NURS 6521 Week 4 Assignment: Solved Case Studies (Walden University)

NURS-6521 Week 4 Assignment Walden University

WEEK 4 ASSIGNMENT

Case studies are a useful way for you to apply your knowledge of pharmacokinetic and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.

For your Week 4 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.

DIRECTIONS

For each of the scenarios below, answer the questions using your learning resources, Medscape, and clinical practice guidelines (i.e., 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.

SCENARIO 1 – NURS-6521 Week 4 Assignment Walden University

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)?

linaglipton 5 mg PO daily #30 5 RF

Tresiba inject 10 units SC TID with meals #1 box of 5 pens 1 RF

tiotropium (Spiriva) 2.5 mcg PO BID #60 1 RF

Qulipta 60 mg PRN for migraine #30 1 RF

levothyroxine 88 mg PO daily #30 5 RF

Scenario 1 SOLVED: Prescription Error Identification & Correction – NURS-6521 Week 4 Assignment Walden University

Prescription mistakes are a global public health issue, leading to severe medication responses and poor patient outcomes, especially among the elderly (Agustí et al., 2023). Adverse medication responses, inappropriate usage, interactions, inaccurate doses, and poor compliance are compounded by systemic inefficiencies such as prior authorization delays. To reduce these hazards, advanced practice nurses must grasp pharmaceutical categorization, MOA, and prescription formatting.

The prescription “linagliptin 5 mg PO daily #30 5 RF” has three significant errors, including the medicine name is misspelt (“linaglipton” should be “linagliptin”), the abbreviation “RF” should be “refills,” and the amount “#30” should be “30 tablets.” This might cause dispensing errors and patient damage. The exact prescription is Linagliptin 5 mg tablet, one tablet daily. Give 30 pills and 5 refills for type 2 diabetes. Linagliptin inhibits DPP-4. Inhibiting the DPP-4 enzyme increases incretin hormones (GLP-1 and GIP), which enhance glucose-dependent insulin release and reduce glucagon production, decreasing blood glucose (Aroda et al., 2012).

“Tresiba inject 10 units SC TID with meals #1 box of 5 pens 1 RF” is dangerously inaccurate. Tresiba (insulin degludec) is a once-daily basal insulin; “TID with meals” might lead to harmful buildup and severe hypoglycemia (Philis-Tsimikas et al., 2019). “Inject” is redundant, “SC” is better, and “#1 box of 5 pens” is unclear. Mixing strengths (100 vs 200 units/mL) or moving from pen to syringe can cause an overdose. Correct prescription: 100 units/mL insulin degludec (Tresiba) injection. Daily subcutaneous injection of 10 units. Dispense one refill and one 3mL pre-filled pen (300 units). For diabetes. Its long-lasting effect results from multi-hexamer synthesis upon injection (Philis-Tsimikas et al., 2019).

The prescription “tiotropium (Spiriva) 2.5 mcg PO BID #60 1 RF” contains route and frequency problems. Inoculation of tiotropium is once daily (“BID”), not twice (“PO”). The proper prescription is a tiotropium bromide (Spiriva Respimat) 1.25 mcg per actuation. Orally inhale 2 puffs (2.5 mcg) every day. One inhaler (60 puffs), one refill. To maintain COPD. Long-acting muscarinic antagonists (LAMAs) block M3 receptors, preventing bronchoconstriction (Agustí et al., 2023).

The prescription “Qulipta 60 mg PRN for migraine #30 1 RF” misuses “PRN”. Daily preventative medicine Qulipta (atogepant) is not used for acute attacks (Vernieri et al., 2025). The prescription is Atogepant (Qulipta) 60 mg tablet, taken once daily. 30 pills, 1 refill. For episodic migraine prevention. According to Vernieri et al. (2025), it selectively blocks the CGRP receptor, inhibiting the neurogenic inflammation and vasodilation implicated in migraine pathophysiology.

The life-threatening mistake in the levothyroxine prescription “levothyroxine 88 mg PO daily #30 5 RF” is milligrams instead of micrograms. 88 mg is 1000 times the usual amount. The exact prescription is one levothyroxine sodium 88 mcg tablet taken once a day on an empty stomach. Give 30 pills and 5 refills. The metabolic regulator levothyroxine is a synthetic T4 prohormone converted to active T3 for hypothyroidism.

SCENARIO 2 – NURS-6521 Week 4 Assignment Walden University

PK is a 16-year-old female diagnosed with mild persistent asthma since age 12. During her visit today, she reports having to use her albuterol MDI 3 days per week over the past 2 months. Over the past week she has been using albuterol at least once per day. She reports being awakened by a cough 5 nights during the last month. She also has a fluticasone MDI, which she uses “most days of the week.” Her current medications include: Flovent HFA 44 mcg two puffs BID, Proventil HFA two puffs Q 4-6 hr PRN shortness of breath, fexofenadine 180 mg po daily, diphenhydramine 50 mg qhs prn. What treatment plan would you implement for PK? What medication changes would you make? Include a complete medication order . How would you monitor the effectiveness of this plan, and what patient education would you provide?

NURS-6521 Week 4 Assignment Walden University – SCENARIO 3

ES is a 45-year-old African American male that was prescribed bisoprolol for his high blood pressure SOLVED . Blood pressure today is 142/89 HR 60 RR 15. He states that he only occasionally takes the medication because he does not like the side effects. What information would you provide to the patient at his visit? What is his goal blood pressure? How is hypertension treated per current guidelines (JNC 8, ACC, AHA)? How would you improve his treatment? Include a complete medication order.

SCENARIO 4 – NURS-6521 Week 4 Assignment Walden University

TF is a 60-year-old male presenting to the clinic for medication refills (SOLVED) . Current medications include acetylcholinesterase inhibitor donepezil 5 mg po qhs, anti-amyloid monoclonal antibody lecanemab (Leqembi) 10 mg/kg IV every 2 weeks for early Alzheimer’s disease, and atorvastatin 40 mg po daily. His lab work today includes: fasting BG is 195 mg/dL; HgA1C = 8.5%. Basic Metabolic Profile (BMP) is normal except for Cr 1.9 and eGFR 28. What is his goal A1C? Please SELECT and DISCUSS which of the following would be best to prescribe for TF:

canagliflozin (Invokana) 100 mg PO daily

exenatide (Byetta) 5 mcg SC twice daily

glimepiride 1 mg PO daily

glyburide 2.5 mg PO daily

metformin 500 mg PO daily

semaglutide (Ozempic) 0.25 mg SC once weekly

sitagliptin (Januvia) 50 mg PO daily

NURS-6521 Week 4 Assignment Walden University