SU NSG6005 Full Course Latest 2019 September (No Quizzes)

NSG6005 Advanced Pharmacology

Week 1 Discussion

Ms. BD is a
33-year-old G2P1 female who has a history of chronic HTN. She was diagnosed
with this in the interim since her first pregnancy, and she has been well
controlled with Prinizide 12.5/20 PO BID. Her period, usually very regular, was
5 days late. She performed a home pregnancy test which was positive. She states
she feel “OK” but is concerned about both her HTN and her developing
fetus. She has no other medical problems, symptoms, or concerns.

Assessment:
Physical examination is unremarkable. Her BP is 128/68 and her pulse is 74. Her
urine human chorionic gonadotropin (HCG) is positive. Her potassium is 4.2,
blood

urea
nitrogen (BUN) is 14, and creatinine is 0.6. Alanine aminotransferase (ALT) is
29. White blood cells (WBCs) are 6.5, hemoglobin (Hgb) is 12.8, hematocrit
(Hct) is 39, and platelets are 330,000.

Is there
any additional subjective or objective information you need for this client?
Explain.

Is
Prinizide safe in pregnancy? What are the possible complications to the
pregnant woman and her fetus?

Why is it
important to assess the above laboratory values? How might this information
impact your treatment plan?

Would you
make any changes to Ms. BD’s blood pressure medications? Explain. If yes, what
would you prescribe? Discuss the medications safety in pregnancy, mechanism of
action, route, the half-life; how it is metabolized in and eliminated from the
body; and contraindications and black box warnings.

What health
maintenance or preventive education is important for this client based on your
choice medication/treatment?

Would you
treat this patient or refer her? Where would you refer this patient?

NSG6005 Advanced Pharmacology

Week 2 Discussion

Gami is a
48-year-old who you discover when completing a health history is taking
cinnamon to treat Type II Diabetes. She is specifically using cassia Cinnamon.
You also discover that she is taking Ginseng to assist with memory. Her
prescribed medications are Aricept and Coumadin.

Ms. GM is a
48-year-old who presents to your clinic to establish care. During the health
history, you learn that she has a history of Type II Diabetes. When asked about
prescription and non-traditional medications, she reports being prescribed
Aricept, Coumadin, Cassia cinnamon for Type II Diabetes and Ginseng for memory.

Is there
any additional subjective or objective information you need for this client?
Explain.

What would
be your position on the Ms. GMs use of alternative supplements for her diabetes
and memory? Explain and include contraindications, if any.

Are there
any additional test/assessments you would complete for this patient given this
list of medications? Explain.

How might
your treatment plan, in terms of medications, differ for this patient? Include
the class of the medication, mechanism of action, route, the half-life; how it
is metabolized in and eliminated from the body; contraindications and black box
warnings.

What health
maintenance or preventive education is important for this client based on your
choice medication/treatment?

NSG6005 Advanced Pharmacology

Week 3 Discussion

Mr. JD is a
24-year-old who presents to Urgent Care with a 2-week history of cough and
congestion. He says it started out as a “normal cold” and it will not
go away. He has a productive cough for green mucous and has green nasal
discharge. He says he has had a low-grade temperature for the past 2 days. John
reports an intermittent frontal headache with this cold. He is otherwise
healthy, with no known allergies.

In his assessment
it is found that his vital signs are stable, temperature is 99.9 degrees F,
tympanic membranes (TMs) are clear bilaterally, pharynx is erythematous with no
exudate; there is greenish postnasal drainage; turbinates are swollen and red;
frontal sinus tenderness; no cervical adenopathy, and lungs are clear
bilaterally.

Is there
any additional subjective or objective information you need for this client?
Explain.

Would you
treat Mr. JDs cold? Why or why not?

What would
you prescribe and for how many days? Include the class of the medication,
mechanism of action, route, the half-life; how it is metabolized in and
eliminated from the body; and contraindications and black box warnings.

