NURS 6521 Week 1 Advance Pharmacology Discussion
NURS 6521 Week 1 Advance Pharmacology Discussion
This case involves a 23-year-old African American female with a history of sickle cell disease, asthma, and anemia. The patient came in with complaints of pain in back and legs, unrelieved with home prescribed Norco 10/325 mg three times daily. The patient’s labs reflected that the patient was in leukocytosis and mild dehydration. The patient reports a lack of appetite since the pain began 3-4 days ago. Pharmacokinetics determine how the body reacts to the medication, pharmacodynamics explores the effects medication has on the body (Rosenthal, & Burchum, 2021). When creating a plan of care for this patient I would consider the state their body was currently in (dehydration) and decreased nutritional status can affect any medication that I may prescribe. In patients suffering from dehydration or a nutritional decline, it can cause drug metabolism to alter (Rosenthal, & Burchum, 2021). A necessity to prescribing medication is understanding disease processes and which medications will best treat most of the symptoms presented.
One of my first orders would be to replace the fluids they have lost. Dehydration and a lack of oxygen can cause an increase of the sickling of cells which can cause a sickle crisis to become more severe (McCance, & Huether, 2019). While the patient is being hydrated I would provide pain relief since the by mouth prescriptions home meds failed I would provide the patient with some IV medication to obtain pain control if they were in a true crisis and after pain control was achieved attempt to wean them off to by mouth pain medications that are effective. Patients that suffer from sickle cell disease have a continuous complication with pain control due to drug adherence and many other factors but it has been found that when in severe crisis opioids are a good first line of defense for pain control (Chu et. al, 2020). In my experience, I have found that sickle cell patients often get accustomed to remarkably high dosages of pain medicines quickly especially if they have very frequent sickle cell crises. Hopefully, these combined measures will relieve the patient’s pain and allow the patient’s labs to stabilize, and the patient’s dietary intake will also have to be measured before discharge. Care is completed when the patient affirms that adequate proficiency of care has been provided (Fowler, M. D. M., & American Nurses Association, 2015). I have found that it is extremely important to discuss the treatment plan and expectations with patients so that they have an understanding of the healthcare goals you are attempting to achieve. When it comes to prescribing medication I plan to provide adequate education to my patents to ensure that they know how, when, and why taking the medication as prescribed is important. NURS 6521 Week 1 Advance Pharmacology Discussion
Week 1: Basic Pharmacotherapeutic Concepts/Ethical and Legal Aspects of Prescribing
How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow? NURS 6521 Week 1 Advance Pharmacology Discussion
Questions like these are related to the underlying pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics. As an advanced practice nurse, understanding these fundamental pharmacotherapeutic concepts is important to ensure that the prescription drugs you recommend for your patients will be safe and effective to treat and/or manage their symptoms. Additionally, as the advanced practice nurse, it is your responsibility to ensure that when prescribing prescription drugs, you adhere to the ethical and legal principles set forth for prescribing drugs as an added layer of protection and safety for the patients you will treat. NURS 6521 Week 1 Advance Pharmacology Discussion
This week, you will analyze factors that may influence pharmacokinetic and pharmacodynamics processes of a patient and assess the details of a personalized plan of care that you develop based on influencing factors and patient history. You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs, including disclosure and nondisclosure, and analyze the process of writing prescriptions to avoid medication errors. NURS 6521 Week 1 Advance Pharmacology Discussion
Learning Objectives- NURS 6521 Week 1 Advance Pharmacology Discussion
- Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients
- Assess patient factors and history to develop personalized plans of care
- Evaluate ethical and legal implications related to prescribing drugs
- Analyze ethical and legal practices of prescribing drugs
- Analyze strategies to address disclosure and nondisclosure
- Justify advanced practice nurse strategies to guide prescription drug decision-making
- Analyze the process of writing prescriptions to avoid medication errors
Discussion: Pharmacokinetics and Pharmacodynamics
As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.
Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body. NURS 6521 Week 1 Advance Pharmacology Discussion
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 (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease. NURS 6521 Week 1 Advance Pharmacology Discussion
For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug. NURS 6521 Week 1 Advance Pharmacology Discussion
- Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
- Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
- Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
- Think about a personalized plan of care based on these influencing factors and patient history in your case study. NURS 6521 Week 1 Advance Pharmacology Discussion
By Day 3 of Week 1
Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples. NURS 6521 Week 1 Advance Pharmacology Discussion
By Day 6 of Week 1
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure. NURS 6521 Week 1 Advance Pharmacology Discussion
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Grading Criteria- NURS 6521 Week 1 Advance Pharmacology Discussion
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 of Week 1 and Respond by Day 6 of Week 1
To Participate in this Discussion:
Week 1 Discussion
Assignment: Ethical and Legal Implications of Prescribing Drugs
What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient? NURS 6521 Week 1 Advance Pharmacology Discussion
These are some of the questions you might consider when selecting a treatment plan for a patient. NURS 6521 Week 1 Advance Pharmacology Discussion
As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond. NURS 6521 Week 1 Advance Pharmacology Discussion
To Prepare- NURS 6521 Week 1 Advance Pharmacology Discussion
- Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
- Review the scenario assigned by your Instructor for this Assignment.
- Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
- Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
- Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors. NURS 6521 Week 1 Advance Pharmacology Discussion
By Day 7 of Week 1
Write a 2- to 3-page paper that addresses the following:
- Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family. NURS 6521 Week 1 Advance Pharmacology Discussion
- Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state. NURS 6521 Week 1 Advance Pharmacology Discussion
- Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
- Explain the process of writing prescriptions, including strategies to minimize medication errors. NURS 6521 Week 1 Advance Pharmacology Discussion
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting. NURS 6521 Week 1 Advance Pharmacology Discussion
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
- Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 1 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 “WK1Assgn+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. NURS 6521 Week 1 Advance Pharmacology Discussion
Grading Criteria- NURS 6521 Week 1 Advance Pharmacology Discussion
To access your rubric:
Week 1 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 1 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 1
To participate in this Assignment:
Week 1 Assignment
Learning Resources- NURS 6521 Week 1 Advance Pharmacology Discussion
Required Readings (click to expand/reduce)
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
- Chapter 1, “Prescriptive Authority” (pp. 1–3)
- Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
- Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
- Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
- Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
- Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)
American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767
American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.
This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.
Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm
This website outlines the code of federal regulations for prescription drugs.
Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html
This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.
Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.
Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html
This website details key aspects of drug registration.
Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.
This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice. NURS 6521 Week 1 Advance Pharmacology Discussion
Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list
This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.
Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17
This article provides NPs with information regarding state-based laws for NP prescribing.
Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446
The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.
Required Media (click to expand/reduce)
Introduction to Advanced Pharmacology
Meet Dr. Terry Buttaro, associate professor of practice at Simmons College of Nursing and Health Sciences as she discusses the importance of pharmacology for the advanced practice nurse. (8m). NURS 6521 Week 1 Advance Pharmacology Discussion