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NURS 6521 Discussion Pharmacokinetics and Pharmacodynamics

NURS 6521 Discussion Pharmacokinetics and Pharmacodynamics

 

NURS 6521- Week 1 Discussion Board- R. Glanton

Pharmacokinetics and pharmacodynamics are critical components of patient care. Pharmacokinetics is the study of how drugs move through the body (Rosenthal and Burchum, 2021). It involves four distinct processes: absorption, distribution, metabolism, and excretion. These processes may have an effect on how drug therapy is managed therapeutically in patients. Pharmacodynamics is the study of the biochemical and physiological effects of medications on the body, as well as the molecular mechanisms underlying these effects (Rosenthal and Burchum, 2021). The duration and intensity of therapeutic effects, as well as the occurrence of adverse drug reactions, determine the outcome of these effects. Numerous factors, including age, gender, ethnic origin, behavior, genetics, and disease processes, can affect the pharmacokinetics and pharmacodynamic processes. To develop an effective plan of care for patients, it is critical for the health care provider to understand pharmacokinetics and pharmacodynamics and their influence on drug therapy.

One previously worked as a home health nurse and cared for K.S. at her residence. K.S. is a 70-year-old African American female who was recently discharged from the hospital following surgery to repair her tricuspid valve. According to K.S.’s medical history, he has right-sided heart failure, hypertension, hepatitis C, and liver ascites. K.S. was diagnosed with chronic kidney disease, hypotension, and atrial fibrillation following surgery. K.S.’s discharge instructions included the continuation of previously prescribed medications in addition to midodrine and warfarin. K.S. was unsure of why she was taking certain medications, when and if her blood pressure should be checked, the blood pressure parameters to monitor while on midodrine and other prescribed hypertensive medications, the daily dose of warfarin, and when laboratory testing to check her PT/INR was required. K.S. was observed in statue to be frail and was ordered Three times daily, ensure. NURS 6521 Pharmacokinetics and Pharmacodynamics Discussion

Age along with pathophysiologic changes related to disease are huge factors that can affect pharmacokinetics and pharmacodynamic processes. According to Rodrigues, Herdeiro, Figueiras, Coutinho, and Roque (2020), ageing is a process that inevitable resulting in a decline in functioning and increased susceptibility to certain diseases, requiring the use of an increased amount of medication. Ageing can affect the distribution, metabolism, and excretion in the process of pharmacokinetics. Changes in body mass and protein synthesis can affect distribution of a drug and nutritional status can affect the rate of metabolism of a drug in an ageing patient (Rodrigues et. al, 2020). Most drugs are eliminated through kidneys. In the ageing patient, there is a decline in renal function related to a decrease in the glomerular filtration rate and renal blood flow, which makes it difficult for drugs to be excreted through the kidneys. This, in turn, puts the patient at risk for adverse drug reactions. According to Ponticelli, Sala, and Glassock (2015), older patients who have kidney disease are most at risk for adverse drug reactions. The process of pharmacodynamics affected by ageing can cause drug sensitivity and impaired homeostasis.

The patient K.S. has several medical conditions, resulting in a numerous amount of prescribed medications. She is frail in statue and

NURS 6521 Discussion Pharmacokinetics and Pharmacodynamics

NURS 6521 Discussion Pharmacokinetics and Pharmacodynamics

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has a lean body mass, which can affect the distribution of the medications prescribed. She, also, has poor nutritional status, which can affect the metabolism of the medications prescribed. She has been recently diagnosed with chronic kidney disease, which can affect elimination of the medications prescribed. She is prescribed warfarin, in which the response can be increased due to drug sensitivity leading to an adverse event. Also, due to impaired homeostasis, blood pressure regulation could be affected. NURS 6521 Discussion Pharmacokinetics and Pharmacodynamics

In developing a personalized plan of care for patient K.S., one has to take into consideration the patient’s age and medical history. One would review the drug therapy with the patient and discontinue any medications that are not necessary, have drug interactions, or put the patient at risk for an adverse drug reaction. One would ensure that current laboratory testing has been completed and review the laboratory results with the patient. Based on these results, one would consider medications that are safer for the patient and has the lowest effective dose possible. One would provide education to the patient on disease processes, purpose of medications prescribed, checking blood pressure and parameters to follow. One would stress the adherence to medication regimen and the importance of laboratory testing.