Would this
treatment vary if Mr. JD was a 10 year-old 78 lb child? Include the class of
the medication, mechanism of action, dosing, route, the half-life; how it is
metabolized in and eliminated from the body; and contraindications and black
box warnings

What health
maintenance or preventive education is important for this client based on your
choice medication/treatment?

NSG6005 Advanced Pharmacology

Week 4 Discussion

Johnathan,
age 7, presents to the office with symptoms of worsening cough and wheezing for
the past 24 hours. He is accompanied by his mother, who is a good historian.
She reports that her son started having symptoms of a viral upper respiratory
infection 2 to 3 days ago, beginning with a runny nose, low-grade fever of
101.0 degrees F orally, and loose cough. Wheezing started on the day before the
visit, so Johnathan ‘s mother started administering albuterol metered-dose
inhaler (MDI) two puffs before bed and then two puffs at around 2 AM. The cough
and wheezing appear worse today, according to the mother. He had difficulty
taking deep-enough breaths to inhale this morning’s dose of albuterol, even
using the spacer.

Johnathan
has been a patient at the clinic since birth and is up to date on his
immunizations. His growth and development have been normal, and he is generally
healthy except for mild intermittent asthma. This is his first asthma
exacerbation of the school year, and his mother expresses a concern about sending
him to school with an inhaler.

Johnathan
is afebrile with a respiratory rate of 36 and a tight cough every 1 or 2
minutes. He weighs 45 pounds (20.5 kgs.). The examination is all within normal
limits except for his breath sounds. He has diffused expiratory wheezes and
mild retractions. Pulse oximetry readings have been 93% of oxygen saturation.

What is the
appropriate pharmacological therapies to be prescribed for Johnathan

What
information is necessary to provide to Johnathan and his mother regarding asthma
exacerbation?

What is an
appropriate clinical assessment tool to be use with Johnathan?

What are
the classification of asthma?

How would
you as the NP address his mother’s concern regarding providing an inhaler at
school?

What is an
appropriate plan of care for Johnathan?

NSG6005 Advanced Pharmacology

Week 5 Discussion

Discussion
Question 1

Mr. EBR is
a 74-year-old retired Hispanic gentleman with known coronary artery disease
(CAD), who presents to your clinic with substernal chest pain for the past 3
months. It is not positional; it reliably occurs with exertion, approximately
one to two times daily, and is relieved with rest, or one or two sublingual
nitroglycerin (NTG) tabs. It is similar in quality, but is much less severe,
than the chest pain that occurred with his previous inferior myocardial
infarction (MI) 3 years ago. Until the past 3 months, he has felt well.

The chest
pain is accompanied by diaphoresis and nausea, but no shortness of breath (SOB)
or palpitations. He does not vomit. He denies orthopnea, paroxysmal nocturnal
dyspnea (PND), syncope, presyncope, dizziness, lightheadedness, and symptoms of
stroke or transient ischemic attack (TIA). An echocardiogram done after his MI
demonstrated a preserved left ventricular ejection fraction (LVEF). Other
medical problems include well-controlled type 2 diabetes mellitus (DM),
well-controlled hypertension (HTN), and hyperlipidemia, with low-density
lipoprotein (LDL) at goal. He also has stage 3 chronic kidney disease (CKD) and
diabetic neuropathy. He no longer smokes and does not use alcohol or
recreational drugs. His daily medications include: Atenolol 25 mg PO bid,
Lisinopril 20 mg PO bid, aspirin 81 mg PO daily, Simvastatin 80 mg PO each
evening, and metformin 500 mg PO bid.

Mr. EBR’s
physical examination includes the following: height 68 inches, weight 185 lb,
Blood pressure (BP) 126/78, heart rate (HR) 64, Respiratory rate (RR) 16, and
temperature 98.6°F orally. He is alert and oriented, and in no apparent
distress (NAD). His neck is without jugular venous distention (JVD) or carotid
bruits. Lungs are clear to auscultation bilaterally. Cardiovascular:normal S1
& S2, RRR, without rubs, murmurs or gallops. Abdomen has active bowel tones
and is soft, nontender, and nondistended (NTND). Extremities are without
clubbing, cyanosis, or edema. Distal pedal pulses are 2+ bilaterally

What would
you add to the current treatment plan? Why?

