NR 508 Week 6 Discussion: challenging aspects of prescribing medications

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NR 508 Week 6 Discussion: challenging aspects of prescribing medications

NR 508 Week 6 Discussion challenging aspects of prescribing medications

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Week 6: Open Forum Discussion

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A Sample Answer For the Assignment: NR 508 Week 6 Discussion: challenging aspects of prescribing medications

Title: NR 508 Week 6 Discussion: challenging aspects of prescribing medications

Dr. Landry and fellow classmate,

One of the most challenging aspects of prescribing medications is the possibility of dangerous interactions with those patients on multi-drug therapies. According to Woo & Robinson, 2016, Colchicine, probenecid, and sulfinpyrazone are all used cautiously in the presence of peptic ulcer disease or spastic colon. Gastrointestinal (GI) adverse reactions from these drugs are likely to make these disorders worse. When it comes to prescriptive authority, precise critical thinking in decision making is crucial.  Medications can and do alter people’s lives, and the ability to prescribe them is an awesome responsibility. Some of the antigout medication that is being utilized such as allopurinol and febuxostat has hepatoxicity side effects. Liver function test should be performed on a regular basis. During my career as a nurse I have given patients colchicine and allopurinol numerous times, but I wasn’t aware of the dangerous side effects of these drugs.  The mechanism of action is quite impressive, allopurinol and febuxostat inhibit xanthine oxidase, the enzyme responsible for the conversion of hypoxanthine and xanthine to uric acid. Allopurinol has a metabolite (alloxanthine) that is also an inhibitor of xanthine oxidase. Allopurinol acts directly on purine metabolism, reducing the production of uric acid, without disrupting the biosynthesis of vital purines. (Woo & Robinson, 2016). Part of the fear of having this responsibility lies in the fact that many times, as providers, we do not always know what medications a patient is already taking. Many of the antigout medicines excreted via the renal system, so it is essential to know what other medication the patient is taking. Indeed, patients do their best in relaying their medical history and providing up-to-date lists of their current medications; however, we know that information is often forgotten or omitted from our conversations with them. Febuxostat, a xanthine oxidase inhibitor, is contraindicated in patients treated with drugs requiring xanthine oxidase for metabolism (azathioprine, mercaptopurine, or theophylline) because of increased risk for toxicity. (Woo & Robinson, 2016). The risk causes concern when prescribing new medications, as there may be harmful drug-drug interactions that we are not able to avoid without all the pertinent information from the patient.

Ingrid

 

 

Reference NR 508 Week 6 Discussion: challenging aspects of prescribing medications

 

Woo, T. M., & Robinson, M. V. (2016). Pharmacotherapeutics for Advance Practice Nurse prescribers (4th ed.). Retrieved from http://bookshelf.vitalsource.com

 

NR 508Wk 6 Open Forum

Professor and Class,

In reviewing this week’s lesson on pain management. The current opioid crisis and changes to interventions and pain management. More specifically interventions mid-level providers must take into consideration in regards to effective pain management. As we have learned throughout this course, a significant number of states have prescriptive authority restrictions for schedule 2 through 5 dependent substances (“SOP Policy,” 2018). However, the lesson on pain management really put into perspective what considerations to assess prior to prescribing opioids such as the levels of pain. In which as nurses we either assess the patient’s pain employing descriptive factors and numerical scales or for the non-verbal pain the Wong-Baker assessment chart. What I found interesting is the recommendation for limited use of Demerol (Meperidine) related to the increased risk of adverse outcomes from “degradation to neurotoxic metabolites and association with tremors, delirium and seizures” (Woo & Robinson, 2016, p. 1363). More importantly, when managing pain the provider should also educate the patient on both pharmacological and non-pharmacological therapies such as emotional support, guided imagery and complement therapies such as acupuncture. Which has proven to help alleviate pain with both medication and behavior modification therapy.

Thanks,

Stacy Cooper

 

References NR 508 Week 6 Discussion: challenging aspects of prescribing medications

Georgia scope of practice policy: State profile. (2018). Retrieved from http://scopeofpracticepolicy.org/states/ga/

Woo, T. M., & Robinson, M. V. (2016). The role of the advanced practice nurse as a prescriber. In Pharmacotherapeutics for advanced practice nurse prescribers (4th ed. (pp. 1-1373). Retrieved from https://online.vitalsource.com/#/books/9780803658110/cfi/6/2!/4/16/32@0:0

NR 508 Week 6 Discussion challenging aspects of prescribing medications
NR 508 Week 6 Discussion challenging aspects of prescribing medications

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NR 508 Week 6 Discussion: challenging aspects of prescribing medications Grading Rubric Guidelines

Performance Category 10 9 8 4 0
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic decisions.
  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
Performance Category  10 9 8 4 0
Application of Course Knowledge –

Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category  5 4 3 2 0
Interactive Dialogue

Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.

(5 points possible per graded thread)
  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  Minus 1 Point Minus 2 Point Minus 3 Point Minus 4 Point Minus 5 Point
Grammar, Syntax, APA

Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition
  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
0 points lost       -5 points lost
Total Participation Requirements

per discussion thread

 The student answers the threaded discussion question or topic on one day and posts a second response on another day. The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement

per discussion thread

 The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

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