Sample Answer for NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN Included After Question<\/strong><\/em><\/h2>\n…heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke\u2014some of the leading risk factors for heart disease\u2026<\/p>\n
\u2014Murphy et al., 2018<\/p>\n
Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.<\/p>\n
Photo Credit: Getty Images\/Science Photo Library RF<\/p>\n
As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.<\/p>\n
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db328.htm<\/a><\/p>\nTo Prepare<\/strong><\/h2>\n\n- Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.<\/li>\n
- Review the case study assigned by your Instructor for this Assignment.<\/li>\n
- Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.<\/li>\n
- Reflect on how the factor you selected might influence the patient\u2019s pharmacokinetic and pharmacodynamic processes.<\/li>\n
- Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient\u2019s recommended drug therapy.<\/li>\n
- Think about how you might improve the patient\u2019s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.<\/li>\n<\/ul>\n
By Day 7 of Week 2<\/strong><\/h2>\nWrite<\/strong> a 2- to 3-page paper that addresses the following:<\/p>\n\n- Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.<\/li>\n
- Describe how changes in the processes might impact the patient\u2019s recommended drug therapy. Be specific and provide examples.<\/li>\n
- Explain how you might improve the patient\u2019s drug therapy plan and explain why you would make these recommended improvements.<\/li>\n<\/ul>\n
Reminder:<\/strong> The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https:\/\/academicguides.waldenu.edu\/writingcenter\/templates\/general#s-lg-box-20293632)<\/a>. All papers submitted must use this formatting.<\/p>\nSubmission and Grading Information<\/strong><\/h2>\nTo submit your completed Assignment for review and grading, do the following:<\/strong><\/p>\n\n- Please save your Assignment using the naming convention \u201cWK2Assgn+last name+first initial.(extension)\u201d as the name.<\/li>\n
- Click the\u00a0Week 2 Assignment Rubric\u00a0<\/strong>to review the Grading Criteria for the Assignment.<\/li>\n
- Click the\u00a0Week 2 Assignment\u00a0<\/strong>link. You will also be able to \u201cView Rubric\u201d for grading criteria from this area.<\/li>\n
- Next, from the Attach File area, click on the\u00a0Browse My Computer<\/strong>\u00a0button. Find the document you saved as \u201cWK2Assgn+last name+first initial.(extension)\u201d and click\u00a0Open<\/strong>.<\/li>\n
- If applicable: From the Plagiarism Tools area, click the checkbox for\u00a0I agree to submit my paper(s) to the Global Reference Database<\/strong>.<\/li>\n
- Click on the\u00a0Submit<\/strong>\u00a0button to complete your submission.<\/li>\n<\/ul>\n
Grading Criteria<\/strong><\/h3>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/a><\/span><\/h3>\nPhoto Credit: Getty Images\/Science Photo Library RF<\/p>\n![\"NURS](\"https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2023\/03\/NURS-6521-Assignment-Pharmacotherapy-for-Cardiovascular-Disorders-IN-300x150.png\")
NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/figcaption><\/figure>\nAs an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.<\/p>\n
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db328.htm<\/a><\/p>\nA Sample Answer For the Assignment: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nTitle: <\/strong> NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nSafety, quality, and efficiency are important in the management of health problems in nursing practice. Advanced nurse practitioners ensure that medication prescription considers patient, medication, and comorbid factors that affect the realization of the desired treatment outcomes. Therefore, this paper explores the effect of age on pharmacokinetic and pharmacodynamic processes in the assigned patient. The patient has a history of transient ischemic attack and atrial fibrillation. The patient also has been diagnosed with hypertension, type 2 diabetes mellitus, ischemic heart disease, and hyperlipidemia. The patient is currently using several medications that include warfarin, aspirin, metformin, glyburide, atenolol, and Motrin.<\/p>\n
Effect of Age on Pharmacokinetic and Pharmacodynamic Processes<\/strong><\/h2>\nThe multiple comorbidities the patient in this case study has points to the increased likelihood that he\/she is elderly. Advancing age is associated with increased risk of comorbid conditions such as hypertension, diabetes, ischemic heart disease, and mental health issues. Age significantly affects pharmacokinetic and pharmacokinetic processes. Aging is associated with significant changes in the body\u2019s processes involved in drug absorption, metabolism, and excretion. First, aging reduces first-pass metabolism due to decline in blood flow and liver mass. The reduction increases the first-pass metabolism that drugs metabolized in the liver undergo (van den Anker et al., 2018). Aging also results in changes in drug distribution. For example, water-soluble drugs have reduced distribution volume due to changes such as decreased gastrointestinal motility and elimination, hence, high serum levels in the elderly.<\/p>\n
Aging also affects processes such as reduction in gastric sections, emptying, and splanchnic blood flow. The absorption capacity of the intestines also reduces. These changes affect pharmacokinetic processes, including drug absorption and the realization of the desired therapeutic effectiveness of the prescribed medications in the elderly (Cossart et al., 2019). Aging also lowers protein binding of drugs. The reduction is attributed to the decline in the concentrations of albumin with the advancing age. Drug clearance reduces significantly with aging. Changes such as the reduction in renal clearance affects the elimination of water-soluble drugs, digoxin, diuretics, and lithium among others (Farkouh et al., 2020). Therefore, the effects of change on pharmacokinetics and pharmacodynamics require a careful approach to prescribing medications for children and the elderly.<\/p>\n
Impact of Changes on Recommended Drug Therapy<\/strong><\/h2>\nChanges in pharmacokinetics and pharmacodynamic processes affects the recommended drug therapy for the patient in the case study. For example, changes in the renal clearance of drug metabolites affect the patient\u2019s health and wellbeing by increasing renal toxicity and high serum concentration of the drug. As a result, advanced nurse practitioners minimize nephrotoxic medications in such cases to optimize treatment effectiveness and minimize further deterioration in the client\u2019s status (Farkouh et al., 2020). Skin changes such as redistribution of fat and adipose tissue affects the absorption of medications administered via intramuscular or subcutaneous routes. A reduction in gastric emptying and production of gastric juice may also affect absorption of drugs (van den Anker et al., 2018). Consequently, advanced nurse practitioners consider alternative routes of medication administration such as through the intravenous routes to increase drug absorption and distribution.<\/p>\n
Liver is the largest organ involved in the metabolism of most drugs through the first-pass mechanism. However, liver diseases such as hepatitis and cirrhosis affect liver\u2019s ability to undertake these roles. The patient in the case study has multiple comorbidities, which predisposes him to hepato-renal complications due to the disease processes and polypharmacy (D\u00edez-Villanueva et al., 2019). Therefore, healthcare providers involved in developing the plan of the patient\u2019s care should minimize the administration of hepatotoxic and nephrotoxic medications to prevent harm. An example is withholding aspirin due to its adverse hepatic effects.<\/p>\n
Improving Patient\u2019s Treatment Plan<\/strong><\/h2>\nThe client\u2019s treatment requires some improvements. Firstly, the client has hyperlipidemia. As a result, I would prescribe statins to help in lowering body lipid levels. This decision will lower harmful triglycerides, which improves cardiovascular symptoms and type 2 diabetes that the client has. The second improvement that I would consider is eliminating warfarin therapy (D\u00edez-Villanueva et al., 2019). Combined use of warfarin and aspirin increases the risk of gastrointestinal bleeding and ulcers. Consequently, prescribing a platelet inhibitor such as Fondaparinux is appropriate to ensure safety in the treatment process. I would also perform liver function and renal function tests to help in developing an effective treatment plan. The results will help in adjusting the current plan. For example, I will replace Motrin with Tylenol if liver function tests are normal. In addition, I will select one oral hypoglycemic agent if the patient reports glycemic crises such as hypoglycemia or hyperglycemia (Strain et al., 2018). For instance, I will replace glyburide with dipeptidyl peptidase-IV inhibitors due to their associated enhanced therapeutic effectiveness.<\/p>\n
Conclusion<\/strong><\/h2>\nIn summary, safety is crucial in developing treatment plan for patients with multiple comorbidities. Advanced nurse practitioners should consider the different factors that affect pharmacokinetics and pharmacodynamics of the prescribed medications. Age is a crucial factor that affects these processes. Factors such as decreased renal and hepatic clearance of medications affect their effectiveness in disease management. Advanced nurse practitioners should make sound decisions to minimize the administration of drugs that may worsen the declining functioning in these organs. Therefore, I will improve the treatment plan for the patient in the case study to ensure safety, quality, and efficiency in the treatment of the comorbidities.<\/p>\n
References<\/h2>\n
Cossart, A. R., Cottrell, W. N., Campbell, S. B., Isbel, N. M., & Staatz, C. E. (2019). Characterizing the pharmacokinetics and pharmacodynamics of immunosuppressant medicines and patient outcomes in elderly renal transplant patients. Translational Andrology and Urology<\/em>, 8<\/em>(Suppl 2), S198\u2013S213. https:\/\/doi.org\/10.21037\/tau.2018.10.16<\/a><\/p>\nD\u00edez-Villanueva, P., Ariz\u00e1-Sol\u00e9, A., Vid\u00e1n, M. T., Bonanad, C., Formiga, F., Sanchis, J., Mart\u00edn-S\u00e1nchez, F. J., Ruiz Ros, V., Sanmart\u00edn Fern\u00e1ndez, M., Bueno, H., & Mart\u00ednez-Sell\u00e9s, M. (2019). Recommendations of the Geriatric Cardiology Section of the Spanish Society of Cardiology for the Assessment of Frailty in Elderly Patients With Heart Disease. Revista Espa\u00f1ola de Cardiolog\u00eda (English Edition)<\/em>, 72<\/em>(1), 63\u201371. https:\/\/doi.org\/10.1016\/j.rec.2018.06.035<\/a><\/p>\nFarkouh, A., Riedl, T., Gottardi, R., Czejka, M., & Kautzky-Willer, A. (2020). Sex-Related Differences in Pharmacokinetics and Pharmacodynamics of Frequently Prescribed Drugs: A Review of the Literature. Advances in Therapy<\/em>, 37<\/em>(2), 644\u2013655. https:\/\/doi.org\/10.1007\/s12325-019-01201-3<\/a><\/p>\nStrain, W. D., Hope, S. V., Green, A., Kar, P., Valabhji, J., & Sinclair, A. J. (2018). Type 2 diabetes mellitus in older people: A brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative. Diabetic Medicine<\/em>, 35<\/em>(7), 838\u2013845. https:\/\/doi.org\/10.1111\/dme.13644<\/a><\/p>\nvan den Anker, J., Reed, M. D., Allegaert, K., & Kearns, G. L. (2018). Developmental Changes in Pharmacokinetics and Pharmacodynamics. The Journal of Clinical Pharmacology<\/em>, 58<\/em>(S10), S10\u2013S25. https:\/\/doi.org\/10.1002\/jcph.1284<\/a><\/p>\nA Sample Answer 2 For the Assignment: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nTitle: <\/strong> NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nAsthma is one of the most common conditions affecting more than 20 million individuals in the United States and over 150 million across the globe. It takes up to $14 billion to treat asthma annually. Particularly hard hit are adolescents and children between the ages of 10 to 18 years. Studies show that up to 14% of children and adolescents in the inner city are diagnosed with asthma. A larger percentage of asthmatic patients in the emergency rooms are children and adolescents. Consequently, most patients hospitalized as a result of asthma or asthma-related problems are also children. As such, appropriate interventions must be implemented to help in managing asthma among children and adolescents hence reducing their visits to the ER or hospitalization. In the same line, Sentara Home Care Services came up with an innovative program to help in improving asthma management among children and adolescents through home-based strategies such as \u201cLife Coaches\u201d where they are educated on the proper use of medication and lifestyle behaviors for both the patient and their families. This paper reviews different pieces of literature for a better understanding of the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents.<\/p>\n