References

Ponticelli, C., Sala, G., and Glassock, R. (2015). Drug management in the elderly adult with

chronic kidney disease: a review for the primary care physician. Mayo Clinic Proc., 90

(5). Doi.org/10.1016/j.mayocp.2015.01.016.

Rodrigues, D., Herdeiro, M., Coutinho, P., and Roque, F. (2020). Elderly and polypharmacy:

physiological and cognitive changes. Frailty in the Elderly.

Doi:10.5772/intecopen.92122.

Rosenthal, L.D. and Burchum, J.R. (2021). Lehne’s pharmacotherapeutics for advanced practice

nurses and physician assistants (2nd ed.). St. Louis, MO: Elsevier.

RE: NURS 6521- Week 1 Discussion Board

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Hello Robin,

Great discussion post, I really enjoyed reading your discussion. I’ve worked in a hospital for five years and one of the main reason for readmission is patients not taking medications, due to not understanding why they are taking them, not to mention over taking medications that cause a whole new list of issues.  Medications like midodrine and coumadin are very sensitive medications that need to be closely monitored. For a patient taking midodrine, the patient needs to understand that this medication is very influential peripheral acting aplpha-1 agonist that is mostly used for patients with hypotension (Wong, Wong, Robertson, Burns, Roberts and Isbister, 2017). The mechanism of action of Midodrine is to make an increase in peripheral venous resistance and then to decline venous capacity, with the goal being to increase laying and standing blood pressure ( Wong, Wong, Robertson, Burns, Roberts and Isbister, 2017). With midodrine the patient needs to educate on heart rate to make sure they don’t become bradycardic; the patient needs to be educated on how to check pulse and blood pressure before medication administration and there needs to be an order for parameters for the patient, for when the patient should and should not take the medication ( Wong, Wong, Robertson, Burns, Roberts and Isbister, 2017).

With coumadin the patient needs to have their INR checked frequently to make sure it’s within a therapeutic range, and to also make sure the patients’ blood is not too thin. Anticoagulation drugs have a risk for bleeding due to their complexity (Bajorek,2011). For this patient you stated in this scenario she was on several other medications as well, and when patients are on several medications, the risk of them being misused is even higher (Bajorek,2011). When a patient is unable to take medications as prescribed, there current health care issues aren’t being treated, which is why a lot of times they end up being readmitted with the same problem they were previously in the hospital for. Kymes, Sullivan, Jackson & Raj (2020), note that a patient not being able to comply with their medications is a very huge public health problem, that affects a lot of comorbidities that a person has. I agree with your plan of care and discontinuing any medications that aren’t necessary, as more medications add to more adverse reactions that could happen and to monitor blood pressure and pulse before administration of midodrine. The patient also needs to be following the orders for her coumadin and to have her INR checked as frequent as the physician wants. The patient can have her INR checked at home with a home health nurse. I would also suggest this patient to keep a log of her blood pressure and pulse to show her provider, so they can adjust as needed to keep her as safe as possible.   NURS 6521 Discussion Pharmacokinetics and Pharmacodynamics

Heather

References:

Bajorek B. (2011). A review of the safety of anticoagulants in older people using the medicines management pathway: weighing the benefits against the risks. Therapeutic advances in drug safety, 2(2), 45–58. https://doi.org/10.1177/2042098611400495

Kymes, S. M., Sullivan, C., Jackson, K., & Raj, S. R. (2020). Real-world droxidopa or midodrine treatment persistence in patients with neurogenic orthostatic hypotension or orthostatic hypotension. Autonomic Neuroscience: Basic and Clinical, 225. https://doi-org.ezp.waldenulibrary.org/10.1016/j.autneu.2020.102659

Wong, L. Y., Wong, A., Robertson, T., Burns, K., Roberts, M., & Isbister, G. K. (2017). Severe Hypertension and Bradycardia Secondary to Midodrine Overdose. Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology, 13(1), 88–90. https://doi-org.ezp.waldenulibrary.org/10.1007/s13181-016-0574-4

Week 1: Basic Pharmacotherapeutic Concepts/Ethical and Legal Aspects of Prescribing

How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow?

