For each of the scenarios below, answer the questions using your learning resources, Medscape, and clinical practice guidelines (ie JNC 8, AHA, ACC etc). Lecturio is an optional resource but highly recommended. Be sure to thoroughly answer ALL questions. When recommending medications, write out a complete medication order . What would you send to a pharmacy? Include the following information: drug, dose, route, frequency, duration (if applicable), quantity, # of refills and indication for use. An example of a complete prescription is as follows: lisinopril 10mg #30 tabs, take 1 tab PO once daily for high blood pressure, refills: 2 . Also state if you would continue, discontinue or taper the patient’s current medications. Review and discuss ALL labs and possible interactions. Use at least 3 sources for each scenario and cite sources using APA format; include in-text citations. You do not need an introduction or conclusion paragraph. Please also review assignment rubric.
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SCENARIO 1
What are the errors in the following prescriptions (5 total)? Rewrite each prescription correctly. What is each medication classification? What is the mechanism of action (MOA)?
Hyzaar (losartan/hydrochlorothiazide) 50/25 mg PO daily #30 3 RF
Lotrel (amlodipine/lisinopril) 5/40 mg PO daily #30 3 RF
hydralizine 25 mg PO QID #120 1 RF
digoxin 1.25 mg PO daily #30 1 RF
Repatha 140 mg IV every 2 weeks #1 1 RF
SCENARIO 1 SOLVED
SCENARIO 2
Does fentanyl have a high or low first pass effect ? Please discuss why this is important to know and how it relates to bioavailability . What route has 100% bioavailability? In addition to parenterally, how can this medication be given to counter the first pass effect? Write a sample prescription for this medication. Scenario 2 solved
SCENARIO 3
Where are the majority of cytochrome P450 (CYP) enzymes located? Using the Medscape pill identifier, enter the following characteristics to identify the medication. What CYP enzyme metabolizes this medication? How can this information be applied to medication therapy management? Write a sample prescription for the identified medication and strength .
Imprint (292) Shape (Oval) Color (Brown) Form (Tablet) Scoring (None)
SCENARIO 4
DL is a 48-year-old male following up on his labs that were drawn last week. He smokes 1 pack per day. He is currently on losartan 50 mg po daily, linagliptin (Tradjenta) 5 mg PO daily and red yeast rice supplement. Fasting lipid profile shows Total Cholesterol 245 mg/dL, LDL 165 mg/dL, HDL 41 mg/dL, and Triglycerides 175 mg/dL. He is 5’10” and weighs 223 lbs. What treatment plan would you implement for DL? Include a complete medication order. What are GOAL Total Cholesterol, LDL, HDL, and Triglyceride levels? What is DL’s BMI per Medscape calculator? What patient monitoring and education would you provide? How many risk factors for Coronary Artery Disease (CAD) does DL have? Identify them specifically .
Assignment: Case Studies
Case studies are a useful way for you to apply your knowledge of pharmacokinetics and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.
For this Assignment, you evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review the case study posted in “Announcements” by your Instructor for this Assignment
Review the information provided and answer questions posed in the case study
When recommending a medication, write out a complete prescription for the medication
Whenever possible, use clinical practice guidelines in developing your answers when possible
Include at least three references to support your answer and cite them in APA format.
By Day 7 of Week 1
Submit the Assignment.
submission information
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To submit your completed assignment, save your Assignment as WK1Assgn1_LastName_Firstinitial
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6521_Week2_Assignment_Rubric
NURS_6521_Week2_Assignment_Rubric
Criteria
Ratings
Pts
This criterion is linked to a Learning Outcome Scenario 1: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.
15 to > 11.0 pts Excellent Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.
11 to > 7.0 pts Good Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.
7 to > 3.0 pts Fair Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.
3 to > 0 pts Poor Medication selected is inappropriate or would not be provided based on patient unique characteristics.
15 pts
This criterion is linked to a Learning Outcome Scenario 1: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts Complete Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
0 pts Poor The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts
This criterion is linked to a Learning Outcome Scenario 1: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.
4 pts Excellent References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.
3 pts Good References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.
2 pts Fair References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.
0 pts Poor No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.
4 pts
This criterion is linked to a Learning Outcome Scenario 1: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
3 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.
2 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.
1 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
3 pts
This criterion is linked to a Learning Outcome Scenario 2: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.
15 to > 11.0 pts Excellent Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.
11 to > 7.0 pts Good Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.
7 to > 3.0 pts Fair Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.
3 to > 0 pts Poor Medication selected is inappropriate or would not be provided based on patient unique characteristics.
15 pts
This criterion is linked to a Learning Outcome Scenario 2: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts Complete Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
0 pts Poor The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts
This criterion is linked to a Learning Outcome Scenario 2: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.
4 pts Excellent References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.
3 pts Good References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.
2 pts Fair References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.
0 pts Poor No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.
4 pts
This criterion is linked to a Learning Outcome Scenario 2: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
3 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.
2 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.
1 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
3 pts
This criterion is linked to a Learning Outcome Scenario 3: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.
15 to > 11.0 pts Excellent Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.
11 to > 7.0 pts Good Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.
7 to > 3.0 pts Fair Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.
3 to > 0 pts Poor Medication selected is inappropriate or would not be provided based on patient unique characteristics.
15 pts
This criterion is linked to a Learning Outcome Scenario 3: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts Complete Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
0 pts Poor The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts
This criterion is linked to a Learning Outcome Scenario 3: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.
4 pts Excellent References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.
3 pts Good References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.
2 pts Fair References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.
0 pts Poor No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.
4 pts
This criterion is linked to a Learning Outcome Scenario 3: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
3 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.
2 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.
1 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
3 pts
This criterion is linked to a Learning Outcome Scenario 4: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.
15 to > 11.0 pts Excellent Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.
11 to > 7.0 pts Good Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.
7 to > 3.0 pts Fair Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.
3 to > 0 pts Poor Medication selected is inappropriate or would not be provided based on patient unique characteristics.
15 pts
This criterion is linked to a Learning Outcome Scenario 4: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
3 pts Complete Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.
0 pts Poor The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.
3 pts
This criterion is linked to a Learning Outcome Scenario 4: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.
4 pts Excellent References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.
3 pts Good References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.
2 pts Fair References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.
0 pts Poor No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.
4 pts
This criterion is linked to a Learning Outcome Scenario 4: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation NURS-6521 Week 2 Assignment: Case Studies
3 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.
2 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.
1 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
3 pts
Total Points: 100