Methods<\/strong><\/h2>\nQuite a significant number of internet sources were available talking about different approaches that can be utilized in managing asthma among children and adolescents. However, only peer-reviewed articles directly relating to the study PICOT questioned were used for this paper. These articles were arrived at by use of several inclusion and exclusion criteria. For instance, the inclusion criteria included studies that had been published within the last 5 years, in English, with participants who are children and adolescents. The studies however could be either experimental or literature review. Exclusion criteria included articles published more than 5 years, in languages other than English. Consequently, relevant keywords such as asthma, \u00a0Sentara\u2019s Asthma Disease Management plan, children and adolescents, and decreased ER\/unscheduled PCP visits were utilized. A wide variety of search engines were used for this study, such as Google Scholar, PubMed\/MEDLINE, and Cochrane. Generally, only peer-reviewed articles and experimental studies covering the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents, were used for this study.<\/p>\n
Synthesize the Literature<\/strong><\/h2>\nPart A: Components of Each Article<\/strong><\/h3>\nThe study carried out by Naar et al., 2018, was aimed at bridging the gap for proper interventions for the management of asthma among African American adolescents who appear to be at high risk of asthma morbidity and mortality. The randomized control trial study revealed the significance of comprehensive family and community-based treatment strategies for better medication adherence, reduction in the frequency of asthma symptoms, and reduced inpatient hospitalization among African American adolescents. The strategies revealed in this study align with the initiatives and goals outlined in Sentara\u2019s Asthma Disease Management plan\u00a0for children and adolescents.<\/p>\n
According to Woods et al., 2016, the hospitalization rate of Black and Hispanic children\u00a0diagnosed with asthma is quite high as compared to white children. As such Woods et al., 2016, carried out a study to evaluate the effectiveness of community asthma initiatives in the management of asthma, hence reducing the hospitalization rate among this high-risk population. Data was collected and analyzed using the longitudinal evaluation of the participants and comparing the results to the control sample. It was noted that the community asthma initiative helped in reducing the health disparities related to asthma, with reduced hospitalization rate among Blacks and Hispanic children. The results support the study PICOT question on the effectiveness of Sentara\u2019s Asthma Disease Management plan\u00a0in reducing visits to the ER and hospitalization among children and adolescents diagnosed with asthma.<\/p>\n
Bellin et al., 2017, conducted a study aimed at finding out the knowledge of children diagnosed with asthma, from low-income families on home-based asthma management strategies. The study utilized a convenience sampling strategy to select appropriate participants. The collected data were analyzed using the grounded theory coding techniques. Based on the findings, it was recommended that more reinforcements need to be put towards providing a multipronged approach aimed at improving asthma control measures among this high-risk population. Such measures include ongoing child and family education, environmental control, and self-management home-based strategies, just like the ones illustrated in Sentara\u2019s Asthma Disease Management plan.<\/p>\n
The study carried out by Jonas, Leu, & Reznik, 2020, was aimed at evaluating the effects of utilizing Community Health Workers for the delivery of home-based\u00a0Wee Wheezers<\/em>\u00a0asthma education program for better manage asthma symptoms among children. A randomized controlled trial was employed for this study. According to the results, delivery of home-based asthma education programs led to the improvement of symptoms, hence reduced disparities in children\u2019s health outcomes. The study supports Sentara\u2019s Asthma Disease Management plan, whose main goal is to educate patients and caregivers on the disease process of asthma, for better treatment outcomes.<\/p>\nLeas et al., 2018 carried out a study evaluating the effectiveness of home-based asthma prevention initiatives such as allergen reduction interventions on asthma outcomes. The utilized systematic literature review of both nonrandomized interventional\u00a0studies and randomized controlled trials for this study. Based on the collected result, the effectiveness of indoor allergen reduction intervention helps in preventing an asthma attack. However, the effectiveness of this intervention was quite inconclusive as a result of inadequate support from previous studies. Indoor allergen reduction interventions are among the several home-based interventions outlined in Sentara\u2019s Asthma Disease Management plan\u00a0for children and adolescents.<\/p>\n
Part B: Compare and contrast the articles: <\/strong><\/h2>\nAll five studies revolve around the same goal of reducing disparities as a result of asthma among children and adolescents by utilizing community and home-based initiatives. According to Sentara\u2019s Asthma Disease Management plan, \u201clife coaches\u201d and home-based strategies are utilized in assessing, teaching, and monitoring asthma through self-management strategies to reduce disparities hence reduced hospitalization and ER visits. The same concept, despite the use of different languages, has been addressed in all five studies. However, some of the studies were experimental such as Naar et al., 2018, Jonas, Leu, & Reznik, 2020 and Bellin et al., 2017, while others were literature reviews, Leas et al., 2018 and Woods et al., 2016.<\/p>\n
Several limitations were however experienced in some of the reviewed studies. For instance, according to Leas et al., 2018, there was limited information availed by studies carried out on the effectiveness of some home-based asthma prevention initiatives such as indoor allergen reduction. Consequently, most of these studies only reveal the kind of home and community-based initiatives for the management and prevention of asthma among children and adolescents, instead of how effective these initiatives are in reducing ER visits and hospitalization rates among these individuals. Lastly, there were no recent studies, within the last five years, which evaluated the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents, making it hard to conclude on the PICOT question.<\/p>\n
Areas of Further Study<\/strong><\/h2>\nSeveral studies have revealed the relevance of community and home-based interventions in reducing the disparities as a result of asthma among children and adolescents. These interventions have been proven to reduce the number of visits by this age group to the ER, in addition to a reduction in hospitalization rates. However, very few studies have established the effectiveness of distinct interventions in achieving such outcomes. Consequently, very few recent studies have also revealed the effectiveness of Sentara\u2019s Asthma Disease Management plan for children and adolescents (Naar et al., 2018). As such, there is a need for further evaluation of the effectiveness of individual home-based interventions for better evidence-based practice in the management and prevention of asthma among children and adolescents.<\/p>\n
References<\/h2>\n
Bellin, Melissa H., Angelica Newsome, Cassie Land, Joan Kub, Shawna S. Mudd, Mary Elizabeth Bollinger, and Arlene M. Butz. 2017. “Asthma Home Management in the Inner-City: What Can the Children Teach Us?”\u00a0Journal of Paediatric Health Care.\u00a0<\/em>31, no. 3: 362-371. https:\/\/doi.org\/10.1016\/j.pedhc.2016.11.002<\/a><\/p>\nJonas, J. A., Leu, C. S., & Reznik, M. (January 01, 2020). A randomized controlled trial of a community health worker delivered home-based asthma intervention to improve pediatric asthma outcomes.\u00a0The Journal of Asthma: Official Journal of the Association for the Care of Asthma,\u00a02020,\u00a0<\/em>1-12. https:\/\/doi.org\/10.1080\/02770903.2020.1846746<\/a><\/p>\nLeas BF, KE D’Anci, AJ Apter, T Bryant-Stephens, MP Lynch, JL Kaczmarek, and CA Umscheid. 2018. “Effectiveness of Indoor Allergen Reduction in Asthma Management: A\u00a0systematic Review”.\u00a0The Journal of Allergy and Clinical Immunology.\u00a0<\/em>141, no. 5: 1854-1869. https:\/\/doi.org\/10.1016\/j.jaci.2018.02.001<\/a><\/p>\nNaar, S., Ellis, D., Cunningham, P., Pennar, A. L., Lam, P., Brownstein, N. C., & Bruzzese, J.-M. (October 01, 2018). Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents.\u00a0Paediatrics,\u00a0142,\u00a0<\/em>4.) \u00a0DOI: https:\/\/doi.org\/10.1542\/peds.2017-3737<\/a><\/p>\nWoods, E. R., Bhaumik, U., Sommer, S. J., Chan, E., Tsopelas, L., Fleegler, E. W., Lorenzi, M., … Dulin, R. (February 12, 2016). Community Asthma Initiative to Improve Health Outcomes and Reduce Disparities Among Children with Asthma.\u00a0Mmwr Supplements,\u00a065,\u00a0<\/em>1, 11-20. DOI:\u00a0http:\/\/dx.doi.org\/10.15585\/mmwr.su6501a4<\/a>.<\/p>\n <\/p>\n
NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN Rubric Detail<\/h3>\n
Select Grid View<\/em> or List View<\/em> to change the rubric’s layout.<\/p>\nContent<\/h3>\nName:\u00a0NURS_6521_Week2_Assignment_Rubric<\/h3>\n\n- \n
NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN Grid View:<\/a><\/h3>\n<\/li>\n- List View<\/a><\/li>\n<\/ul>\n
\n\n\n\u00a0<\/strong><\/td>\nExcellent <\/strong><\/td>\nGood <\/strong><\/td>\nFair <\/strong><\/td>\nPoor <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nExplain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. <\/strong><\/td>\nPoints Range: 23 (23%) – 25 (25%)<\/p>\nThe response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 20 (20%) – 22 (22%)<\/p>\nThe response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 18 (18%) – 19 (19%)<\/p>\nThe response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 0 (0%) – 17 (17%)<\/p>\nThe response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.<\/td>\n<\/tr>\n
\nDescribe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. <\/strong><\/td>\nPoints Range: 27 (27%) – 30 (30%)<\/p>\nThe response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Accurate, complete, and aligned examples are provided to support the response.<\/td>\n
Points Range: 24 (24%) – 26 (26%)<\/p>\nThe response accurately describes how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Accurate examples may be provided to support the response.<\/td>\n
Points Range: 21 (21%) – 23 (23%)<\/p>\nThe response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Inaccurate or vague examples are provided to support the response.<\/td>\n
Points Range: 0 (0%) – 20 (20%)<\/p>\nThe response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing.<\/p>\n
Inaccurate and vague examples may be provided to support the response, or is missing.<\/td>\n<\/tr>\n
\nExplain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements. <\/strong><\/td>\nPoints Range: 27 (27%) – 30 (30%)<\/p>\nThe response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.<\/p>\n
The response includes an accurate and detailed explanation to support the recommended improvements.<\/td>\n
Points Range: 24 (24%) – 26 (26%)<\/p>\nThe response accurately explains how to improve the patient’s drug therapy plan.<\/p>\n
The response may include an accurate explanation to support the recommended improvements.<\/td>\n
Points Range: 21 (21%) – 23 (23%)<\/p>\nThe response inaccurately or vaguely explains how to improve the patient’s drug therapy plan.<\/p>\n
The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.<\/td>\n
Points Range: 0 (0%) – 20 (20%)<\/p>\nThe response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing.<\/p>\n
The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.<\/td>\n<\/tr>\n
\nWritten Expression and Formatting – Paragraph Development and Organization:
\nParagraphs 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. <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity.<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time.<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.<\/td>\n<\/tr>\n
\nWritten Expression and Formatting – English writing standards:
\nCorrect grammar, mechanics, and proper punctuation <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\nUses correct grammar, spelling, and punctuation with no errors<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\nContains a few (1\u20132) grammar, spelling, and punctuation errors<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\nContains several (3\u20134) grammar, spelling, and punctuation errors<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\nContains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding<\/td>\n<\/tr>\n
\nWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, running head, parenthetical\/in-text citations, and reference list. <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\nUses correct APA format with no errors<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\nContains a few (1\u20132) APA format errors<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\nContains several (3\u20134) APA format errors<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\nContains many (\u2265 5) APA format errors<\/td>\n<\/tr>\n
\nTotal Points: 100 <\/strong><\/td>\n<\/td>\n<\/tr>\n \n<\/td>\n <\/td>\n <\/td>\n <\/td>\n <\/td>\n <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nName:\u00a0NURS_6521_Week2_Assignment_Rubric<\/h3>\n
To Prepare<\/strong><\/h2>\n\n- Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.<\/li>\n
- Review the case study assigned by your Instructor for this Assignment.<\/li>\n
- Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.<\/li>\n
- Reflect on how the factor you selected might influence the patient\u2019s pharmacokinetic and pharmacodynamic processes.<\/li>\n
- Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient\u2019s recommended drug therapy.<\/li>\n
- Think about how you might improve the patient\u2019s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.<\/li>\n<\/ul>\n
By Day 7 of Week 2<\/strong><\/h2>\nWrite<\/strong> a 2- to 3-page paper that addresses the following:<\/p>\n\n- Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.<\/li>\n
- Describe how changes in the processes might impact the patient\u2019s recommended drug therapy. Be specific and provide examples.<\/li>\n
- Explain how you might improve the patient\u2019s drug therapy plan and explain why you would make these recommended improvements.<\/li>\n<\/ul>\n
Reminder:<\/strong> The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https:\/\/academicguides.waldenu.edu\/writingcenter\/templates\/general#s-lg-box-20293632)<\/a>. All papers submitted must use this formatting.<\/p>\nSubmission and Grading Information<\/strong><\/h2>\nTo submit your completed Assignment for review and grading, do the following:<\/strong><\/p>\n\n- Please save your Assignment using the naming convention \u201cWK2Assgn+last name+first initial.(extension)\u201d as the name.<\/li>\n
- Click the\u00a0Week 2 Assignment Rubric\u00a0<\/strong>to review the Grading Criteria for the Assignment.<\/li>\n
- Click the\u00a0Week 2 Assignment\u00a0<\/strong>link. You will also be able to \u201cView Rubric\u201d for grading criteria from this area.<\/li>\n
- Next, from the Attach File area, click on the\u00a0Browse My Computer<\/strong>\u00a0button. Find the document you saved as \u201cWK2Assgn+last name+first initial.(extension)\u201d and click\u00a0Open<\/strong>.<\/li>\n
- If applicable: From the Plagiarism Tools area, click the checkbox for\u00a0I agree to submit my paper(s) to the Global Reference Database<\/strong>.<\/li>\n
- Click on the\u00a0Submit<\/strong>\u00a0button to complete your submission.<\/li>\n<\/ul>\n
Grading Criteria<\/strong><\/h3>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/a><\/span><\/h3>\nPhoto Credit: Getty Images\/Science Photo Library RF<\/p>\nNURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/figcaption><\/figure>\nAs an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.<\/p>\n
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db328.htm<\/a><\/p>\nA Sample Answer For the Assignment: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nTitle: <\/strong> NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nSafety, quality, and efficiency are important in the management of health problems in nursing practice. Advanced nurse practitioners ensure that medication prescription considers patient, medication, and comorbid factors that affect the realization of the desired treatment outcomes. Therefore, this paper explores the effect of age on pharmacokinetic and pharmacodynamic processes in the assigned patient. The patient has a history of transient ischemic attack and atrial fibrillation. The patient also has been diagnosed with hypertension, type 2 diabetes mellitus, ischemic heart disease, and hyperlipidemia. The patient is currently using several medications that include warfarin, aspirin, metformin, glyburide, atenolol, and Motrin.<\/p>\n
Effect of Age on Pharmacokinetic and Pharmacodynamic Processes<\/strong><\/h2>\nThe multiple comorbidities the patient in this case study has points to the increased likelihood that he\/she is elderly. Advancing age is associated with increased risk of comorbid conditions such as hypertension, diabetes, ischemic heart disease, and mental health issues. Age significantly affects pharmacokinetic and pharmacokinetic processes. Aging is associated with significant changes in the body\u2019s processes involved in drug absorption, metabolism, and excretion. First, aging reduces first-pass metabolism due to decline in blood flow and liver mass. The reduction increases the first-pass metabolism that drugs metabolized in the liver undergo (van den Anker et al., 2018). Aging also results in changes in drug distribution. For example, water-soluble drugs have reduced distribution volume due to changes such as decreased gastrointestinal motility and elimination, hence, high serum levels in the elderly.<\/p>\n
Aging also affects processes such as reduction in gastric sections, emptying, and splanchnic blood flow. The absorption capacity of the intestines also reduces. These changes affect pharmacokinetic processes, including drug absorption and the realization of the desired therapeutic effectiveness of the prescribed medications in the elderly (Cossart et al., 2019). Aging also lowers protein binding of drugs. The reduction is attributed to the decline in the concentrations of albumin with the advancing age. Drug clearance reduces significantly with aging. Changes such as the reduction in renal clearance affects the elimination of water-soluble drugs, digoxin, diuretics, and lithium among others (Farkouh et al., 2020). Therefore, the effects of change on pharmacokinetics and pharmacodynamics require a careful approach to prescribing medications for children and the elderly.<\/p>\n
Impact of Changes on Recommended Drug Therapy<\/strong><\/h2>\nChanges in pharmacokinetics and pharmacodynamic processes affects the recommended drug therapy for the patient in the case study. For example, changes in the renal clearance of drug metabolites affect the patient\u2019s health and wellbeing by increasing renal toxicity and high serum concentration of the drug. As a result, advanced nurse practitioners minimize nephrotoxic medications in such cases to optimize treatment effectiveness and minimize further deterioration in the client\u2019s status (Farkouh et al., 2020). Skin changes such as redistribution of fat and adipose tissue affects the absorption of medications administered via intramuscular or subcutaneous routes. A reduction in gastric emptying and production of gastric juice may also affect absorption of drugs (van den Anker et al., 2018). Consequently, advanced nurse practitioners consider alternative routes of medication administration such as through the intravenous routes to increase drug absorption and distribution.<\/p>\n
Liver is the largest organ involved in the metabolism of most drugs through the first-pass mechanism. However, liver diseases such as hepatitis and cirrhosis affect liver\u2019s ability to undertake these roles. The patient in the case study has multiple comorbidities, which predisposes him to hepato-renal complications due to the disease processes and polypharmacy (D\u00edez-Villanueva et al., 2019). Therefore, healthcare providers involved in developing the plan of the patient\u2019s care should minimize the administration of hepatotoxic and nephrotoxic medications to prevent harm. An example is withholding aspirin due to its adverse hepatic effects.<\/p>\n
Improving Patient\u2019s Treatment Plan<\/strong><\/h2>\nThe client\u2019s treatment requires some improvements. Firstly, the client has hyperlipidemia. As a result, I would prescribe statins to help in lowering body lipid levels. This decision will lower harmful triglycerides, which improves cardiovascular symptoms and type 2 diabetes that the client has. The second improvement that I would consider is eliminating warfarin therapy (D\u00edez-Villanueva et al., 2019). Combined use of warfarin and aspirin increases the risk of gastrointestinal bleeding and ulcers. Consequently, prescribing a platelet inhibitor such as Fondaparinux is appropriate to ensure safety in the treatment process. I would also perform liver function and renal function tests to help in developing an effective treatment plan. The results will help in adjusting the current plan. For example, I will replace Motrin with Tylenol if liver function tests are normal. In addition, I will select one oral hypoglycemic agent if the patient reports glycemic crises such as hypoglycemia or hyperglycemia (Strain et al., 2018). For instance, I will replace glyburide with dipeptidyl peptidase-IV inhibitors due to their associated enhanced therapeutic effectiveness.<\/p>\n
Conclusion<\/strong><\/h2>\nIn summary, safety is crucial in developing treatment plan for patients with multiple comorbidities. Advanced nurse practitioners should consider the different factors that affect pharmacokinetics and pharmacodynamics of the prescribed medications. Age is a crucial factor that affects these processes. Factors such as decreased renal and hepatic clearance of medications affect their effectiveness in disease management. Advanced nurse practitioners should make sound decisions to minimize the administration of drugs that may worsen the declining functioning in these organs. Therefore, I will improve the treatment plan for the patient in the case study to ensure safety, quality, and efficiency in the treatment of the comorbidities.<\/p>\n
References<\/h2>\n
Cossart, A. R., Cottrell, W. N., Campbell, S. B., Isbel, N. M., & Staatz, C. E. (2019). Characterizing the pharmacokinetics and pharmacodynamics of immunosuppressant medicines and patient outcomes in elderly renal transplant patients. Translational Andrology and Urology<\/em>, 8<\/em>(Suppl 2), S198\u2013S213. https:\/\/doi.org\/10.21037\/tau.2018.10.16<\/a><\/p>\nD\u00edez-Villanueva, P., Ariz\u00e1-Sol\u00e9, A., Vid\u00e1n, M. T., Bonanad, C., Formiga, F., Sanchis, J., Mart\u00edn-S\u00e1nchez, F. J., Ruiz Ros, V., Sanmart\u00edn Fern\u00e1ndez, M., Bueno, H., & Mart\u00ednez-Sell\u00e9s, M. (2019). Recommendations of the Geriatric Cardiology Section of the Spanish Society of Cardiology for the Assessment of Frailty in Elderly Patients With Heart Disease. Revista Espa\u00f1ola de Cardiolog\u00eda (English Edition)<\/em>, 72<\/em>(1), 63\u201371. https:\/\/doi.org\/10.1016\/j.rec.2018.06.035<\/a><\/p>\nFarkouh, A., Riedl, T., Gottardi, R., Czejka, M., & Kautzky-Willer, A. (2020). Sex-Related Differences in Pharmacokinetics and Pharmacodynamics of Frequently Prescribed Drugs: A Review of the Literature. Advances in Therapy<\/em>, 37<\/em>(2), 644\u2013655. https:\/\/doi.org\/10.1007\/s12325-019-01201-3<\/a><\/p>\nStrain, W. D., Hope, S. V., Green, A., Kar, P., Valabhji, J., & Sinclair, A. J. (2018). Type 2 diabetes mellitus in older people: A brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative. Diabetic Medicine<\/em>, 35<\/em>(7), 838\u2013845. https:\/\/doi.org\/10.1111\/dme.13644<\/a><\/p>\nvan den Anker, J., Reed, M. D., Allegaert, K., & Kearns, G. L. (2018). Developmental Changes in Pharmacokinetics and Pharmacodynamics. The Journal of Clinical Pharmacology<\/em>, 58<\/em>(S10), S10\u2013S25. https:\/\/doi.org\/10.1002\/jcph.1284<\/a><\/p>\nA Sample Answer 2 For the Assignment: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nTitle: <\/strong> NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nAsthma is one of the most common conditions affecting more than 20 million individuals in the United States and over 150 million across the globe. It takes up to $14 billion to treat asthma annually. Particularly hard hit are adolescents and children between the ages of 10 to 18 years. Studies show that up to 14% of children and adolescents in the inner city are diagnosed with asthma. A larger percentage of asthmatic patients in the emergency rooms are children and adolescents. Consequently, most patients hospitalized as a result of asthma or asthma-related problems are also children. As such, appropriate interventions must be implemented to help in managing asthma among children and adolescents hence reducing their visits to the ER or hospitalization. In the same line, Sentara Home Care Services came up with an innovative program to help in improving asthma management among children and adolescents through home-based strategies such as \u201cLife Coaches\u201d where they are educated on the proper use of medication and lifestyle behaviors for both the patient and their families. This paper reviews different pieces of literature for a better understanding of the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents.<\/p>\n