Questions like these are related to the underlying pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics. As an advanced practice nurse, understanding these fundamental pharmacotherapeutic concepts is important to ensure that the prescription drugs you recommend for your patients will be safe and effective to treat and/or manage their symptoms. Additionally, as the advanced practice nurse, it is your responsibility to ensure that when prescribing prescription drugs, you adhere to the ethical and legal principles set forth for prescribing drugs as an added layer of protection and safety for the patients you will treat.

This week, you will analyze factors that may influence pharmacokinetic and pharmacodynamics processes of a patient and assess the details of a personalized plan of care that you develop based on influencing factors and patient history. You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs, including disclosure and nondisclosure, and analyze the process of writing prescriptions to avoid medication errors.

Learning Objectives
Students will:

Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients
Assess patient factors and history to develop personalized plans of care
Evaluate ethical and legal implications related to prescribing drugs
Analyze ethical and legal practices of prescribing drugs
Analyze strategies to address disclosure and nondisclosure
Justify advanced practice nurse strategies to guide prescription drug decision-making
Analyze the process of writing prescriptions to avoid medication errors
Learning Resources
Required Readings (click to expand/reduce)

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

Chapter 1, “Prescriptive Authority” (pp. 1–3)
Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)
American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767

American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

 

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

 

This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

 

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf

This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

 

This website details key aspects of drug registration.

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the code of ethics for nurses with interpretive statements: Development, interpretation, and application (2nd ed.). American Nurses Association.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

 

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

Required Media (click to expand/reduce)

Introduction to Advanced Pharmacology

Meet Dr. Terry Buttaro, associate professor of practice at Simmons College of Nursing and Health Sciences as she discusses the importance of pharmacology for the advanced practice nurse. (8m)

Accessible player
Nature Video. (2016). The evolution of oral anticoagulants [Video]. https://www.youtube.com/watch?v=Gp-ucDRiaUA

Note: This media program is approximately 5 minutes.

Speed Pharmacology. (2015). Pharmacology – Pharmocokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s

Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2017). Pharmacology – Diuretics (Made Easy) [Video]. https://www.youtube.com/watch?v=9OBvNpnS0h4&t=664s

Note: This media program is approximately 18 minutes.

Speed Pharmacology. (2017). Pharmacology – Antiarrhythmic Drugs (Made easy) [Video]. https://www.youtube.com/watch?v=9xSqezCMHnw&t=1205s

Note: This media program is approximately 23 minutes.

Speed Pharmacology. (2015). Pharmacology – Pharmocokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s

Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2016). Pharmacology – Adrenergic receptors & agonists (MADE EASY) [Video]. https://www.youtube.com/watch?v=KtmV-yMDYPI&t=372s

Note: This media program is approximately 18 minutes.

Speed Pharmacology. (2017). Drugs for Hyperlipidemia (Made Easy) [Video]. https://www.youtube.com/watch?v=Of1Aewx-zRM&t=24s

Note: This media program is approximately 14 minutes.

Discussion: Pharmacokinetics and Pharmacodynamics
As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.

Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.

Photo Credit: Getty Images/Ingram Publishing

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare
Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history in your case study.
By Day 3 of Week 1
Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

By Day 6 of Week 1
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information
Grading Criteria
To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1
To Participate in this Discussion:

Week 1 Discussion

RE: Discussion – Week 1

 Discussion Main PostPharmacokinetics and Pharmacodynamics

 

For an advanced practice nurse, advanced knowledge of pharmacotherapeutics is important. A few factors that affect how the patient can react to the medication are the age, genetics, and metabolism of the patient. Understanding pharmacokinetics and pharmacodynamics is a vital component in successfully designing a patient-focused drug treatment strategy while preparing care for any patient population. Pharmacokinetics is the study of the movement of drugs in the body, and this involves the ingestion, metabolization, delivery, and excretion of the drug. Pharmacodynamics is how the body reacts to the drug and its action mechanisms (Rosenthal & Burchum, 2018).

Description of the Patient Case

A 66-year-old female was admitted to our nursing facility with Major depression with psychosis. This patient was discharged from another sister  nursing facility for aggressive, combative and refusing care. This patient was brought to us because our sister facility was not equip to handle this type of patients.  The physician ordered Haldol, and Benadryl. After receiving the IM injection, the patient calmed down and was drowsy which increased her risk for fall and injury.

