NURS 6521 _ Pharm Week 2 Discussion
Week 2 Assignment: Pharmacotherapy for Cardiovascular Disorders
…heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…
—Murphy et al., 2018
Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.
Photo Credit: Getty Images/Science Photo Library RF
As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm
To Prepare
- Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
- Review the case study assigned by your Instructor for this Assignment.
- Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
- Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
- Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
- Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
By Day 2 of Week 2
Write a 2- to 3-page paper that addresses the following:
- Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
- Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
- Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
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.
More Directions
- Explain how the factor (i.e. genetics, gender, ethnicity, age or behavior) you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
- Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
- Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements. Would you discontinue any medications, change the dosage, and/or add medications to the patient’s regimen? DISCUSS EACH MEDICATION.
Case study assigned
LM is an 89-year-old female resident of a long-term care facility who has been experiencing multiple falls, some resulting in injuries such as bruising and skin tears. Over the last 6 months, her ambulation status has declined from independent to wheelchair level. She complains of pain in her legs when walking more than short distances across the nursing unit.
PMH:
- HTN
- Alzheimer’s disease
- Hypothyroidism
- Osteoarthritis
- Diabetes
MEDICATIONS:
- Amlodipine 10 mg QD
- Donepezil 10 mg QHS
- Levothyroxine 88 mcg QAM
- Celecoxib 200 mg QD
- Furosemide 40 mg QAM
- Metformin 500mg, 1 BID
- Glyburide 5mg, 1 BID
ALLERGIES: NKA
SOCIAL HISTORY:
Widowed with 2 adult children living in town, retired photographer and owner of an art supply store
VITALS: LABS:
Weight: 129 lbs TSH 2.45, Free T4 0.98
Height: 64 inches Na 135, K+ 3.5, Cl 99, CO2 25
BP: Supine = 177/82 Glucose 101
HR: 78 bpm WBC 7.0, RBC 4.5, Hgb 11.9, Hct 34.1, Plt 255
BUN 42, Cr 1.6, UA Clear
eGFR: 45 ml/min
PE:
- HEENT: Normocephalic, no evidence of trauma, PERRLA, EOMI
- CV: RRR
- Respiratory: Clear to auscultation bilaterally
- Abdomen: Soft, non-tender, no masses or guarding
- G/U: Skin intact, assisted with toileting and personal hygiene by staff
- Extremities: Bilateral 2+ edema to lower extremities; skin dry, dark bruising and skin tear to right elbow and forearm
- Neuro: Alert and oriented to person only. MMSE 18/30, stable over last 12 months