Methods<\/strong><\/h2>\nQuite a significant number of internet sources were available talking about different approaches that can be utilized in managing asthma among children and adolescents. However, only peer-reviewed articles directly relating to the study PICOT questioned were used for this paper. These articles were arrived at by use of several inclusion and exclusion criteria. For instance, the inclusion criteria included studies that had been published within the last 5 years, in English, with participants who are children and adolescents. The studies however could be either experimental or literature review. Exclusion criteria included articles published more than 5 years, in languages other than English. Consequently, relevant keywords such as asthma, \u00a0Sentara\u2019s Asthma Disease Management plan, children and adolescents, and decreased ER\/unscheduled PCP visits were utilized. A wide variety of search engines were used for this study, such as Google Scholar, PubMed\/MEDLINE, and Cochrane. Generally, only peer-reviewed articles and experimental studies covering the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents, were used for this study.<\/p>\n
Synthesize the Literature<\/strong><\/h2>\nPart A: Components of Each Article<\/strong><\/h3>\nThe study carried out by Naar et al., 2018, was aimed at bridging the gap for proper interventions for the management of asthma among African American adolescents who appear to be at high risk of asthma morbidity and mortality. The randomized control trial study revealed the significance of comprehensive family and community-based treatment strategies for better medication adherence, reduction in the frequency of asthma symptoms, and reduced inpatient hospitalization among African American adolescents. The strategies revealed in this study align with the initiatives and goals outlined in Sentara\u2019s Asthma Disease Management plan\u00a0for children and adolescents.<\/p>\n
According to Woods et al., 2016, the hospitalization rate of Black and Hispanic children\u00a0diagnosed with asthma is quite high as compared to white children. As such Woods et al., 2016, carried out a study to evaluate the effectiveness of community asthma initiatives in the management of asthma, hence reducing the hospitalization rate among this high-risk population. Data was collected and analyzed using the longitudinal evaluation of the participants and comparing the results to the control sample. It was noted that the community asthma initiative helped in reducing the health disparities related to asthma, with reduced hospitalization rate among Blacks and Hispanic children. The results support the study PICOT question on the effectiveness of Sentara\u2019s Asthma Disease Management plan\u00a0in reducing visits to the ER and hospitalization among children and adolescents diagnosed with asthma.<\/p>\n
Bellin et al., 2017, conducted a study aimed at finding out the knowledge of children diagnosed with asthma, from low-income families on home-based asthma management strategies. The study utilized a convenience sampling strategy to select appropriate participants. The collected data were analyzed using the grounded theory coding techniques. Based on the findings, it was recommended that more reinforcements need to be put towards providing a multipronged approach aimed at improving asthma control measures among this high-risk population. Such measures include ongoing child and family education, environmental control, and self-management home-based strategies, just like the ones illustrated in Sentara\u2019s Asthma Disease Management plan.<\/p>\n
The study carried out by Jonas, Leu, & Reznik, 2020, was aimed at evaluating the effects of utilizing Community Health Workers for the delivery of home-based\u00a0Wee Wheezers<\/em>\u00a0asthma education program for better manage asthma symptoms among children. A randomized controlled trial was employed for this study. According to the results, delivery of home-based asthma education programs led to the improvement of symptoms, hence reduced disparities in children\u2019s health outcomes. The study supports Sentara\u2019s Asthma Disease Management plan, whose main goal is to educate patients and caregivers on the disease process of asthma, for better treatment outcomes.<\/p>\nLeas et al., 2018 carried out a study evaluating the effectiveness of home-based asthma prevention initiatives such as allergen reduction interventions on asthma outcomes. The utilized systematic literature review of both nonrandomized interventional\u00a0studies and randomized controlled trials for this study. Based on the collected result, the effectiveness of indoor allergen reduction intervention helps in preventing an asthma attack. However, the effectiveness of this intervention was quite inconclusive as a result of inadequate support from previous studies. Indoor allergen reduction interventions are among the several home-based interventions outlined in Sentara\u2019s Asthma Disease Management plan\u00a0for children and adolescents.<\/p>\n
Part B: Compare and contrast the articles: <\/strong><\/h2>\nAll five studies revolve around the same goal of reducing disparities as a result of asthma among children and adolescents by utilizing community and home-based initiatives. According to Sentara\u2019s Asthma Disease Management plan, \u201clife coaches\u201d and home-based strategies are utilized in assessing, teaching, and monitoring asthma through self-management strategies to reduce disparities hence reduced hospitalization and ER visits. The same concept, despite the use of different languages, has been addressed in all five studies. However, some of the studies were experimental such as Naar et al., 2018, Jonas, Leu, & Reznik, 2020 and Bellin et al., 2017, while others were literature reviews, Leas et al., 2018 and Woods et al., 2016.<\/p>\n
Several limitations were however experienced in some of the reviewed studies. For instance, according to Leas et al., 2018, there was limited information availed by studies carried out on the effectiveness of some home-based asthma prevention initiatives such as indoor allergen reduction. Consequently, most of these studies only reveal the kind of home and community-based initiatives for the management and prevention of asthma among children and adolescents, instead of how effective these initiatives are in reducing ER visits and hospitalization rates among these individuals. Lastly, there were no recent studies, within the last five years, which evaluated the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents, making it hard to conclude on the PICOT question.<\/p>\n
Areas of Further Study<\/strong><\/h2>\nSeveral studies have revealed the relevance of community and home-based interventions in reducing the disparities as a result of asthma among children and adolescents. These interventions have been proven to reduce the number of visits by this age group to the ER, in addition to a reduction in hospitalization rates. However, very few studies have established the effectiveness of distinct interventions in achieving such outcomes. Consequently, very few recent studies have also revealed the effectiveness of Sentara\u2019s Asthma Disease Management plan for children and adolescents (Naar et al., 2018). As such, there is a need for further evaluation of the effectiveness of individual home-based interventions for better evidence-based practice in the management and prevention of asthma among children and adolescents.<\/p>\n
References<\/h2>\n
Bellin, Melissa H., Angelica Newsome, Cassie Land, Joan Kub, Shawna S. Mudd, Mary Elizabeth Bollinger, and Arlene M. Butz. 2017. “Asthma Home Management in the Inner-City: What Can the Children Teach Us?”\u00a0Journal of Paediatric Health Care.\u00a0<\/em>31, no. 3: 362-371. https:\/\/doi.org\/10.1016\/j.pedhc.2016.11.002<\/a><\/p>\nJonas, J. A., Leu, C. S., & Reznik, M. (January 01, 2020). A randomized controlled trial of a community health worker delivered home-based asthma intervention to improve pediatric asthma outcomes.\u00a0The Journal of Asthma: Official Journal of the Association for the Care of Asthma,\u00a02020,\u00a0<\/em>1-12. https:\/\/doi.org\/10.1080\/02770903.2020.1846746<\/a><\/p>\nLeas BF, KE D’Anci, AJ Apter, T Bryant-Stephens, MP Lynch, JL Kaczmarek, and CA Umscheid. 2018. “Effectiveness of Indoor Allergen Reduction in Asthma Management: A\u00a0systematic Review”.\u00a0The Journal of Allergy and Clinical Immunology.\u00a0<\/em>141, no. 5: 1854-1869. https:\/\/doi.org\/10.1016\/j.jaci.2018.02.001<\/a><\/p>\nNaar, S., Ellis, D., Cunningham, P., Pennar, A. L., Lam, P., Brownstein, N. C., & Bruzzese, J.-M. (October 01, 2018). Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents.\u00a0Paediatrics,\u00a0142,\u00a0<\/em>4.) \u00a0DOI: https:\/\/doi.org\/10.1542\/peds.2017-3737<\/a><\/p>\nWoods, E. R., Bhaumik, U., Sommer, S. J., Chan, E., Tsopelas, L., Fleegler, E. W., Lorenzi, M., … Dulin, R. (February 12, 2016). Community Asthma Initiative to Improve Health Outcomes and Reduce Disparities Among Children with Asthma.\u00a0Mmwr Supplements,\u00a065,\u00a0<\/em>1, 11-20. DOI:\u00a0http:\/\/dx.doi.org\/10.15585\/mmwr.su6501a4<\/a>.<\/p>\n <\/p>\n
NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN Rubric Detail<\/h3>\n
Select Grid View<\/em> or List View<\/em> to change the rubric’s layout.<\/p>\nContent<\/h3>\nName:\u00a0NURS_6521_Week2_Assignment_Rubric<\/h3>\n\n- \n
NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN Grid View:<\/a><\/h3>\n<\/li>\n- List View<\/a><\/li>\n<\/ul>\n
\n\n\n\u00a0<\/strong><\/td>\nExcellent <\/strong><\/td>\nGood <\/strong><\/td>\nFair <\/strong><\/td>\nPoor <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nExplain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. <\/strong><\/td>\nPoints Range: 23 (23%) – 25 (25%)<\/p>\nThe response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 20 (20%) – 22 (22%)<\/p>\nThe response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 18 (18%) – 19 (19%)<\/p>\nThe response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 0 (0%) – 17 (17%)<\/p>\nThe response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.<\/td>\n<\/tr>\n
\nDescribe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. <\/strong><\/td>\nPoints Range: 27 (27%) – 30 (30%)<\/p>\nThe response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Accurate, complete, and aligned examples are provided to support the response.<\/td>\n
Points Range: 24 (24%) – 26 (26%)<\/p>\nThe response accurately describes how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Accurate examples may be provided to support the response.<\/td>\n
Points Range: 21 (21%) – 23 (23%)<\/p>\nThe response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Inaccurate or vague examples are provided to support the response.<\/td>\n
Points Range: 0 (0%) – 20 (20%)<\/p>\nThe response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing.<\/p>\n
Inaccurate and vague examples may be provided to support the response, or is missing.<\/td>\n<\/tr>\n
\nExplain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements. <\/strong><\/td>\nPoints Range: 27 (27%) – 30 (30%)<\/p>\nThe response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.<\/p>\n
The response includes an accurate and detailed explanation to support the recommended improvements.<\/td>\n
Points Range: 24 (24%) – 26 (26%)<\/p>\nThe response accurately explains how to improve the patient’s drug therapy plan.<\/p>\n
The response may include an accurate explanation to support the recommended improvements.<\/td>\n
Points Range: 21 (21%) – 23 (23%)<\/p>\nThe response inaccurately or vaguely explains how to improve the patient’s drug therapy plan.<\/p>\n
The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.<\/td>\n
Points Range: 0 (0%) – 20 (20%)<\/p>\nThe response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing.<\/p>\n
The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.<\/td>\n<\/tr>\n
\nWritten Expression and Formatting – Paragraph Development and Organization:
\nParagraphs 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. <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity.<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time.<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.<\/td>\n<\/tr>\n
\nWritten Expression and Formatting – English writing standards:
\nCorrect grammar, mechanics, and proper punctuation <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\nUses correct grammar, spelling, and punctuation with no errors<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\nContains a few (1\u20132) grammar, spelling, and punctuation errors<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\nContains several (3\u20134) grammar, spelling, and punctuation errors<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\nContains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding<\/td>\n<\/tr>\n
\nWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, running head, parenthetical\/in-text citations, and reference list. <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\nUses correct APA format with no errors<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\nContains a few (1\u20132) APA format errors<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\nContains several (3\u20134) APA format errors<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\nContains many (\u2265 5) APA format errors<\/td>\n<\/tr>\n
