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Case scenario: LM is an 86-year-old female admitted to the emergency department with delirium. Her spouse is with her and verifies that LM adheres to the medications she is currently prescribed. She does not self-monitor her BP or heart rate at home.

PMH:

· A Fib diagnosed 1 month ago

· HTN x 10 years

· CKD x 5 years

· Osteoarthritis x 7 years

· GERD x 20 years

Medications: 

· Digoxin 0.25 mg QD

· Metoprolol XL 25mg QD

· Warfarin 3 mg QD

· APAP 650 mg TID

· Omeprazole 20mg QD

· Multivitamin QD

Allergies: NKDA

Social History:

· Married to husband for 57 years

· No smoking, alcohol, limited daily exercise (short walks each morning)

Family History:

None reported

Vitals:                                     Labs:

Wt 113 lbs Ht 5’4”                   Na+ 138          K+ 4.0 Cl- 99              CO2 27

BP 101/58, HR 52                   BUN 33           Cr 1.2 Gluc 109         INR 3.8

                                              Dig 2.4

PE:

Elderly female with altered level of consciousness, no signs of bruising, bleeding, or other injury.                        

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 College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. 

Develop the work, each question with its answer individually, Not explain altogether.

using formal APA writing convention, using the 7th Edition

References at least 4 and not more than 5 years ago

Plagiarism document…. Thank you

please read the teacher’s instructions, to correctly develop the work

 I would also like you to start making dosing recommendations in all of your responses were applicable (i.e.   acetaminophen (Tylenol) 650 mg PO q 6 hours).  Remember, if you are making a medication recommendation, please have at least 3 sentences and provide a reference as to why you think the recommendation is the best for the patient. 

Also, please ensure, when discussing a disease state, you elaborate on the medications and potential adverse effects.  I am also not a stickler for going over the page requirements in the event it is needed.  Refer to the class rubric for specific grading criteria. A common citation mistake is using commonly abbreviated names.  Such as example is with the CDC.   Per APA formatting, please reference abbreviations in the following manner when citing them (Centers for Disease Control [CDC], 2017).   After you establish this initial citation, you can use (CDC, 2017) for subsequent citations within the paper. 

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

· Chapter 33, “Review of Hemodynamics” (pp. 285–289)

· Chapter 37, “Diuretics” (pp. 290–296)

· Chapter 38, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 297–307)

· Chapter 39, “Calcium Channel Blockers” (pp. 308–312)

· Chapter 40, “Vasodilators” (pp. 313–317)

· Chapter 41, “Drugs for Hypertension” (pp. 316–324)

· Chapter 42, “Drugs for Heart Failure” (pp. 325–336)

· Chapter 43, “Antidysrhythmic Drugs” (pp. 337–348)

· Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 349–363)

· Chapter 45, “Drugs for Angina Pectoris” (pp. 364–371)

· Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388)

 

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.

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.

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

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