NURP 424 ADVANCED PHARMACOLOGY ACROSS THE LIFE SPAN
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages To Order 5-10 Pages Description/Paper Instructions
NURP 424: ADVANCED PHARMACOLOGY ACROSS THE LIFE SPAN
Please submit via uploading in this assignment section an electronic copy of your completed case study which includes an adult case and pediatric case by the end of Week 10, Sunday 11:59 PM EST. This case study is worth 25% of your final grade and will be counted as your cumulative exam. There are 2 cases for you to complete (one adult and one pediatric). This scholarly paper requires the use of a variety of sources. You may use your textbook, journal articles from weekly discussions, lectures and any other evidence-based reference materials necessary to complete this assignment. Case studies may not exceed TWELVE (12) pages in length (excluding title and reference page.) Anything on pages 13+ will not be read or counted toward your final grade. We want you to focus on the pharmacology aspect of this case by following the prompts in the case analysis. You must adhere to APA guidelines. The following is all the information available regarding your patients. If the information you have is incomplete, please note this in your analysis. In the clinical setting, you may be dealing with incomplete information and sometimes that must be included in your clinical reasoning.
ADULT CASE:
Brief Adult Patient History:
Mr. Jon Smith, a 50 year old African American male, has come to your clinic with a 15 year history of hypertension and type 2 diabetes. He drinks “a few beers” per week and confirms cigarette use of 1 ppd for the past 30 years. He tells you that he works a physical job in construction so is mostly on his feet and active. He eats what is available and tries to watch his diet when he can. Mr. Smith is taking Amlodipine 10 mg daily for hypertension and metformin 1,000mg BID for diabetes. His blood pressure has been hovering around 150/90 and Hemoglobin A1c has been 6.8. Also included in blood work is a total cholesterol of 243 mg/dL, LDL 170 mg/dL, HDL 36 mg/dL, Triglycerides 201 mg/dL. Additional findings include normal electrolytes, renal function and liver enzymes. You decide to enter these results in the ASCVD risk calculator to further learn his CAD risk.
Positive Review of Systems (otherwise you can assume negative):
Respiratory: No SOB, +non productive cough that he has had for “quite sometime”
Past Medical/Surgical History:
- Diabetes
- Hypertension
- Hyperlipidemia
- Tobacco use disorder
Social History:
- Smokes 1 PPD for the past 30 years
- A “few beers” per week
- Married with 2 teenage children
Medications:
Amlodipine 10 mg daily
Metformin 1000 mg BID
Naproxen 500mg PO daily PRN
Allergies: Penicillin (anaphylactic reaction)
PE: 50 year old African American Male in no acute distress. VS: Temp 98.0, BP 150/92, Pulse 86, R 18. Height 6’ 0”; weight 230 lbs. Exam unremarkable.
CASE ANALYSIS:
Illustrate your understanding of Pharmacotherapeutics in this patient’s care. Please no copying and pasting but you are welcome to make your own charts or graphs if desired.
Complete an analysis for each medication and any medication you decide to prescribe including:
- Describe the mechanism of action, side effects, caution and/or contraindications, monitoring parameters and determine if the medication is the best option for this patient
- Common dosage, route and schedule for the medication
- Determine cost of each medication
- Is the medication being used reasonably in this situation (risk/benefit analysis)?
- Would you make any changes in the use of the drug if you were the provider?
Complete an analysis of the patient including:
- Evidence of drug effectiveness
- Indicate potential drug interactions (drug-drug, drug-food, drug-herb, etc.)
- Indications of possible adverse drug effects
- Factors affecting compliance/adherence
- What social factors must you considered for this patient?
- What education must you provide to the patient about these medications
- Are there special considerations for this patient population that must be considered? When would you want to see this patient again in a follow up visit?
- Include any nonpharmacologic interventions that you feel are appropriate.
NEXT CASE:
PEDIATRIC CASE:
Brief Pediatric Patient History:
Annie Ramirez, a nine-year-old Hispanic female, has presented to your clinic with a four-day history of cough, fever and increasing fatigue. Prior to the onset of symptoms, Annie had been feeling well, attending school regularly, and participating on her competitive soccer team. Annie has a history of a peanut allergy as well as mild persistent asthma. Annie’s father reports that at baseline, Annie has a nighttime cough “maybe once a week or so” and does wheeze “if she forgets her inhaler before her soccer games.”
Over the past four days, Annie’s activity level has decreased dramatically and she feels that “it is hard to breathe” when she tries to move around. She has a persistent cough that is worse at nighttime. She has been using her inhalers according to her sick plan, but they “do not seem to be helping.” Her father reports that Annie’s fever has been as high as 102.9 °F (tympanic) and ibuprofen has been helpful to reduce her fever. She is eating, but less than normal, and her parents have been encouraging her to drink water throughout the day.