\nTotal Points: 100 <\/strong><\/td>\n<\/td>\n<\/tr>\n \n<\/td>\n <\/td>\n <\/td>\n <\/td>\n <\/td>\n <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nName:\u00a0NURS_6521_Week2_Assignment_Rubric<\/h3>\n
By Day 7 of Week 2<\/strong><\/h2>\nWrite<\/strong> a 2- to 3-page paper that addresses the following:<\/p>\n\n- Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.<\/li>\n
- Describe how changes in the processes might impact the patient\u2019s recommended drug therapy. Be specific and provide examples.<\/li>\n
- Explain how you might improve the patient\u2019s drug therapy plan and explain why you would make these recommended improvements.<\/li>\n<\/ul>\n
Reminder:<\/strong> The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https:\/\/academicguides.waldenu.edu\/writingcenter\/templates\/general#s-lg-box-20293632)<\/a>. All papers submitted must use this formatting.<\/p>\nSubmission and Grading Information<\/strong><\/h2>\nTo submit your completed Assignment for review and grading, do the following:<\/strong><\/p>\n\n- Please save your Assignment using the naming convention \u201cWK2Assgn+last name+first initial.(extension)\u201d as the name.<\/li>\n
- Click the\u00a0Week 2 Assignment Rubric\u00a0<\/strong>to review the Grading Criteria for the Assignment.<\/li>\n
- Click the\u00a0Week 2 Assignment\u00a0<\/strong>link. You will also be able to \u201cView Rubric\u201d for grading criteria from this area.<\/li>\n
- Next, from the Attach File area, click on the\u00a0Browse My Computer<\/strong>\u00a0button. Find the document you saved as \u201cWK2Assgn+last name+first initial.(extension)\u201d and click\u00a0Open<\/strong>.<\/li>\n
- If applicable: From the Plagiarism Tools area, click the checkbox for\u00a0I agree to submit my paper(s) to the Global Reference Database<\/strong>.<\/li>\n
- Click on the\u00a0Submit<\/strong>\u00a0button to complete your submission.<\/li>\n<\/ul>\n
Grading Criteria<\/strong><\/h3>\nClick here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/a><\/span><\/h3>\nPhoto Credit: Getty Images\/Science Photo Library RF<\/p>\nNURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/figcaption><\/figure>\nAs an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.<\/p>\n
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db328.htm<\/a><\/p>\nA Sample Answer For the Assignment: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nTitle: <\/strong> NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nSafety, quality, and efficiency are important in the management of health problems in nursing practice. Advanced nurse practitioners ensure that medication prescription considers patient, medication, and comorbid factors that affect the realization of the desired treatment outcomes. Therefore, this paper explores the effect of age on pharmacokinetic and pharmacodynamic processes in the assigned patient. The patient has a history of transient ischemic attack and atrial fibrillation. The patient also has been diagnosed with hypertension, type 2 diabetes mellitus, ischemic heart disease, and hyperlipidemia. The patient is currently using several medications that include warfarin, aspirin, metformin, glyburide, atenolol, and Motrin.<\/p>\n
Effect of Age on Pharmacokinetic and Pharmacodynamic Processes<\/strong><\/h2>\nThe multiple comorbidities the patient in this case study has points to the increased likelihood that he\/she is elderly. Advancing age is associated with increased risk of comorbid conditions such as hypertension, diabetes, ischemic heart disease, and mental health issues. Age significantly affects pharmacokinetic and pharmacokinetic processes. Aging is associated with significant changes in the body\u2019s processes involved in drug absorption, metabolism, and excretion. First, aging reduces first-pass metabolism due to decline in blood flow and liver mass. The reduction increases the first-pass metabolism that drugs metabolized in the liver undergo (van den Anker et al., 2018). Aging also results in changes in drug distribution. For example, water-soluble drugs have reduced distribution volume due to changes such as decreased gastrointestinal motility and elimination, hence, high serum levels in the elderly.<\/p>\n
Aging also affects processes such as reduction in gastric sections, emptying, and splanchnic blood flow. The absorption capacity of the intestines also reduces. These changes affect pharmacokinetic processes, including drug absorption and the realization of the desired therapeutic effectiveness of the prescribed medications in the elderly (Cossart et al., 2019). Aging also lowers protein binding of drugs. The reduction is attributed to the decline in the concentrations of albumin with the advancing age. Drug clearance reduces significantly with aging. Changes such as the reduction in renal clearance affects the elimination of water-soluble drugs, digoxin, diuretics, and lithium among others (Farkouh et al., 2020). Therefore, the effects of change on pharmacokinetics and pharmacodynamics require a careful approach to prescribing medications for children and the elderly.<\/p>\n
Impact of Changes on Recommended Drug Therapy<\/strong><\/h2>\nChanges in pharmacokinetics and pharmacodynamic processes affects the recommended drug therapy for the patient in the case study. For example, changes in the renal clearance of drug metabolites affect the patient\u2019s health and wellbeing by increasing renal toxicity and high serum concentration of the drug. As a result, advanced nurse practitioners minimize nephrotoxic medications in such cases to optimize treatment effectiveness and minimize further deterioration in the client\u2019s status (Farkouh et al., 2020). Skin changes such as redistribution of fat and adipose tissue affects the absorption of medications administered via intramuscular or subcutaneous routes. A reduction in gastric emptying and production of gastric juice may also affect absorption of drugs (van den Anker et al., 2018). Consequently, advanced nurse practitioners consider alternative routes of medication administration such as through the intravenous routes to increase drug absorption and distribution.<\/p>\n
Liver is the largest organ involved in the metabolism of most drugs through the first-pass mechanism. However, liver diseases such as hepatitis and cirrhosis affect liver\u2019s ability to undertake these roles. The patient in the case study has multiple comorbidities, which predisposes him to hepato-renal complications due to the disease processes and polypharmacy (D\u00edez-Villanueva et al., 2019). Therefore, healthcare providers involved in developing the plan of the patient\u2019s care should minimize the administration of hepatotoxic and nephrotoxic medications to prevent harm. An example is withholding aspirin due to its adverse hepatic effects.<\/p>\n
Improving Patient\u2019s Treatment Plan<\/strong><\/h2>\nThe client\u2019s treatment requires some improvements. Firstly, the client has hyperlipidemia. As a result, I would prescribe statins to help in lowering body lipid levels. This decision will lower harmful triglycerides, which improves cardiovascular symptoms and type 2 diabetes that the client has. The second improvement that I would consider is eliminating warfarin therapy (D\u00edez-Villanueva et al., 2019). Combined use of warfarin and aspirin increases the risk of gastrointestinal bleeding and ulcers. Consequently, prescribing a platelet inhibitor such as Fondaparinux is appropriate to ensure safety in the treatment process. I would also perform liver function and renal function tests to help in developing an effective treatment plan. The results will help in adjusting the current plan. For example, I will replace Motrin with Tylenol if liver function tests are normal. In addition, I will select one oral hypoglycemic agent if the patient reports glycemic crises such as hypoglycemia or hyperglycemia (Strain et al., 2018). For instance, I will replace glyburide with dipeptidyl peptidase-IV inhibitors due to their associated enhanced therapeutic effectiveness.<\/p>\n
Conclusion<\/strong><\/h2>\nIn summary, safety is crucial in developing treatment plan for patients with multiple comorbidities. Advanced nurse practitioners should consider the different factors that affect pharmacokinetics and pharmacodynamics of the prescribed medications. Age is a crucial factor that affects these processes. Factors such as decreased renal and hepatic clearance of medications affect their effectiveness in disease management. Advanced nurse practitioners should make sound decisions to minimize the administration of drugs that may worsen the declining functioning in these organs. Therefore, I will improve the treatment plan for the patient in the case study to ensure safety, quality, and efficiency in the treatment of the comorbidities.<\/p>\n
References<\/h2>\n
Cossart, A. R., Cottrell, W. N., Campbell, S. B., Isbel, N. M., & Staatz, C. E. (2019). Characterizing the pharmacokinetics and pharmacodynamics of immunosuppressant medicines and patient outcomes in elderly renal transplant patients. Translational Andrology and Urology<\/em>, 8<\/em>(Suppl 2), S198\u2013S213. https:\/\/doi.org\/10.21037\/tau.2018.10.16<\/a><\/p>\nD\u00edez-Villanueva, P., Ariz\u00e1-Sol\u00e9, A., Vid\u00e1n, M. T., Bonanad, C., Formiga, F., Sanchis, J., Mart\u00edn-S\u00e1nchez, F. J., Ruiz Ros, V., Sanmart\u00edn Fern\u00e1ndez, M., Bueno, H., & Mart\u00ednez-Sell\u00e9s, M. (2019). Recommendations of the Geriatric Cardiology Section of the Spanish Society of Cardiology for the Assessment of Frailty in Elderly Patients With Heart Disease. Revista Espa\u00f1ola de Cardiolog\u00eda (English Edition)<\/em>, 72<\/em>(1), 63\u201371. https:\/\/doi.org\/10.1016\/j.rec.2018.06.035<\/a><\/p>\nFarkouh, A., Riedl, T., Gottardi, R., Czejka, M., & Kautzky-Willer, A. (2020). Sex-Related Differences in Pharmacokinetics and Pharmacodynamics of Frequently Prescribed Drugs: A Review of the Literature. Advances in Therapy<\/em>, 37<\/em>(2), 644\u2013655. https:\/\/doi.org\/10.1007\/s12325-019-01201-3<\/a><\/p>\nStrain, W. D., Hope, S. V., Green, A., Kar, P., Valabhji, J., & Sinclair, A. J. (2018). Type 2 diabetes mellitus in older people: A brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative. Diabetic Medicine<\/em>, 35<\/em>(7), 838\u2013845. https:\/\/doi.org\/10.1111\/dme.13644<\/a><\/p>\nvan den Anker, J., Reed, M. D., Allegaert, K., & Kearns, G. L. (2018). Developmental Changes in Pharmacokinetics and Pharmacodynamics. The Journal of Clinical Pharmacology<\/em>, 58<\/em>(S10), S10\u2013S25. https:\/\/doi.org\/10.1002\/jcph.1284<\/a><\/p>\nA Sample Answer 2 For the Assignment: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nTitle: <\/strong> NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\nAsthma is one of the most common conditions affecting more than 20 million individuals in the United States and over 150 million across the globe. It takes up to $14 billion to treat asthma annually. Particularly hard hit are adolescents and children between the ages of 10 to 18 years. Studies show that up to 14% of children and adolescents in the inner city are diagnosed with asthma. A larger percentage of asthmatic patients in the emergency rooms are children and adolescents. Consequently, most patients hospitalized as a result of asthma or asthma-related problems are also children. As such, appropriate interventions must be implemented to help in managing asthma among children and adolescents hence reducing their visits to the ER or hospitalization. In the same line, Sentara Home Care Services came up with an innovative program to help in improving asthma management among children and adolescents through home-based strategies such as \u201cLife Coaches\u201d where they are educated on the proper use of medication and lifestyle behaviors for both the patient and their families. This paper reviews different pieces of literature for a better understanding of the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents.<\/p>\n
Methods<\/strong><\/h2>\nQuite a significant number of internet sources were available talking about different approaches that can be utilized in managing asthma among children and adolescents. However, only peer-reviewed articles directly relating to the study PICOT questioned were used for this paper. These articles were arrived at by use of several inclusion and exclusion criteria. For instance, the inclusion criteria included studies that had been published within the last 5 years, in English, with participants who are children and adolescents. The studies however could be either experimental or literature review. Exclusion criteria included articles published more than 5 years, in languages other than English. Consequently, relevant keywords such as asthma, \u00a0Sentara\u2019s Asthma Disease Management plan, children and adolescents, and decreased ER\/unscheduled PCP visits were utilized. A wide variety of search engines were used for this study, such as Google Scholar, PubMed\/MEDLINE, and Cochrane. Generally, only peer-reviewed articles and experimental studies covering the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents, were used for this study.<\/p>\n