Would you
discontinue any of the currently prescribed medication? Why or why not?

How does
the diagnosis stage 3 chronic kidney disease affect your choices?

Why is the
patient prescribed more than one antihypertensive?

What is the
benefit of the aspirin therapy in this patient?

Discussion
Question 2

List three
classes of drugs affecting the Hematopoietic System. List the mechanism of
action for each class of drug. Choose one medication from the three classes and
discuss what disorder the drug is used to treat? How often the medication is
given? What labs should get monitored while the patient is taking this
medication? Your response should be at least 350 words.

NSG6005 Advanced Pharmacology

Week 6 Discussion

Discussion
Question 1

Mike is a
46-year-old who presents with a complaint of “heartburn” for 3
months. He describes the pain as burning and it is located in the epigastric
area. The pain improves after he takes an antacid or drinks milk. He has been
taking either over-the-counter (OTC) famotidine or ranitidine off and on for
the past 2 months and he still has recurring epigastric pain. He has lost 6 lb
since his last visit.

Assessment

His
examination is unremarkable. His blood pressure (BP) is 118/72. Laboratory
values are normal complete blood count (CBC) and a positive serum Helicobacter
pylori test.

What would
you prescribe initially?

How long
would you prescribe these medications?

What other
possible meds could you prescribe to assist with the side effects from the
medications prescribed?

How would
the treatment vary if the patient has GERD instead?

Discussion
Question 2

List
differential diagnosis that would help confirm GERD while ruling out other
diagnosis. Which medication is the best medication for treatment of GERD and
why? What labs or other diagnostic tests that are used to confirm GERD? Your
response should be at least 350 words.

NSG6005 Advanced Pharmacology

Week 7 Discussion

Discussion
1

Tom, a
26-year-old runner, came in to the office today complaining of constant pain in
the right ankle. While running his usual route, he accidentally stepped on a
branch lying in his path, twisting his ankle inward. He denies hearing a
“pop.” He was able to walk, or limp, the remaining ¼ mile back to his
home, where he immediately elevated and iced the ankle for 30 minutes. He took
two acetaminophen 325 mg, showered and dressed for work, and drove to his place
of employment. He continued to experience significant pain in the ankle, worse
when walking. His foot became swollen. Since his job in a sporting goods store
requires that he be on his feet most of the day, he was unable to continue his
normal workday, and made a same-day appointment to be seen. He has no chronic
diseases, takes no medication, and denies recent use of NSAIDs, as aspirin and
ibuprofen cause him to have gastritis. He sprained the ankle last year, but was
able to manage that injury at home.

Assessment

A
26-year-old, otherwise healthy male presents limping into the examination room,
holding his right shoe in his hand. He grimaces with partial weight-bearing of
the affected foot. He has local ecchymosis and 1+ edema over the anterolateral
ligaments of the right ankle. Capillary refill, pulses, and sensation of the
foot and toes are intact. There is no lateral or anterior instability of the
joint or tendons. X-ray of the ankle and foot are negative for fracture or
dislocation. He has a grade I lateral ankle sprain.

What pain
relieving medications would you prescribe? Defend your choice.

How would
your prescribe them?

What side
effects should you educate the patient about?

Does the
age of the patient influence what your choice?

Discussion
Question 2

What organs
are damaged mostly by taking NSAIDS? What patient education would you provide
to someone taking NSAIDS? What organ is damaged by taking too much aspirin?
What patient education should you provide to a patient taking Aspirin? List 3
diagnosis for which you would administer NSAIDS. List 3 diagnosis for which you
would administer Aspirin. What labs or diagnostic tests would you perform for a
patient who has consumed too much Aspirin and NSAIDS. Your response should be
at least 350 words.

