American Sentinel N521 Module 4 Assignment 2

American Sentinel N521 Module 4 Assignment 2 American Sentinel N521 Module 4 Assignment 2 Permalink: https://nursingpaperessays.com/ american-sentine…e-4-assignment-2 / Assignment 2 R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years. He reports to his CNP in his family practice clinic. He presents with progressive difficulty getting his breath while doing simple tasks. He is having difficulty doing any manual work, but he has no symptoms when working behind his desk. He also reports a cough, fatigue, and weight loss. He has been treated for three respiratory infections a year for the past 3 years and feels like another one is developing now. On physical examination, you notice clubbing of his fingers, use of accessory muscles for respiration, wheezing in the lungs, and hyperresonance on percussion of the lungs. Pulmonary function studies show an FEV1 of 58%. American Sentinel N521 Module 4 Assignment 2 In a paper not to exceed six pages, excluding title and reference pages, please answer the following: What is R. W.’s likely diagnosis? What stage of disease does RW have? List specific pharmacotherapeutic treatment goals for R. W. What drug therapy would the CNP likely prescribe? Why? What are the parameters for monitoring the success of the therapy? Describe specific patient education based on the prescribed therapy. List one or two adverse reactions for the selected agent that would cause the CNP to change therapy. What would be the choice for second-line therapy? What health promotion activities should be recommended for this patient? If RW was currently taking metoprolol for “headaches” would a change be recommended? Please use the Case Study Analysis rubric provided to guide you in completing this assignment. It will be used to evaluate your submitted work. Competency 40 36 33 0 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. American Sentinel N521 Module 4 Assignment 2 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. American Sentinel N521 Module 4 Assignment 2 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 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 10 9 8 0 APA Compliance. American Sentinel N521 Module 4 Assignment 2 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 Competency 40 36 33 0 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 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. American Sentinel N521 Module 4 Assignment 2 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 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 10 9 8 0 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 4 R. S., a 65-year-old African-American man, was referred to the CNP in the hypertension clinic for evaluation of high BP noted on an initial screening. He reports having headaches and nocturia. He states that he has gained 8 pounds over the last year. Past medical history: Appendectomy 30 years ago, Peptic ulcer disease 10 years ago, Type 2 diabetes mellitus for 10 years; Family history: Father had hypertension; died of myocardial infarction at age 55, Mother had diabetes mellitus and hypertension; died of cerebrovascular accident at age 60; Physical examination: Height 69 in, weight 108 kg; BP: 140/89 mm Hg (left arm), 138/82 mm Hg (right arm); Pulse: 84 beats/min, regular; Funduscopic examination: mild arterial narrowing, sharp discs, no exudates or hemorrhages; Laboratory findings: Blood urea nitrogen: 24 mg/dL, Serum creatinine: 1.5 mg/dL, Glucose: 95 mg/dL, Potassium: 4.0 mEq/L, Total cholesterol: 201 mg/dL, High-density lipoprotein cholesterol: 30 mg/dL, Triglycerides: 167 mg/dL, Urinalysis: 1+ proteinuria; Electrocardiogram and chest radiograph: mild left ventricular hypertrophy; Social history: Tobacco: 35 pack years, Alcohol: pint of vodka/week, Coffee: 2 cups/day Diagnosis: Stage 1 Hypertension In this discussion forum: Discuss specific goals for pharmacotherapy for treating R. S.’s hypertension and cholesterol Discuss what you would consider to be first-line pharmacotherapy for R. S., and why. Discuss the parameters for monitoring the success of the therapy. Discuss health promotion recommendations you would consider for R. S. Does the presence of Diabetes Mellitus impact your treatment selection? Remember to respond to at least two of your peers. Please see the Course Syllabus for Discussion Participation Requirements and Grading Criteria. American Sentinel N521 Module 4 Assignment 2 Example Discussion 4 Essay The ultimate goal is to get R.S. as close to normotensive as possible and to get his cholesterol within normal guidelines. This will take a lot of participation of R.S. He will need to be enrolled in the diabetic case management program, where he will closely monitored weekly and provides a log of daily events for 90 days. During this 90 day period he will be called weekly and blood sugars will be discussed and he will be counseled educated on the signs and symptoms of the highs and lows of diabetes and how to manage them. He will connected with a registered dietitian who will have educate on the right choices to make to obtain his goal and enroll him in a diabetic class for food and nutrition. It is super hard to know what to eat and what not to eat when you are a newly diagnosed diabetic. Once R.S. embraces the lifestyle changes he will be on the road to success. He will be encouraged to stop smoking now. Moreover, the first-line pharmacotherapy for treating R.S. hypertension and cholesterol is ACE inhibitors, for example, lisinopril. According to Arcangelo & Peterson, ACEIs decrease morbidity and mortality rates in patients with congestive heart failure, post- MI, and systolic dysfunction. African Americans are known to have a higher risk of death associated with hypertension. R.S. should be educated on family history and how he can be the change with education and counseling. He might take the job of being active in his care serious since his parents died. His father at age 55 died of myocardial infarction and his mother cerebrovascular accident at age 60. This a lot for any individual especially one that admits to 35 years of smoking, a pint of vodka a week and 2 cups of coffee a day. A lot has to change for him to get closer to his goal (Arcangelo & Peterson, 2017). Furthermore, explaining to R.S. this is journey that he must commit to be successful; daily monitoring of blood sugars and stop smoking. He will need to call 1-800-QUIT-NOW (1-800-784-8669) for free. Encourage R.S. to join the group and accept the help. He would be encouraged to adopt the Dietary Approaches to Stop Hypertension (DASH) diet or the American Heart Association (AHA) diet that recommends that you consume a variety of fruits and vegetables, whole grains, fat-free and low fat dairy, lean meats, legumes and poultry. Both are more expensive. During the writer frequent visits to the grocery store, fruits and vegetables are rarely on sale but cookies, candy and sodas are always on sale. You can’t just buy one 12 pack to get the reduced rate. You must buy all 3 to get the 3 for $12. Although, I am aware that’s a marketing ploy to get you to buy more and you think you are getting bargain but one 12 pack is normally $5.99. But we should not be drinking the sodas for so many reasons. One reason is they are really high in sugar and he will need to watch his sugar intake as much as possible and looking 30 grams to one can of coke might not be worth it him. Finally, patients with hypertension and diabetes are just special. It does dictate how you want to treat R.S. Looking at the patient overall health his kidney function and getting him to change his lifestyle to live a longer healthier life. Getting him to buy-in on this plan might prove to be a challenge so we will be sure to give him all the support he needs. He will set up with resources in the community, such as, the senior fruits and vegetable market. They are sold to seniors on the Tuesdays and Thursdays from 10am -3pm at a discounted rate. This will offset the higher cost they grocery stores have. He will be connected to the local food bank so he can pick up nutritious items. He won’t have the temptation of cookies, chips and sodas either. He will be offered cooking classes for seniors. R.S. will be signed up with Meals-On-Wheels to help him meet his goals as well. He will be assisted with all the free literature from 1-800- QUIT-NOW and encouraged to join a support group. References Arcangelo, V.P., & Peterson, A. M. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4 th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins. https://www.cdc.gov/tobacco/ https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and- Lifestyle-recommendations American Sentinel N521 Module 4 Assignment 2 Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10