasonal allergies and her mother has asthma. This morning she woke up and heard “funny sounds” when she took a breath. Her coughing increased when she took a deep breath. In her nose, the mucosa is pale and swollen bilaterally. Her lungs have bilateral expiratory wheezing; respirations are 22 and PEF is 400. Her heart shows a normal sinus rhythm, with no murmurs or gallops; pulse is 72; and there is no cyanosis.

Diagnosis: Mild Persistent Asthma

In this discussion forum:

Discuss specific goals of pharmacotherapy for treating M. L.’s mild persistent asthma.
Discuss the drug therapy a CNP would likely prescribe and why.
Discuss the parameters for monitoring the success of the therapy.
Discuss age appropriate health promotion recommendations you would consider for M. L.

Remember to respond to at least two of your peers. Please see the Course Syllabus for Discussion Participation Requirements and Grading Criteria. N521-19B_21 Advanced Pharmacology Module 7 Assignment 3

Example Discussion 3 Approach

In the United States, asthma affects roughly 26 million people, with approximately 7 million of that figure including children from the ages of 0-17 years old (Arcangelo, 2017). M.L. has been diagnosed with mild persistent asthma and the goal of asthma therapy is to prevent pulmonary dysfunction by maintaining a close to optimal pulmonary environment (Arcangelo, 2017). Overall, pharmacotherapy should help M.L. with better tolerance of physical activity, decrease, if not eliminate, the number of times she is awakened at night due to dyspnea, and a decrease in rhinitis and itchy eyes from seasonal allergies.

According to the National Heart, Lung, and Blood Institute (2020), regardless of age, a short-term or quick-acting medication is need. Medication management may include a short-term inhaled beta 2 agonist that opens the airway by relaxing the muscles that are causing constriction for exacerbations and an oral corticosteroid for persistent asthma to address the inflammation created.

Monitoring the success of therapy would include monitoring how often she is experiencing symptoms during the day, how many times is she awakened at night due to symptoms, how often is she using her inhaler, and how is she able to tolerate physical activity (American Lung Association, 2020). According to Baylor College of Medicine’s Rules of Two, asthma is uncontrolled if there are positives for one or more of the following statements: use of inhaler is greater than twice a week, awakening at night due to pulmonary symptoms is greater than twice a month, or if the inhaler is filled more than twice in one year (American Lung Association, 2020).

Health promotion and education is important for those diagnosed with asthma, particularly school-aged children. Education for M.L. would include identifying triggers that affect her asthma, take her medications as prescribed, be able to identify symptoms of an exacerbation early, learn the proper use of the inhaler, monitor her peak flow values, and have an asthma plan of action in place ( Hollier, 2018).

References

American Lung Association. (2020, April 08). Assess and monitor your asthma control. Retrieved from https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma/assess-and-monitor-your

Arcangelo, V.P., Peterson, A.M., Reinhold, J.A., & Wilbur, V. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4^th ed.). Philadelphia, PA: Wolters Kluwer.

Hollier, A. (2018). Clinical guidelines in primary care. (3^rd ed.). Lafayette, LA: Advanced Practice Education Associates.

National Heart, Lung, and Blood Institute. (2020, December 03). Asthma. Retrieved from https://www.nhlbi.nih.gov/health-topics/asthma