You conduct a physical exam and diagnose Annie with left lower lobe community acquired pneumonia (CAP) resulting in an acute asthma exacerbation. You administer albuterol via a nebulizer during the visit and you note that Annie has decreased working of breathing and an increased SpO2%. Your assessment is that she can be treated in the outpatient setting. What additional medications would you prescribe?
Focused Review of Systems
General: Reports fatigue; exacerbated by physical activity.
HEENT: Denies ear pain, discharge from ears, or difficulty hearing. Denies drainage or difficulty breathing through nose. Denies sore throat or difficulty swallowing. Denies neck pain or decreased range of motion.
RESP: Reports cough productive of green sputum; consistent throughout the day, but worsens at night. Shortness of breath with physical activity. Difficulty “getting the air in” even at rest. Using inhalers with minimal results.
CV: Denies heart racing.
GI: Reports a decreased appetite but drinking water throughout the day. Reports soft daily bowel movements; voiding 4-5 times daily.
PAST MEDICAL HISTORY/PAST SURGICAL HISTORY:
- Product of a normal pregnancy/delivery (full term infant)
- Peanut allergy (anaphylaxis at 18 months)
- Mild persistent asthma (diagnosed at 4yo, last required oral corticosteroids 3 years ago)
- Denies past surgeries
SOCIAL HISTORY:
- Lives with two fathers and one 4-year-old brother
- 3rd grade, great student, loves reading. Plays competitive soccer
- Parents are non-smokers, no second-hand smoke exposure
MEDICATIONS:
- Asmanex HFA (mometasone furoate), 100mcg/actuation: 1 puff once daily when well; 2 puffs BID when sick with respiratory symptoms
- Ventolin HFA (albuterol sulfate), 90mcg/actuation: 2 puffs every 4-6 hours PRN for wheeze/cough; 2 puffs prior to exercise; when sick with respiratory symptoms, increase to 4 puffs every 4 hours
- Epi-pen (epinephrine), 0.3mg: Administer in thigh for any exposure to peanuts or signs consistent with an allergic reaction; seek immediate medical attention after using. May repeat in 5-10 minutes as needed for return of symptoms.
- Motrin (ibuprofen), 100g/5mL: 15mL every six hours as needed for fever
ALLERGIES:
- Foods: peanuts (anaphylaxis)
- Medications: none
- Environmental: none
PHYSICAL EXAM:
Vitals: Wt-71 lbs, Ht-54.75 inches, BMI 16.7, Temp-101.3 °F (tympanic), HR-118, RR-30, SpO2-95%, BP-92/46, pain-denies
HEENT: Normocephalic; no lesions. Pupils 3 to 4 mm, and symmetrically reactive to light. TMs are flat, non-erythematous, with appropriate light reflexes bilaterally. Nares patent bilaterally. Mucus membranes are moist, good dentition, tonsils are 2+ without exudate, pharynx is non-erythematous.
Lungs: Diffuse inspiratory and expiratory wheezes, coarse crackles in the left lower lobe; no change with deep inspiration/cough. Intercostal and substernal retractions noted. Post-albuterol: Coarse crackles RLL, occasional inspiratory wheeze, resolved retractions.
Cardiovascular: Normal S1 and S2. No murmurs or abnormal heart sounds.
Abdomen: Soft, non-tender, non-distended. No hepatosplenomegaly noted.
CASE ANALYSIS:
Illustrate your understanding of Pharmacotherapeutics in this patient’s care. Please no copying and pasting but you are welcome to make your own charts or graphs if desired.
Complete an analysis for each medication and any medication you decide to prescribe including:
- Describe the mechanism of action, side effects, caution and/or contraindications, monitoring parameters and determine if the medication is the best option for this patient
- Common dosage, route and schedule for the medication
- Determine cost of each medication
- Is the medication being used reasonably in this situation (risk/benefit analysis)?
- Would you make any changes in the use of the drug if you were the provider?
Complete an analysis of the patient including:
- Evidence of drug effectiveness
- Indicate potential drug interactions (drug-drug, drug-food, drug-herb, etc.)
- Indications of possible adverse drug effects
- Factors affecting compliance/adherence
- What social factors must you considered for this patient?
- What education must you provide to the patient about these medications
- Are there special considerations for this patient population that must be considered? When would you want to see this patient again in a follow up visit?
- Include any nonpharmacologic interventions that you feel are appropriate.
Use the grading rubric provided in the LMS
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. The can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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