NURS6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics

NURS6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics NURS6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics Module 1 Discussion Post – NURS6521 Week 1 Discussion Example Approach Introduction to Facility In my current position as a corrections nurse, I see all types of patients with all types of illnesses. I work in a small correctional facility located in Juneau, Alaska. We have no onsite provider and no infirmary. This means that when we have urgent needs, we have to contact a physician in another town or send the patient to the ER. As we are an Alaska State facility, sending to the ER would be costly and is the last resort. We are also land locked, so there is no way out of Juneau other than by plane, boat or ferry. This can cause many complicated medical situations. We also try to manage patients’ conditions in house, without sending to the ER. We do not use IVs and use oral medicals when possible. Patient Case The patient is a male in his middle 30’s with diagnosis of congestive heart failure with an EF of 20%. The patient is an IV drug user who has been incarcerated for 6 months with a few years left of his sentence. The patient has depression and anxiety, as he is afraid he will not live to see outside of the correctional facility again. We as health care providers, continue to encourage and treat the patient. We have hope that he will he live to see his freedom again. Medical management of the patient can at times be tricky. This patient is not very compliant with his medications, unless asked to come to medical to take them. He also has frequent changes in his weight due to non-compliance with diet and his edema. In addition, this patient is on many other medications including digoxin. Factors Influencing Pharmacokinetic and Pharmacodynamic Processes Loop diuretics, such as furosemide, inhibit chloride and sodium reabsorption in the thick ascending loop of henle (Olson, 2020). Furosemide is metabolized in the liver and excreted in the kidneys unchanged (Rosenthal & Burchum, 2018). Normally 20% of filtered sodium and chloride is reabsorbed in the ascending loop of henle (Rosenthal & Burchum, 2018). This section of the kidneys is not permeable to water (Rosenthal & Burchum, 2018). Blocking the reabsorption of chloride and sodium, causes the osmotic pressure to prevent passive reabsorption of water (Rosenthal & Burchum, 2018). Furosemide generally works within 60 minutes and can persist for up to eight hours when given orally (Rosenthal & Burchum, 2018). Although furosemide helps to reduce blood pressure, increase urine production, help to reduce edema, it can also have some complications (Olson, 2020). Complications that can arise due to the effects of furosemide can include dehydration (dry mouth, unusual thirst, and decreased urine output), hypotension (dizziness, fainting, lightheadedness), and hypokalemia (dysrhythmia) (Rosenthal & Burchum, 2018). Personalized Plan of Care Due to the patients’ noncompliance, he will need to see medical on a daily basis. This will include daily blood pressure screening and weight checks. He will also need weekly lab draws to assess BUN, electrolytes, and digoxin. We will monitor for signs and symptoms of hypokalemia, hypovolemia, acid base imbalances, and electrolyte imbalances. He will receive spironolactone to prevent hypokalemia due to also being on digoxin. He will also need to be on a beta blocker. The addition of a beta blocker in patients with heart failure can provide lifesaving benefits (Okabe et al., 2017). In addition, long term use of loop diuretics has the potential for worsening prognosis, especially in higher doses (Okabe et al., 2017). The patient will be given furosemide as needed, when there is an increase of greater than 5 kilograms of weight gain within one week. We will closely monitor the patients’ medication and diet compliance after greater than 2.5 kg weight gain. As patient is non-compliant with his diet, it is difficult to assess at times if weight gain is related to increase edema or fluid retention, or diet. Patient will need to be on furosemide until his fluid retention stabilized. References Okabe, T., Yakushiji, T., Kido, T., Oyama, Y., Igawa, W., Ono, M., Ebara, S., Yamashita, K., Yamamoto, M., Saito, S., Amemiya, K., Isomura, N., & Ochiai, M. (2017). The association between high-dose loop diuretic use at discharge and cardiovascular mortality in patients with heart failure. ESC Heart Failure, 5, 87–94. Retrieved June 3, 2020, from https://doi.org/10.1002/ehf2.12221 Olson, J. (2020). Clinical pharmacology made ridiculously simple (5th ed.). MedMaster. Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for nurse practitioners and physician assistants. Elsevier. The Assignment 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. NURS6521 Week 1 Discussion: 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. Photo Credit: Getty Images/Ingram Publishing 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. 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. ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS To Prepare 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. 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. 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. 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. NURS6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics Grading Criteria 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 Rubric Detail Select Grid View or List View to change the rubric’s layout. Name: NURS_6521_Week1_Discussion_Rubric. NURS6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics. Grid View List View Excellent Good Fair Poor Main Posting 45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. NURS6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Post: Timeliness 10 (10%) – 10 (10%) Posts main post by day 3 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) Does not post by day 3 First Response 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 15 (15%) – 16 (16%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. NURS6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. Second Response 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. . Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. NURS6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics Participation 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days. NURS6521 Week 1 Discussion: Pharmacokinetics and Pharmacodynamics 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days Total Points: 100 Name: NURS_6521_Week1_Discussion_Rubric Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10