Synthesize the Literature<\/strong><\/h2>\nPart A: Components of Each Article<\/strong><\/h3>\nThe study carried out by Naar et al., 2018, was aimed at bridging the gap for proper interventions for the management of asthma among African American adolescents who appear to be at high risk of asthma morbidity and mortality. The randomized control trial study revealed the significance of comprehensive family and community-based treatment strategies for better medication adherence, reduction in the frequency of asthma symptoms, and reduced inpatient hospitalization among African American adolescents. The strategies revealed in this study align with the initiatives and goals outlined in Sentara\u2019s Asthma Disease Management plan\u00a0for children and adolescents.<\/p>\n
According to Woods et al., 2016, the hospitalization rate of Black and Hispanic children\u00a0diagnosed with asthma is quite high as compared to white children. As such Woods et al., 2016, carried out a study to evaluate the effectiveness of community asthma initiatives in the management of asthma, hence reducing the hospitalization rate among this high-risk population. Data was collected and analyzed using the longitudinal evaluation of the participants and comparing the results to the control sample. It was noted that the community asthma initiative helped in reducing the health disparities related to asthma, with reduced hospitalization rate among Blacks and Hispanic children. The results support the study PICOT question on the effectiveness of Sentara\u2019s Asthma Disease Management plan\u00a0in reducing visits to the ER and hospitalization among children and adolescents diagnosed with asthma.<\/p>\n
Bellin et al., 2017, conducted a study aimed at finding out the knowledge of children diagnosed with asthma, from low-income families on home-based asthma management strategies. The study utilized a convenience sampling strategy to select appropriate participants. The collected data were analyzed using the grounded theory coding techniques. Based on the findings, it was recommended that more reinforcements need to be put towards providing a multipronged approach aimed at improving asthma control measures among this high-risk population. Such measures include ongoing child and family education, environmental control, and self-management home-based strategies, just like the ones illustrated in Sentara\u2019s Asthma Disease Management plan.<\/p>\n
The study carried out by Jonas, Leu, & Reznik, 2020, was aimed at evaluating the effects of utilizing Community Health Workers for the delivery of home-based\u00a0Wee Wheezers<\/em>\u00a0asthma education program for better manage asthma symptoms among children. A randomized controlled trial was employed for this study. According to the results, delivery of home-based asthma education programs led to the improvement of symptoms, hence reduced disparities in children\u2019s health outcomes. The study supports Sentara\u2019s Asthma Disease Management plan, whose main goal is to educate patients and caregivers on the disease process of asthma, for better treatment outcomes.<\/p>\nLeas et al., 2018 carried out a study evaluating the effectiveness of home-based asthma prevention initiatives such as allergen reduction interventions on asthma outcomes. The utilized systematic literature review of both nonrandomized interventional\u00a0studies and randomized controlled trials for this study. Based on the collected result, the effectiveness of indoor allergen reduction intervention helps in preventing an asthma attack. However, the effectiveness of this intervention was quite inconclusive as a result of inadequate support from previous studies. Indoor allergen reduction interventions are among the several home-based interventions outlined in Sentara\u2019s Asthma Disease Management plan\u00a0for children and adolescents.<\/p>\n
Part B: Compare and contrast the articles: <\/strong><\/h2>\nAll five studies revolve around the same goal of reducing disparities as a result of asthma among children and adolescents by utilizing community and home-based initiatives. According to Sentara\u2019s Asthma Disease Management plan, \u201clife coaches\u201d and home-based strategies are utilized in assessing, teaching, and monitoring asthma through self-management strategies to reduce disparities hence reduced hospitalization and ER visits. The same concept, despite the use of different languages, has been addressed in all five studies. However, some of the studies were experimental such as Naar et al., 2018, Jonas, Leu, & Reznik, 2020 and Bellin et al., 2017, while others were literature reviews, Leas et al., 2018 and Woods et al., 2016.<\/p>\n
Several limitations were however experienced in some of the reviewed studies. For instance, according to Leas et al., 2018, there was limited information availed by studies carried out on the effectiveness of some home-based asthma prevention initiatives such as indoor allergen reduction. Consequently, most of these studies only reveal the kind of home and community-based initiatives for the management and prevention of asthma among children and adolescents, instead of how effective these initiatives are in reducing ER visits and hospitalization rates among these individuals. Lastly, there were no recent studies, within the last five years, which evaluated the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents, making it hard to conclude on the PICOT question.<\/p>\n
Areas of Further Study<\/strong><\/h2>\nSeveral studies have revealed the relevance of community and home-based interventions in reducing the disparities as a result of asthma among children and adolescents. These interventions have been proven to reduce the number of visits by this age group to the ER, in addition to a reduction in hospitalization rates. However, very few studies have established the effectiveness of distinct interventions in achieving such outcomes. Consequently, very few recent studies have also revealed the effectiveness of Sentara\u2019s Asthma Disease Management plan for children and adolescents (Naar et al., 2018). As such, there is a need for further evaluation of the effectiveness of individual home-based interventions for better evidence-based practice in the management and prevention of asthma among children and adolescents.<\/p>\n
References<\/h2>\n
Bellin, Melissa H., Angelica Newsome, Cassie Land, Joan Kub, Shawna S. Mudd, Mary Elizabeth Bollinger, and Arlene M. Butz. 2017. “Asthma Home Management in the Inner-City: What Can the Children Teach Us?”\u00a0Journal of Paediatric Health Care.\u00a0<\/em>31, no. 3: 362-371. https:\/\/doi.org\/10.1016\/j.pedhc.2016.11.002<\/a><\/p>\nJonas, J. A., Leu, C. S., & Reznik, M. (January 01, 2020). A randomized controlled trial of a community health worker delivered home-based asthma intervention to improve pediatric asthma outcomes.\u00a0The Journal of Asthma: Official Journal of the Association for the Care of Asthma,\u00a02020,\u00a0<\/em>1-12. https:\/\/doi.org\/10.1080\/02770903.2020.1846746<\/a><\/p>\nLeas BF, KE D’Anci, AJ Apter, T Bryant-Stephens, MP Lynch, JL Kaczmarek, and CA Umscheid. 2018. “Effectiveness of Indoor Allergen Reduction in Asthma Management: A\u00a0systematic Review”.\u00a0The Journal of Allergy and Clinical Immunology.\u00a0<\/em>141, no. 5: 1854-1869. https:\/\/doi.org\/10.1016\/j.jaci.2018.02.001<\/a><\/p>\nNaar, S., Ellis, D., Cunningham, P., Pennar, A. L., Lam, P., Brownstein, N. C., & Bruzzese, J.-M. (October 01, 2018). Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents.\u00a0Paediatrics,\u00a0142,\u00a0<\/em>4.) \u00a0DOI: https:\/\/doi.org\/10.1542\/peds.2017-3737<\/a><\/p>\nWoods, E. R., Bhaumik, U., Sommer, S. J., Chan, E., Tsopelas, L., Fleegler, E. W., Lorenzi, M., … Dulin, R. (February 12, 2016). Community Asthma Initiative to Improve Health Outcomes and Reduce Disparities Among Children with Asthma.\u00a0Mmwr Supplements,\u00a065,\u00a0<\/em>1, 11-20. DOI:\u00a0http:\/\/dx.doi.org\/10.15585\/mmwr.su6501a4<\/a>.<\/p>\n <\/p>\n
NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN Rubric Detail<\/h3>\n
Select Grid View<\/em> or List View<\/em> to change the rubric’s layout.<\/p>\nContent<\/h3>\nName:\u00a0NURS_6521_Week2_Assignment_Rubric<\/h3>\n\n- \n
NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN Grid View:<\/a><\/h3>\n<\/li>\n- List View<\/a><\/li>\n<\/ul>\n
\n\n\n\u00a0<\/strong><\/td>\nExcellent <\/strong><\/td>\nGood <\/strong><\/td>\nFair <\/strong><\/td>\nPoor <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nExplain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. <\/strong><\/td>\nPoints Range: 23 (23%) – 25 (25%)<\/p>\nThe response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 20 (20%) – 22 (22%)<\/p>\nThe response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 18 (18%) – 19 (19%)<\/p>\nThe response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 0 (0%) – 17 (17%)<\/p>\nThe response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.<\/td>\n<\/tr>\n
\nDescribe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. <\/strong><\/td>\nPoints Range: 27 (27%) – 30 (30%)<\/p>\nThe response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Accurate, complete, and aligned examples are provided to support the response.<\/td>\n
Points Range: 24 (24%) – 26 (26%)<\/p>\nThe response accurately describes how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Accurate examples may be provided to support the response.<\/td>\n
Points Range: 21 (21%) – 23 (23%)<\/p>\nThe response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Inaccurate or vague examples are provided to support the response.<\/td>\n
Points Range: 0 (0%) – 20 (20%)<\/p>\nThe response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing.<\/p>\n
Inaccurate and vague examples may be provided to support the response, or is missing.<\/td>\n<\/tr>\n
\nExplain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements. <\/strong><\/td>\nPoints Range: 27 (27%) – 30 (30%)<\/p>\nThe response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.<\/p>\n
The response includes an accurate and detailed explanation to support the recommended improvements.<\/td>\n
Points Range: 24 (24%) – 26 (26%)<\/p>\nThe response accurately explains how to improve the patient’s drug therapy plan.<\/p>\n
The response may include an accurate explanation to support the recommended improvements.<\/td>\n
Points Range: 21 (21%) – 23 (23%)<\/p>\nThe response inaccurately or vaguely explains how to improve the patient’s drug therapy plan.<\/p>\n
The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.<\/td>\n
Points Range: 0 (0%) – 20 (20%)<\/p>\nThe response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing.<\/p>\n
The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.<\/td>\n<\/tr>\n
\nWritten Expression and Formatting – Paragraph Development and Organization:
\nParagraphs 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. <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity.<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time.<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\nParagraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.<\/td>\n<\/tr>\n
\nWritten Expression and Formatting – English writing standards:
\nCorrect grammar, mechanics, and proper punctuation <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\nUses correct grammar, spelling, and punctuation with no errors<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\nContains a few (1\u20132) grammar, spelling, and punctuation errors<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\nContains several (3\u20134) grammar, spelling, and punctuation errors<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\nContains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding<\/td>\n<\/tr>\n
\nWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, running head, parenthetical\/in-text citations, and reference list. <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\nUses correct APA format with no errors<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\nContains a few (1\u20132) APA format errors<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\nContains several (3\u20134) APA format errors<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\nContains many (\u2265 5) APA format errors<\/td>\n<\/tr>\n
\nTotal Points: 100 <\/strong><\/td>\n<\/td>\n<\/tr>\n \n<\/td>\n <\/td>\n <\/td>\n <\/td>\n <\/td>\n <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nName:\u00a0NURS_6521_Week2_Assignment_Rubric<\/h3>\n
- \n
- Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.<\/li>\n
- Describe how changes in the processes might impact the patient\u2019s recommended drug therapy. Be specific and provide examples.<\/li>\n