NSG6005 Advanced Pharmacology

Week 8 Discussion

Discussion
1:

Margaret is
a 40-year-old white female in for her annual examination. She states she has
been under increased stress in her life for the past few months. She and her
husband are currently separated and considering divorce. Her teenaged sons are
acting out and she is working extra hours to make ends meet. Secondary to the
increased stress she has started smoking again, “about a pack per
day” and states “I know that I am not eating right.”

Margaret
has been on the “pill” for almost 20 years and has always liked the
method. She states the she has heard that smoking and taking the pill are not
good, and she is worried about that. “I really do not need birth control
since I am separated but just in case I probably need something.” She
states that she has been in a mutually monogamous relationship (as far as she
knows) since her marriage 18 years ago. She denies a new partner since her
separation. Menarche was at 11 years, her cycles when on the pill are regular
and very light. Her menstrual period should start tomorrow as she just finished
her active pills. She denies a personal history of abnormal Pap smears,
gynecological issues, hypertension (HTN), or diabetes. She is G2P2002, and her
pregnancies were full term and uncomplicated at ages 24 and 26. Family history
is significant for both parents with HTN and mom has type 2 diabetes. Her
paternal grandfather died at age 64 years from type 2 diabetes, HTN, and
coronary artery disease. Her other grandparents died in their late 70s early
80s and she is unaware of any medical issues.

Assessment:

Margaret’s
examination finds her height 5’5″, weight 172 lb (up 10 lb. from last
year), current body mass index (BMI 28.6), and blood pressure (BP) 148/88.
Head, eyes, ears, nose, and throat (HEENT) are grossly within normal limits
(WNL). No thyromegaly or lymphadenopathy. Heart rate is regular and rhythm is
without murmurs, thrills, or rubs. Lungs are clear to auscultation in all
lobes. Breasts are without masses, nipple discharge, asymmetry, or
lymphadenopathy; self breast examination techniques and frequency reviewed
during examination. Abdomen is soft, nontender, with no masses or
hepatosplenomegaly; bowel sounds present in all four quadrants. Pelvic
examination reveals normal vulva and negative Bartholin’s and Skene’s glands;
vagina is pink, rugated, with minimal white nonodorous discharge; cervix is
pink, multiparous os. Pap smear collected during speculum examination was
normal. Bimanual examination reveals a retoverted, firm, mobile, nonenlarged,
nontender uterus with negative cervical motion tenderness; adnexa nontender;
and ovaries palpable bilaterally, mobile, without masses. Lower extremities
were without edema or varicosities.

1. What
options are appropriate for this patient?

2. What
contraceptive options are contraindicated?

3. What
type of patient education is indicated?

4. Given
that she has a normal pelvic exam, does that change would that influence your
decision?

NSG6005 Advanced Pharmacology

Week 9 Discussion

Discussion:

Angela is a
54-year-old married woman with three adult children. She has been the office manager
of a small law firm for 20 years and has enjoyed her work until this past year.
She has rheumatoid arthritis with minimal impairment that has been managed well
with NSAIDs. She has been taking conjugated estrogens for 8 years and decided
to stop taking them because of her concern of their risks without sufficient
medical benefit. She has tolerated the discontinuation without difficulty.

Assessment:

At her
annual medical checkup appointment, she told her primary care provider that she
seemed to be tired all the time, and she was gaining weight because she had no
interest in her usual exercise activities and had been overeating, not from
appetite but out of boredom. She denied that she and her husband have had
marital difficulties beyond the ordinary and she was pleased with the
achievements of her children. She noticed that she has difficulty falling
asleep at night and awakens around 4 a.m. most mornings without her alarm and
cannot go back to sleep even though she still feels tired. She finds little joy
in her life but cannot pinpoint any particular concern. Although she denies
suicidal feelings, she does not feel that there is meaning to her life:

“My husband
and kids would go on fine if I died and probably wouldn’t miss me that much.”