The majority of drugs are excreted by the kidneys; pharmacokinetics in patients sixty-five or older are affected by loss of kidney function (Aymanns, Keller, Maus, Hartman & Czock, 2010; Rosenthal & Burchum, 2018). Pharmacotherapy is difficult because of the complexities of comorbidities, polypharmacy and age-related liver/kidney changes, and drug interactions or toxicity may occur.( Boparai & Korc-Grodzicki, 2011).

The personalized plan of care for this 66 years old patient would be a modified confusion assessment method (mCAM-ED) and a reality orientation. Behavioral symptoms change and evolve throughout dementia; agitation, restlessness, and hallucinations are frequent in these patients, reduction in agitation rather than sedation is a goal of treatment in most cases ( Casey, 2015). The first drug of choice would be Haldol, which has a shorter half-life, causes less sedation, respiratory depression, and has minimal effects on BP (Calver & Isbister, 2013).

Reference

Aymanns, C., Keller, F., Maus, S., Hartman, B., & Czock, D. (2010). Review on pharmacokinetics and pharmacodynamics and the aging kidney. Clinical Journal of American Society of Nephrology5(2). doi: 10.2215/CJN.03960609

Boparai, M., & Korc-Grodzicki, B. (2011). Prescribing for older adults. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine78(4), 613–626. doi: 10.1002/msj.20278

Calver, L., & Isbister, G. K. (2013). Parenteral sedation of elderly patients with acute behavioral disturbance in the ED. The American Journal of Emergency Medicine, 31(6), 970-3. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.ajem.2013.03.026

Casey D. A. (2015). Pharmacotherapy of neuropsychiatric symptoms of dementia. P & T: a peer-reviewed journal for formulary management40(4), 284–287.

Hasemann, W., Grossmann, F. F., Stadler, R., Bingisser, R., Breil, D., Hafner, M., & Kressig, R. W. (2018). Screening and detection of delirium in older ED patients: performance of the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). A two-step tool. Internal and Emergency Medicine, (6), 915. https://doi-org.ezp.waldenulibrary.org/10.1007/s11739-017-1781-y

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

Response 1 

Hello Noah

Thanks for sharing your post. Because of the physiologic changes that come with aging, such as decreased renal and liver function, practitioners have to fully understand the possible adverse effects medication can have on elderly patients. As you stated, understanding pharmacokinetics and pharmacodynamics is a vital component in successfully designing patient-focused treatment strategies. Physiological changes with age may alter absorption, distribution, metabolism, and excretion of drugs in the elderly population. “Reduced elimination and prolonged half-life are most commonly observed pharmacokinetic changes in older patients whereas altered sensitivity to drugs and change in receptor affinity are major pharmacodynamic changes” (Mukker et al., 2016, para.1).

In response to your scenario, I have to question if the primary care provider ruled out a urinary tract infection. Did he/she order lab work before administering Haldol (Haloperidol) to check the patient’s renal and liver function?  Did the patient begin a new medication, which could have caused a drug-drug interaction, causing the behaviors? What other comorbidities did the patient have? A thorough medication review should be considered when administering new medications to patients, particularly in children and older adults. Drug dosing for older adults should be reduced or started at a very low dose due to decreased renal and liver function (Rosenthal & Burchum, 2021). Haldol (Haloperidol) is considered a typical antipsychotic and is not recommended to treat patients with dementia-related psychosis (Drugs.com, 2020). If the patient has a diagnosis of Dementia, administering Haldol (Haloperidol) can lead to detrimental outcomes.

References

Drugs.com. (2020). Haldol side effects. https://www.drugs.com/sfx/haldol-side-effects.html

Mukker, J., Singh, R., & Derendorf, H. (2016). Pharmacokinetic and pharmacodynamic considerations in elderly population. https://doi.org/10.1007/978-3-319-43099-7_10

Rosenthal, L., & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.).

NURS_6521_Week1_Discussion_Rubric

Excellent Good Fair Poor
Main Posting
Points Range: 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Points Range: 35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Points Range: 0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3
First Response
Points Range: 17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

Points Range: 15 (15%) – 16 (16%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

Points Range: 13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Points Range: 0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response
Points Range: 16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

Points Range: 14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Points Range: 12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed. .

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Points Range: 0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days
Total Points: 100
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