- Explain how you might improve the patient\u2019s drug therapy plan and explain why you would make these recommended improvements.<\/li>\n<\/ul>\n
Reminder:<\/strong> The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https:\/\/academicguides.waldenu.edu\/writingcenter\/templates\/general#s-lg-box-20293632)<\/a>. All papers submitted must use this formatting.<\/p>\n
Submission and Grading Information<\/strong><\/h2>\n
To submit your completed Assignment for review and grading, do the following:<\/strong><\/p>\n
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- Please save your Assignment using the naming convention \u201cWK2Assgn+last name+first initial.(extension)\u201d as the name.<\/li>\n
- Click the\u00a0Week 2 Assignment Rubric\u00a0<\/strong>to review the Grading Criteria for the Assignment.<\/li>\n
- Click the\u00a0Week 2 Assignment\u00a0<\/strong>link. You will also be able to \u201cView Rubric\u201d for grading criteria from this area.<\/li>\n
- Next, from the Attach File area, click on the\u00a0Browse My Computer<\/strong>\u00a0button. Find the document you saved as \u201cWK2Assgn+last name+first initial.(extension)\u201d and click\u00a0Open<\/strong>.<\/li>\n
- If applicable: From the Plagiarism Tools area, click the checkbox for\u00a0I agree to submit my paper(s) to the Global Reference Database<\/strong>.<\/li>\n
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Grading Criteria<\/strong><\/h3>\n
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/a><\/span><\/h3>\n
Photo Credit: Getty Images\/Science Photo Library RF<\/p>\n
NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/figcaption><\/figure>\n As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.<\/p>\n
Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db328.htm<\/a><\/p>\n
A Sample Answer For the Assignment: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\n
Title: <\/strong> NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\n
Safety, quality, and efficiency are important in the management of health problems in nursing practice. Advanced nurse practitioners ensure that medication prescription considers patient, medication, and comorbid factors that affect the realization of the desired treatment outcomes. Therefore, this paper explores the effect of age on pharmacokinetic and pharmacodynamic processes in the assigned patient. The patient has a history of transient ischemic attack and atrial fibrillation. The patient also has been diagnosed with hypertension, type 2 diabetes mellitus, ischemic heart disease, and hyperlipidemia. The patient is currently using several medications that include warfarin, aspirin, metformin, glyburide, atenolol, and Motrin.<\/p>\n
Effect of Age on Pharmacokinetic and Pharmacodynamic Processes<\/strong><\/h2>\n
The multiple comorbidities the patient in this case study has points to the increased likelihood that he\/she is elderly. Advancing age is associated with increased risk of comorbid conditions such as hypertension, diabetes, ischemic heart disease, and mental health issues. Age significantly affects pharmacokinetic and pharmacokinetic processes. Aging is associated with significant changes in the body\u2019s processes involved in drug absorption, metabolism, and excretion. First, aging reduces first-pass metabolism due to decline in blood flow and liver mass. The reduction increases the first-pass metabolism that drugs metabolized in the liver undergo (van den Anker et al., 2018). Aging also results in changes in drug distribution. For example, water-soluble drugs have reduced distribution volume due to changes such as decreased gastrointestinal motility and elimination, hence, high serum levels in the elderly.<\/p>\n
Aging also affects processes such as reduction in gastric sections, emptying, and splanchnic blood flow. The absorption capacity of the intestines also reduces. These changes affect pharmacokinetic processes, including drug absorption and the realization of the desired therapeutic effectiveness of the prescribed medications in the elderly (Cossart et al., 2019). Aging also lowers protein binding of drugs. The reduction is attributed to the decline in the concentrations of albumin with the advancing age. Drug clearance reduces significantly with aging. Changes such as the reduction in renal clearance affects the elimination of water-soluble drugs, digoxin, diuretics, and lithium among others (Farkouh et al., 2020). Therefore, the effects of change on pharmacokinetics and pharmacodynamics require a careful approach to prescribing medications for children and the elderly.<\/p>\n
Impact of Changes on Recommended Drug Therapy<\/strong><\/h2>\n
Changes in pharmacokinetics and pharmacodynamic processes affects the recommended drug therapy for the patient in the case study. For example, changes in the renal clearance of drug metabolites affect the patient\u2019s health and wellbeing by increasing renal toxicity and high serum concentration of the drug. As a result, advanced nurse practitioners minimize nephrotoxic medications in such cases to optimize treatment effectiveness and minimize further deterioration in the client\u2019s status (Farkouh et al., 2020). Skin changes such as redistribution of fat and adipose tissue affects the absorption of medications administered via intramuscular or subcutaneous routes. A reduction in gastric emptying and production of gastric juice may also affect absorption of drugs (van den Anker et al., 2018). Consequently, advanced nurse practitioners consider alternative routes of medication administration such as through the intravenous routes to increase drug absorption and distribution.<\/p>\n
Liver is the largest organ involved in the metabolism of most drugs through the first-pass mechanism. However, liver diseases such as hepatitis and cirrhosis affect liver\u2019s ability to undertake these roles. The patient in the case study has multiple comorbidities, which predisposes him to hepato-renal complications due to the disease processes and polypharmacy (D\u00edez-Villanueva et al., 2019). Therefore, healthcare providers involved in developing the plan of the patient\u2019s care should minimize the administration of hepatotoxic and nephrotoxic medications to prevent harm. An example is withholding aspirin due to its adverse hepatic effects.<\/p>\n
Improving Patient\u2019s Treatment Plan<\/strong><\/h2>\n
The client\u2019s treatment requires some improvements. Firstly, the client has hyperlipidemia. As a result, I would prescribe statins to help in lowering body lipid levels. This decision will lower harmful triglycerides, which improves cardiovascular symptoms and type 2 diabetes that the client has. The second improvement that I would consider is eliminating warfarin therapy (D\u00edez-Villanueva et al., 2019). Combined use of warfarin and aspirin increases the risk of gastrointestinal bleeding and ulcers. Consequently, prescribing a platelet inhibitor such as Fondaparinux is appropriate to ensure safety in the treatment process. I would also perform liver function and renal function tests to help in developing an effective treatment plan. The results will help in adjusting the current plan. For example, I will replace Motrin with Tylenol if liver function tests are normal. In addition, I will select one oral hypoglycemic agent if the patient reports glycemic crises such as hypoglycemia or hyperglycemia (Strain et al., 2018). For instance, I will replace glyburide with dipeptidyl peptidase-IV inhibitors due to their associated enhanced therapeutic effectiveness.<\/p>\n
Conclusion<\/strong><\/h2>\n
In summary, safety is crucial in developing treatment plan for patients with multiple comorbidities. Advanced nurse practitioners should consider the different factors that affect pharmacokinetics and pharmacodynamics of the prescribed medications. Age is a crucial factor that affects these processes. Factors such as decreased renal and hepatic clearance of medications affect their effectiveness in disease management. Advanced nurse practitioners should make sound decisions to minimize the administration of drugs that may worsen the declining functioning in these organs. Therefore, I will improve the treatment plan for the patient in the case study to ensure safety, quality, and efficiency in the treatment of the comorbidities.<\/p>\n
References<\/h2>\n
Cossart, A. R., Cottrell, W. N., Campbell, S. B., Isbel, N. M., & Staatz, C. E. (2019). Characterizing the pharmacokinetics and pharmacodynamics of immunosuppressant medicines and patient outcomes in elderly renal transplant patients. Translational Andrology and Urology<\/em>, 8<\/em>(Suppl 2), S198\u2013S213. https:\/\/doi.org\/10.21037\/tau.2018.10.16<\/a><\/p>\n
D\u00edez-Villanueva, P., Ariz\u00e1-Sol\u00e9, A., Vid\u00e1n, M. T., Bonanad, C., Formiga, F., Sanchis, J., Mart\u00edn-S\u00e1nchez, F. J., Ruiz Ros, V., Sanmart\u00edn Fern\u00e1ndez, M., Bueno, H., & Mart\u00ednez-Sell\u00e9s, M. (2019). Recommendations of the Geriatric Cardiology Section of the Spanish Society of Cardiology for the Assessment of Frailty in Elderly Patients With Heart Disease. Revista Espa\u00f1ola de Cardiolog\u00eda (English Edition)<\/em>, 72<\/em>(1), 63\u201371. https:\/\/doi.org\/10.1016\/j.rec.2018.06.035<\/a><\/p>\n
Farkouh, A., Riedl, T., Gottardi, R., Czejka, M., & Kautzky-Willer, A. (2020). Sex-Related Differences in Pharmacokinetics and Pharmacodynamics of Frequently Prescribed Drugs: A Review of the Literature. Advances in Therapy<\/em>, 37<\/em>(2), 644\u2013655. https:\/\/doi.org\/10.1007\/s12325-019-01201-3<\/a><\/p>\n
Strain, W. D., Hope, S. V., Green, A., Kar, P., Valabhji, J., & Sinclair, A. J. (2018). Type 2 diabetes mellitus in older people: A brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative. Diabetic Medicine<\/em>, 35<\/em>(7), 838\u2013845. https:\/\/doi.org\/10.1111\/dme.13644<\/a><\/p>\n
van den Anker, J., Reed, M. D., Allegaert, K., & Kearns, G. L. (2018). Developmental Changes in Pharmacokinetics and Pharmacodynamics. The Journal of Clinical Pharmacology<\/em>, 58<\/em>(S10), S10\u2013S25. https:\/\/doi.org\/10.1002\/jcph.1284<\/a><\/p>\n
A Sample Answer 2 For the Assignment: NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\n
Title: <\/strong> NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN<\/strong><\/h2>\n
Asthma is one of the most common conditions affecting more than 20 million individuals in the United States and over 150 million across the globe. It takes up to $14 billion to treat asthma annually. Particularly hard hit are adolescents and children between the ages of 10 to 18 years. Studies show that up to 14% of children and adolescents in the inner city are diagnosed with asthma. A larger percentage of asthmatic patients in the emergency rooms are children and adolescents. Consequently, most patients hospitalized as a result of asthma or asthma-related problems are also children. As such, appropriate interventions must be implemented to help in managing asthma among children and adolescents hence reducing their visits to the ER or hospitalization. In the same line, Sentara Home Care Services came up with an innovative program to help in improving asthma management among children and adolescents through home-based strategies such as \u201cLife Coaches\u201d where they are educated on the proper use of medication and lifestyle behaviors for both the patient and their families. This paper reviews different pieces of literature for a better understanding of the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents.<\/p>\n
Methods<\/strong><\/h2>\n
Quite a significant number of internet sources were available talking about different approaches that can be utilized in managing asthma among children and adolescents. However, only peer-reviewed articles directly relating to the study PICOT questioned were used for this paper. These articles were arrived at by use of several inclusion and exclusion criteria. For instance, the inclusion criteria included studies that had been published within the last 5 years, in English, with participants who are children and adolescents. The studies however could be either experimental or literature review. Exclusion criteria included articles published more than 5 years, in languages other than English. Consequently, relevant keywords such as asthma, \u00a0Sentara\u2019s Asthma Disease Management plan, children and adolescents, and decreased ER\/unscheduled PCP visits were utilized. A wide variety of search engines were used for this study, such as Google Scholar, PubMed\/MEDLINE, and Cochrane. Generally, only peer-reviewed articles and experimental studies covering the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents, were used for this study.<\/p>\n
Synthesize the Literature<\/strong><\/h2>\n
Part A: Components of Each Article<\/strong><\/h3>\n