The primary
care provider asks Angela to fill out a Beck’s Depression Scale, which indicated
she has moderate depression.

1. What
medication would you first prescribe to this patient?

2. She
comes back in 2 weeks and states she has not noticed and change in her mood
since starting on the medication. What would be your response?

3. What are
the possible problems with the medication you prescribed?

4. How long
should you continue the treatment regimen?

NSG6005 Advanced Pharmacology

Week 10 Discussion

Discussion
1

What would
you do first prior to prescribing any medication?

What are
the various schedules of medications for controlled substances?

Would you
prescribe a long or short acting narcotic? Why or why not?

Discussion
2

What other
non narcotic medication options can you offer to this patient?

What
patient education is needed with them?

What would
you do if the patient and his wife tell you that none of them work for him?

Discussion
3

You are
concerned that this patient may have a substance abuse problem.

What
screening testing is available for you to use that is reliable and valid?

What
strategies would you suggest for this patient if he was found to have a
problem?

What type
of referrals would you make?

Discussion
4

After some
investigating, you find that Howard actually is seeing a pain specialist who
has given him epidural injections, and prescribes medication for him.

How does
that impact any intervention that you may consider?

What other
pharmacological options could you offer him?

What
nonpharmacological options could you suggest?

Discussion
5

After
seeing Howard and performing the appropriate screening tools, and a urine drug
screen, he admits to you that he does have a problem with opioids due to his
back injury. He states he has been admitted to an inpatient detox and
twenty-eight day rehabilitation unit previously and was able to quit using for
3 months, but relapsed due to his pain. He states for the last 6 months he has
been unable to get opioids from physicians since there is a record of him being
prescribed a large amount over a short period of time. Due to this, he has
started buying heroin from an acquaintance who he went to high school with. His
wife is very tearful and states she is concerned that eventually Howard will
end up killing himself.

What type
of substance abuse programs would be most appropriate for him?

What
requirements are there for a nurse practitioner to prescribe a medication to
treat opioid addiction?

What are
the requirements for a patient who is enrolled in a medication assisted opioid
treatment program?

NSG6005 Advanced Pharmacology

Week 2 Assignment

TITLE SELECTION

Assigned
student for this week for presentation

This will
be done weekly and according to what we will be studying for that week, and will
begin Week 2, and end Week 9.

Each
student will be responsible for preparing one presentation on pharmacological
management of the disease or pharmacological applications of a drug or group of
drugs.

Each
student will clearly write a title for this topic. Examples are
‘Pharmacological Management of Deep Vein Thrombosis and/or Pulmonary Embolisms
Using Anticoagulants/Thrombolytics and Nursing Implications’ or
‘Pharmacological Effects of Anti-hypertensive Medications in the Management of
Hypertension and Nursing Implications’.

Nursing Implications
are the nursing related consequences and what you as the nurse should be
looking for in the treatment and care of your patient.

Students
must get their title approved by the professor before the deadline shown in
your schedule. Unapproved titles will not be accepted

The
presentation must identify the Pharmacodynamic properties and actual/potential
effects on the patient.

This is
worth 20 points.

Submission
Details:

Submit your
assignment to the Submissions Area by the due date assigned.

NSG6005 Advanced Pharmacology

Week 4 Assignment

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Assigned
student for this week for presentation

This will
be done weekly and according to what we will be studying for that week, and will
begin Week 2, and end Week 9.

Each
student will be responsible for preparing one presentation on pharmacological
management of the disease or pharmacological applications of a drug or group of
drugs.

Each
student will clearly write a title for this topic. Examples are
‘Pharmacological Management of Deep Vein Thrombosis and/or Pulmonary Embolisms
Using Anticoagulants/Thrombolytics and Nursing Implications’ or
‘Pharmacological Effects of Anti-hypertensive Medications in the Management of
Hypertension and Nursing Implications’.

