American Sentinel N521 Module 7 Assignment 3

Permalink:

Assignment 3

L. P., age 23, is a Hispanic woman who graduated from college last year. She reports to the CNP in her local community mental health center. She began working as an accountant 1 month after graduating. Approximately 2 months ago, she moved into a two-bedroom apartment with another woman who works at the same accounting firm. She states that her roommate recommended that she see a doctor to find out if she has anemia or “some sort of fatigue syndrome.” She states that she has felt “restless” and “on edge” for most of the past 9 months. She becomes easily fatigued and irritable and has difficulty concentrating and falling asleep. She states that sometimes her mind “just goes blank,” and she is worried that her work performance is no longer excellent. She reports that all her life she had good grades in school and was very successful in everything she attempted. Although she has been “a worrier from the day I was born,” now she worries more than she ever has and feels nervous “all the time.” L. P. reports that she has a good relationship with her boyfriend but they do not get to see each other very often because he is attending graduate school 100 miles away. She reports having a satisfying sexual relationship with him. She denies having any problems with relationships with her parents, roommate, or peers. She denies having any financial worries unless she is fired from her job for poor work performance. She reports that she has always been healthy and has taken good care of herself. The only medication she takes is birth control pills, which she has taken for the past 4 years without any adverse effects. American Sentinel N521 Module 7 Assignment 3

In a paper not to exceed six pages, excluding title and reference pages, submit your answers to the following in an MS Word document:

What is L. P.’s likely diagnosis?
List specific pharmacotherapeutic treatment goals for L. P.
Should the CNP order any labs for L. P. at this time? Why?
What drug therapy would the CNP likely prescribe? Why?
What are the parameters for monitoring the success of the therapy?
Describe specific patient monitoring based on the prescribed therapy.
List one or two adverse reactions for the selected agent that would cause the CNP to change therapy.
L. P. returns to see the CNP after six weeks, complaining of still feeling anxious and had heard of a medication called Klonopin that she would like to try; how should the CNP respond to her request?
What health promotion activities should be recommended for this patient?
What is L. P.’s long-term prognosis?

Please use the Case Study Analysis rubric provided to guide you in completing this assignment. It will be used to evaluate your submitted work.

Rubric – American Sentinel N521 Module 7 Assignment 3

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 7 Assignment 3	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.	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
Competency	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 American Sentinel N521 Module 7 Assignment 3	/10
Competency	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

Competency

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. American Sentinel N521 Module 7 Assignment 3

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

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

Evidence of critical thinking in prescriptive therapy, monitoring and adverse events. May have lacked a teaching plan or pathophysiologic discussion. American Sentinel N521 Module 7 Assignment 3

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

Competency

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

Competency

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 3

M. L. is a 15-year-old Hispanic female who plays soccer for her school team. She has noticed that when running, she sometimes has trouble catching her breath. She also reports an increased runny nose and itchy eyes. She has a frequent dry cough and is awakened with coughing spells at least four times a week. Her mother and father have seasonal allergies and her mother has asthma. This morning she woke up and heard “funny sounds” when she took a breath. Her coughing increased when she took a deep breath. In her nose, the mucosa is pale and swollen bilaterally. Her lungs have bilateral expiratory wheezing; respirations are 22 and PEF is 400. Her heart shows a normal sinus rhythm, with no murmurs or gallops; pulse is 72; and there is no cyanosis. American Sentinel N521 Module 7 Assignment 3

Diagnosis: Mild Persistent Asthma

In this discussion forum:

Discuss specific goals of pharmacotherapy for treating M. L.’s mild persistent asthma.
Discuss the drug therapy a CNP would likely prescribe and why.
Discuss the parameters for monitoring the success of the therapy.
Discuss age appropriate health promotion recommendations you would consider for M. L.

Remember to respond to at least two of your peers. Please see the Course Syllabus for Discussion Participation Requirements and Grading Criteria.

Example Discussion 3 Approach

Mild Persistent Asthma

The goal of therapy for M.L. is to minimize impairment with risk reduction. And this can be accomplished by avoiding serious symptoms and ensuring that M.L’s pulmonary function is close to normal. M.L’s FEV1/FVC should be 80 to 85% (Arcangelo, et al., 2017).

M.L. is going to require quick-relief rescue inhalers (SABA) and long-term control medications (ICS) for prevention of her asthma symptoms and recurrent attacks. Short-acting B2 agonists (SABA) will be the drug of choice for M.L. as this is often the mainstay of therapy for patients with mild persistent Asthma. “They have a rapid onset action of (5 to 30 minutes) and provide relief for 4 to 6 hours” (Whalen, et al., 2019). M.L. can also utilize a low-dose of inhaled corticosteroids (ICS) for long-term control of her asthma.

M.L. would be monitored for reduced impairment and pulmonary function should be near normal. This can be assessed by her ability to maintain normal activities at school, and less frequent use of her rescue inhaler. M.L. would need to be monitored and reassessed 1 to 3 months following the start of treatment, and if her symptoms have been controlled for 3 months, a 6-month follow-up would be required. Peak flow and incentive spirometry should also be assessed at the initiation of therapy and at every follow-up visit. It could take up to 4 months for asthma medications to reach a therapeutic effect (Arcangelo, et al., 2017).

M.L. would need to be educated on environmental triggers and diet modification. Avoiding cold air, dry air, and high allergen areas may reduce triggers. M.L. may need to warm up before and after exercise or better still, breathing through a face mask or a scarf as this would help pre-warm and humidify her inspired air. Additionally, M.L. may need to use SABA 15 minutes prior to exercise to prevent exercise-induced bronchospasm (EIB). M.L. should be instructed to change to a low-salt diet, with fish oil supplementation. And if SABA is not therapeutic enough, a mast cell – stabilizing drug such as cromolyn, or short-acting anticholinergic drug, such as ipratropium bromide may be recommended (Arcangelo, et al., 2017).

References

Whalen, K., Field, C., & Rahakrishnan, R. (2019). Lippincott Illustrated Reviews: Pharmacology (7th ed). Wolter Kluwer

Arcangelo, V. P., Peterson, A. M., Wilbur, V. F., & Reinhold, J. A. (2017). Pharmacotherapeutics for advanced practice: A practice approach (4th ed). Wolters Kluwer American Sentinel N521 Module 7 Assignment 3

American Sentinel N521 Module 7 Assignment 3