Posted: June 6th, 2024

Evaluate drug treatment plans for patients with various disorders and justify drug

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.
Required Readings
• Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.
o Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348)
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.
• NURS_6521_Week2_Assignment_Rubric
NURS_6521_Week2_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 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 OutcomeScenario 4: 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.

+++++

Case Study: Patient JM
Patient JM is a 62-year-old female with a history of hypertension and type 2 diabetes. She presents to the clinic complaining of intermittent chest palpitations and lightheadedness over the past two weeks. An ECG shows runs of paroxysmal supraventricular tachycardia (PSVT). Her current medications include lisinopril 20mg daily, metformin 1000mg twice daily, and low-dose aspirin.

Appropriate medication and rationale:
For acute treatment of PSVT, adenosine 6mg IV rapid push is recommended. Adenosine is a first-line agent that slows conduction through the AV node and can terminate reentrant SVT rhythms like PSVT (Somberg & Camm, 2022). If adenosine is not effective, synchronized cardioversion may be indicated.

For long-term suppressive therapy, a beta-blocker such as metoprolol 25-100mg twice daily is suggested, starting at a low dose and titrating up as tolerated. JM’s history of diabetes is a consideration, as beta-blockers can mask hypoglycemia symptoms. However, cardioselective agents like metoprolol are less likely to impact glucose control compared to nonselective beta-blockers (Busko, 2017). Her blood pressure should be monitored and lisinopril dose adjusted if needed after starting the beta-blocker.

Prescription:
Metoprolol succinate 25 mg PO twice daily
Disp: 60 tablets
Sig: Take one tablet by mouth twice daily

References:
Busko, M. (2017). Beta-blocker choice in type 2 diabetes may affect hypoglycemia risk. https://www.medscape.com/viewarticle/829696
Somberg, J. C., & Camm, J. A. (2022). Atrial arrhythmias: Treatment. In K. Wang, K. E. Malackaničs Košco, & W. J. Brady (Eds.), Cardiac Arrest (pp. 457-485). Cambridge University Press. https://doi.org/10.1017/9781108917827.029

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