Nursing
Implications are the nursing related consequences and what you as the nurse
should be looking for in the treatment and care of your patient.

Students
must get their title approved by the professor before the deadline shown in
your schedule. Unapproved titles will not be accepted

The
presentation must identify the Pharmacodynamic properties and actual/potential
effects on the patient.

This is
worth 20 points.

Submission
Details:

Submit your
assignment to the Submissions Area by the due date assigned.

NSG6005 Advanced Pharmacology

Week 6 Assignment

DRUGS AFFECTING THE GASTROINTESTINAL SYSTEM

Assigned
student for this week for presentation

This will
be done weekly and according to what we will be studying for that week, and will
begin Week 2, and end Week 9.

Each
student will be responsible for preparing one presentation on pharmacological
management of the disease or pharmacological applications of a drug or group of
drugs.

Each student
will clearly write a title for this topic. Examples are ‘Pharmacological
Management of Deep Vein Thrombosis and/or Pulmonary Embolisms Using
Anticoagulants/Thrombolytics and Nursing Implications’ or ‘Pharmacological
Effects of Anti-hypertensive Medications in the Management of Hypertension and
Nursing Implications’.

Nursing
Implications are the nursing related consequences and what you as the nurse
should be looking for in the treatment and care of your patient.

Students
must get their title approved by the professor before the deadline shown in
your schedule. Unapproved titles will not be accepted

The
presentation must identify the Pharmacodynamic properties and actual/potential
effects on the patient.

This is
worth 20 points.

Submission
Details:

Submit your
assignment to the Submissions Area by the due date assigned.

NSG6005 Advanced Pharmacology

Week 8 Assignment

PHARMACOLOGICAL APPLICATION OF INSULIN

Assigned
student for this week for presentation

This will
be done weekly and according to what we will be studying for that week, and will
begin Week 2, and end Week 9.

Each
student will be responsible for preparing one presentation on pharmacological
management of the disease or pharmacological applications of a drug or group of
drugs.

Each
student will clearly write a title for this topic. Examples are
‘Pharmacological Management of Deep Vein Thrombosis and/or Pulmonary Embolisms
Using Anticoagulants/Thrombolytics and Nursing Implications’ or
‘Pharmacological Effects of Anti-hypertensive Medications in the Management of
Hypertension and Nursing Implications’.

Nursing
Implications are the nursing related consequences and what you as the nurse
should be looking for in the treatment and care of your patient.

Students
must get their title approved by the professor before the deadline shown in
your schedule. Unapproved titles will not be accepted

The
presentation must identify the Pharmacodynamic properties and actual/potential
effects on the patient.

This is
worth 20 points.

Submission
Details:

Submit your
assignment to the Submissions Area by the due date assigned.

NSG6005 Advanced Pharmacology

Week 9 Assignment

PHARMACOLOGICAL APPLICATIONS OF ANTIDEPRESSANTS

Assigned
student for this week for presentation

This will
be done weekly and according to what we will be studying for that week, and will
begin Week 2, and end Week 9.

Each
student will be responsible for preparing one presentation on pharmacological
management of the disease or pharmacological applications of a drug or group of
drugs.

Each
student will clearly write a title for this topic. Examples are
‘Pharmacological Management of Deep Vein Thrombosis and/or Pulmonary Embolisms
Using Anticoagulants/Thrombolytics and Nursing Implications’ or
‘Pharmacological Effects of Anti-hypertensive Medications in the Management of
Hypertension and Nursing Implications’.

Nursing
Implications are the nursing related consequences and what you as the nurse
should be looking for in the treatment and care of your patient.

Students
must get their title approved by the professor before the deadline shown in
your schedule. Unapproved titles will not be accepted

The
presentation must identify the Pharmacodynamic properties and actual/potential
effects on the patient.

This is
worth 20 points.

Submission
Details:

Submit your
assignment to the Submissions Area by the due date assigned.