NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders

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NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders

Assignment: Pharmacotherapy for Cardiovascular Disorders

…heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…

—Murphy et al., 2018

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.

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Photo Credit: Getty Images/Science Photo Library RF

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare
  • Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
  • Review the case study assigned by your Instructor for this Assignment.
  • Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
  • Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
  • Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders.
  • Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
By Day 7 of Week 2

Write a 2- to 3-page paper that addresses the following:

  • Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
  • Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders
  • Click on the Submit button to complete your submission.

Week 2: Cardiovascular System

Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders

This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs.

Learning Objectives

Students will:

  • Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes
  • Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies
  • Evaluate drug therapy plans for cardiovascular disorders

Learning Resources

Required Readings (click to expand/reduce)

Required Media (click to expand/reduce)

Assignment: Pharmacotherapy for Cardiovascular Disorders

…heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…

—Murphy et al., 2018

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders

Photo Credit: Getty Images/Science Photo Library RF

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare
  • Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
  • Review the case study assigned by your Instructor for this Assignment.
  • Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
  • Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
  • Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
  • Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders
By Day 7 of Week 2

Write a 2- to 3-page paper that addresses the following:

  • Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
  • Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 2 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 2 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 2

To participate in this Assignment:

Week 2 Assignment

What’s Coming Up in Week 3?

Photo Credit: Getty Images/iStockphoto

Next week, you will examine strategies for the treatment and management of respiratory disorders, including asthma. You will analyze asthma and stepwise management and consider the impact of this approach for patient health. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders

 

Rubric Detail

 

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6521_Week2_Assignment_Rubric

Excellent Good Fair Poor
Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
23 (23%) – 25 (25%)
The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
20 (20%) – 22 (22%)
The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
18 (18%) – 19 (19%)
The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.
NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders
0 (0%) – 17 (17%)
The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.
Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
27 (27%) – 30 (30%)

The response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy.

Accurate, complete, and aligned examples are provided to support the response.
24 (24%) – 26 (26%)

The response accurately describes how changes in the processes might impact the patient’s recommended drug therapy.

Accurate examples may be provided to support the response.
21 (21%) – 23 (23%)

The response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy.

Inaccurate or vague examples are provided to support the response.
0 (0%) – 20 (20%)

The response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing.

Inaccurate and vague examples may be provided to support the response, or is missing.
Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.
27 (27%) – 30 (30%)

The response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.

The response includes an accurate and detailed explanation to support the recommended improvements.
24 (24%) – 26 (26%)

The response accurately explains how to improve the patient’s drug therapy plan.

The response may include an accurate explanation to support the recommended improvements.
21 (21%) – 23 (23%)

The response inaccurately or vaguely explains how to improve the patient’s drug therapy plan.

The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.
0 (0%) – 20 (20%)

The response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing.

The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors
4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors
0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.
5 (5%) – 5 (5%)
Uses correct APA format with no errors
4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors
0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors
NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders
Total Points: 100

Name: NURS_6521_Week2_Assignment_Rubric

Case Study :

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:

  • Atenolol 12.5 mg daily
  • Doxazosin 8 mg daily
  • Hydralazine 10 mg qid
  • Sertraline 25 mg daily
  • Simvastatin 80 mg daily

Looking into this case study, patient is dealing with a major cardiovascular issue. As a provider caring for this patient, all current medications need to be reviewed and the appropriate changes need to be made. Cardiovascular disease (CVD) is the leading cause of death and a major cause of disability worldwide. In the United States, CVD accounted for 34.4 percent of the 2.4 million deaths in 2003 and remain a major cause of health disparities and rising health care costs. In 2006, health care spending and lost productivity from CVD exceeded $400 billion. (Mesah &Brown, 2007). The main contributing factor to CVD is high blood pressure, overweight/obesity, and diabetes. NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders

With the patient recent weight gain of 9 pounds, I will need to determine if the weight gain is within a week or less which could be fluid retention. If the weight gain is longer, that could be a result of patient’s lifestyle and eating habits. The factor I selected for this case study is behavioral factor due to patient history of obesity. Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It is a medical problem that increases risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers (Mayo Clinic, 2019). The effect of obesity on the pharmacokinetics and pharmacodynamics of drugs used for cardiovascular risk reduction (antihypertensive agents, statins, aspirin, antidiabetic agents) (Sankaralingam, Kim & Padwal, 2015). Also obesity can have effect on distribution and dosages of medication.

The patient is on 3 types of blood pressure medication with different classification (beta block, vasodilator, and alpha blocker). Patient is also on high – dose of cholesterol lowering statin and selective serotonin reuptake inhibitor (SSRI). Before any changes to the medication, further evaluation need to be done by doing a complete cardiac workup which will include BNP and Echocardiogram to determine patient ejection fraction.  Also, comprehensive blood panel need to be done, all this will help to determine if patient is having congestive heart failure, possible side effect of one of the listed above medication, or if weight gain is as a result of patient poor eating habits.

Changes and improvement in patient’s drug therapy

After reviewing the patient’s ordered lab and Echocardiogram results, alteration may be required. If the result shows CHF, some diuretic such as Lasix may be given. Also add ACE inhibitor which as shown to be more effective as it helps decrease the amount of sodium retained in the kidney and stop production of hormone called angiotensin II (Carter, 2018). Doxazosin may be discontinued due its side effect been weight gain because of fluid retention. I will make changes to the dose of simvastatin to 40 milligrams (mg) which is the maximum dose per day. High dose of simvastatin 80 mg is not recommended as this could cause damage to the muscle as result of myopathy or rhabdomyolysis (Medscape, 2019).

On the other side, if the cardiac workup came back to be negative, adjustment to some of the medications still need to be done. As Nurse Practitioner, I will need to discuss with the patient in depth about lifestyle changes such as diet, exercise and important of compliance with prescribed medications. Behavioral modification is another evidence-based approach to improving the patient’s compliance with therapy. Patient education, on the disease as well as pharmacologic (medication) and non-pharmacologic interventions (lifestyle modifications), is a cornerstone of successful treatment (Waldner, 2013). NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders. Recent studies have suggested health coaching because it works as a motivator for patients instead of just reminding them to take their medications. Health coaching has been shown to improve outcomes in cardiovascular risk factors including diabetes and hypertension (Heath, 2016).

References

Cater, A. (2018). ACE Inhibitors for Hypertension. Retrieved from www.healthline.com

Heath, S., (2016). Using Health Coaching to Improve Chronic Disease Management. Retrieved from https://healthitanalytics.com/news/using-health-coaching-to-improve-chronic-disease-management

Mayo Clinic (2019). Obesity. Retrieved from https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742

Medscape (2019).  Simvastatin. Retrieved from www.reference.medscape.com

Mensah G.A., & Brown, D.W. An Overview Of Cardiovascular Disease Burden In The United States. Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.26.1.38

Sankaralingam S., Kim RB, Padwal RS.,(2015).The impact of obesity on the pharmacology of medications used for cardiovascular risk factor control. Rerieved from https://www.ncbi.nlm.nih.gov/pubmed/25661551

Waldner, T.V., (2013). Handling a Silent Killer: Hypertension Management. Retrieved from https://www.rn.com/nursing-news/handling-a-silent-killer-hypertension-management/ NURS 6521: Advanced Pharmacology Assignment: Pharmacotherapy for Cardiovascular Disorders

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