The study carried out by Naar et al., 2018, was aimed at bridging the gap for proper interventions for the management of asthma among African American adolescents who appear to be at high risk of asthma morbidity and mortality. The randomized control trial study revealed the significance of comprehensive family and community-based treatment strategies for better medication adherence, reduction in the frequency of asthma symptoms, and reduced inpatient hospitalization among African American adolescents. The strategies revealed in this study align with the initiatives and goals outlined in Sentara\u2019s Asthma Disease Management plan\u00a0for children and adolescents.<\/p>\n
According to Woods et al., 2016, the hospitalization rate of Black and Hispanic children\u00a0diagnosed with asthma is quite high as compared to white children. As such Woods et al., 2016, carried out a study to evaluate the effectiveness of community asthma initiatives in the management of asthma, hence reducing the hospitalization rate among this high-risk population. Data was collected and analyzed using the longitudinal evaluation of the participants and comparing the results to the control sample. It was noted that the community asthma initiative helped in reducing the health disparities related to asthma, with reduced hospitalization rate among Blacks and Hispanic children. The results support the study PICOT question on the effectiveness of Sentara\u2019s Asthma Disease Management plan\u00a0in reducing visits to the ER and hospitalization among children and adolescents diagnosed with asthma.<\/p>\n
Bellin et al., 2017, conducted a study aimed at finding out the knowledge of children diagnosed with asthma, from low-income families on home-based asthma management strategies. The study utilized a convenience sampling strategy to select appropriate participants. The collected data were analyzed using the grounded theory coding techniques. Based on the findings, it was recommended that more reinforcements need to be put towards providing a multipronged approach aimed at improving asthma control measures among this high-risk population. Such measures include ongoing child and family education, environmental control, and self-management home-based strategies, just like the ones illustrated in Sentara\u2019s Asthma Disease Management plan.<\/p>\n
The study carried out by Jonas, Leu, & Reznik, 2020, was aimed at evaluating the effects of utilizing Community Health Workers for the delivery of home-based\u00a0Wee Wheezers<\/em>\u00a0asthma education program for better manage asthma symptoms among children. A randomized controlled trial was employed for this study. According to the results, delivery of home-based asthma education programs led to the improvement of symptoms, hence reduced disparities in children\u2019s health outcomes. The study supports Sentara\u2019s Asthma Disease Management plan, whose main goal is to educate patients and caregivers on the disease process of asthma, for better treatment outcomes.<\/p>\n
Leas et al., 2018 carried out a study evaluating the effectiveness of home-based asthma prevention initiatives such as allergen reduction interventions on asthma outcomes. The utilized systematic literature review of both nonrandomized interventional\u00a0studies and randomized controlled trials for this study. Based on the collected result, the effectiveness of indoor allergen reduction intervention helps in preventing an asthma attack. However, the effectiveness of this intervention was quite inconclusive as a result of inadequate support from previous studies. Indoor allergen reduction interventions are among the several home-based interventions outlined in Sentara\u2019s Asthma Disease Management plan\u00a0for children and adolescents.<\/p>\n
Part B: Compare and contrast the articles: <\/strong><\/h2>\n
All five studies revolve around the same goal of reducing disparities as a result of asthma among children and adolescents by utilizing community and home-based initiatives. According to Sentara\u2019s Asthma Disease Management plan, \u201clife coaches\u201d and home-based strategies are utilized in assessing, teaching, and monitoring asthma through self-management strategies to reduce disparities hence reduced hospitalization and ER visits. The same concept, despite the use of different languages, has been addressed in all five studies. However, some of the studies were experimental such as Naar et al., 2018, Jonas, Leu, & Reznik, 2020 and Bellin et al., 2017, while others were literature reviews, Leas et al., 2018 and Woods et al., 2016.<\/p>\n
Several limitations were however experienced in some of the reviewed studies. For instance, according to Leas et al., 2018, there was limited information availed by studies carried out on the effectiveness of some home-based asthma prevention initiatives such as indoor allergen reduction. Consequently, most of these studies only reveal the kind of home and community-based initiatives for the management and prevention of asthma among children and adolescents, instead of how effective these initiatives are in reducing ER visits and hospitalization rates among these individuals. Lastly, there were no recent studies, within the last five years, which evaluated the significance of Sentara\u2019s Asthma Disease Management plan in increasing the control of asthma and decrease ER\/unscheduled PCP visit\u2019s for children\/adolescents, making it hard to conclude on the PICOT question.<\/p>\n
Areas of Further Study<\/strong><\/h2>\n
Several studies have revealed the relevance of community and home-based interventions in reducing the disparities as a result of asthma among children and adolescents. These interventions have been proven to reduce the number of visits by this age group to the ER, in addition to a reduction in hospitalization rates. However, very few studies have established the effectiveness of distinct interventions in achieving such outcomes. Consequently, very few recent studies have also revealed the effectiveness of Sentara\u2019s Asthma Disease Management plan for children and adolescents (Naar et al., 2018). As such, there is a need for further evaluation of the effectiveness of individual home-based interventions for better evidence-based practice in the management and prevention of asthma among children and adolescents.<\/p>\n
References<\/h2>\n
Bellin, Melissa H., Angelica Newsome, Cassie Land, Joan Kub, Shawna S. Mudd, Mary Elizabeth Bollinger, and Arlene M. Butz. 2017. “Asthma Home Management in the Inner-City: What Can the Children Teach Us?”\u00a0Journal of Paediatric Health Care.\u00a0<\/em>31, no. 3: 362-371. https:\/\/doi.org\/10.1016\/j.pedhc.2016.11.002<\/a><\/p>\n
Jonas, J. A., Leu, C. S., & Reznik, M. (January 01, 2020). A randomized controlled trial of a community health worker delivered home-based asthma intervention to improve pediatric asthma outcomes.\u00a0The Journal of Asthma: Official Journal of the Association for the Care of Asthma,\u00a02020,\u00a0<\/em>1-12. https:\/\/doi.org\/10.1080\/02770903.2020.1846746<\/a><\/p>\n
Leas BF, KE D’Anci, AJ Apter, T Bryant-Stephens, MP Lynch, JL Kaczmarek, and CA Umscheid. 2018. “Effectiveness of Indoor Allergen Reduction in Asthma Management: A\u00a0systematic Review”.\u00a0The Journal of Allergy and Clinical Immunology.\u00a0<\/em>141, no. 5: 1854-1869. https:\/\/doi.org\/10.1016\/j.jaci.2018.02.001<\/a><\/p>\n
Naar, S., Ellis, D., Cunningham, P., Pennar, A. L., Lam, P., Brownstein, N. C., & Bruzzese, J.-M. (October 01, 2018). Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents.\u00a0Paediatrics,\u00a0142,\u00a0<\/em>4.) \u00a0DOI: https:\/\/doi.org\/10.1542\/peds.2017-3737<\/a><\/p>\n
Woods, E. R., Bhaumik, U., Sommer, S. J., Chan, E., Tsopelas, L., Fleegler, E. W., Lorenzi, M., … Dulin, R. (February 12, 2016). Community Asthma Initiative to Improve Health Outcomes and Reduce Disparities Among Children with Asthma.\u00a0Mmwr Supplements,\u00a065,\u00a0<\/em>1, 11-20. DOI:\u00a0http:\/\/dx.doi.org\/10.15585\/mmwr.su6501a4<\/a>.<\/p>\n
<\/p>\n
NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN Rubric Detail<\/h3>\n
Select Grid View<\/em> or List View<\/em> to change the rubric’s layout.<\/p>\n
Content<\/h3>\n
Name:\u00a0NURS_6521_Week2_Assignment_Rubric<\/h3>\n
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NURS 6521 Assignment Pharmacotherapy for Cardiovascular Disorders IN Grid View:<\/a><\/h3>\n<\/li>\n
- List View<\/a><\/li>\n<\/ul>\n
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\n \u00a0<\/strong><\/td>\n Excellent <\/strong><\/td>\n Good <\/strong><\/td>\n Fair <\/strong><\/td>\n Poor <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n \n Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. <\/strong><\/td>\n Points Range: 23 (23%) – 25 (25%)<\/p>\n The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 20 (20%) – 22 (22%)<\/p>\n The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 18 (18%) – 19 (19%)<\/p>\n The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient.<\/td>\n
Points Range: 0 (0%) – 17 (17%)<\/p>\n The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing.<\/td>\n<\/tr>\n
\n Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. <\/strong><\/td>\n Points Range: 27 (27%) – 30 (30%)<\/p>\n The response accurately and completely describes in detail how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Accurate, complete, and aligned examples are provided to support the response.<\/td>\n
Points Range: 24 (24%) – 26 (26%)<\/p>\n The response accurately describes how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Accurate examples may be provided to support the response.<\/td>\n
Points Range: 21 (21%) – 23 (23%)<\/p>\n The response inaccurately or vaguely describes how changes in the processes might impact the patient’s recommended drug therapy.<\/p>\n
Inaccurate or vague examples are provided to support the response.<\/td>\n
Points Range: 0 (0%) – 20 (20%)<\/p>\n The response inaccurately and vaguely describes how changes in the processes might impact the patient’s recommended drug therapy, or is missing.<\/p>\n
Inaccurate and vague examples may be provided to support the response, or is missing.<\/td>\n<\/tr>\n
\n Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements. <\/strong><\/td>\n Points Range: 27 (27%) – 30 (30%)<\/p>\n The response accurately and clearly explains in detail how to improve the patient’s drug therapy plan.<\/p>\n
The response includes an accurate and detailed explanation to support the recommended improvements.<\/td>\n
Points Range: 24 (24%) – 26 (26%)<\/p>\n The response accurately explains how to improve the patient’s drug therapy plan.<\/p>\n
The response may include an accurate explanation to support the recommended improvements.<\/td>\n
Points Range: 21 (21%) – 23 (23%)<\/p>\n The response inaccurately or vaguely explains how to improve the patient’s drug therapy plan.<\/p>\n
The response may include an inaccurate, vague, or misaligned explanation to support the recommended improvements.<\/td>\n
Points Range: 0 (0%) – 20 (20%)<\/p>\n The response inaccurately and vaguely explains how to improve the patient’s drug therapy plan, or is missing.<\/p>\n
The response may include an inaccurate and vague explanation to support the recommended improvements, or is missing.<\/td>\n<\/tr>\n
\n Written Expression and Formatting – Paragraph Development and Organization:
\nParagraphs 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. <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\n Paragraphs and sentences follow writing standards for flow, continuity, and clarity.<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\n Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\n Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time.<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\n Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.<\/td>\n<\/tr>\n
\n Written Expression and Formatting – English writing standards:
\nCorrect grammar, mechanics, and proper punctuation <\/strong><\/td>\nPoints Range: 5 (5%) – 5 (5%)<\/p>\n Uses correct grammar, spelling, and punctuation with no errors<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\n Contains a few (1\u20132) grammar, spelling, and punctuation errors<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\n Contains several (3\u20134) grammar, spelling, and punctuation errors<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\n Contains many (\u2265 5) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding<\/td>\n<\/tr>\n
\n Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing,\u00a0margins, indentations, page numbers, running head, parenthetical\/in-text citations, and reference list. <\/strong><\/td>\n Points Range: 5 (5%) – 5 (5%)<\/p>\n Uses correct APA format with no errors<\/td>\n
Points Range: 4 (4%) – 4 (4%)<\/p>\n Contains a few (1\u20132) APA format errors<\/td>\n
Points Range: 3.5 (3.5%) – 3.5 (3.5%)<\/p>\n Contains several (3\u20134) APA format errors<\/td>\n
Points Range: 0 (0%) – 3 (3%)<\/p>\n Contains many (\u2265 5) APA format errors<\/td>\n<\/tr>\n
\n Total Points: 100 <\/strong><\/td>\n <\/td>\n<\/tr>\n \n <\/td>\n <\/td>\n <\/td>\n <\/td>\n <\/td>\n <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n Name:\u00a0NURS_6521_Week2_Assignment_Rubric<\/h3>\n
- List View<\/a><\/li>\n<\/ul>\n
- Click the\u00a0Week 2 Assignment\u00a0<\/strong>link. You will also be able to \u201cView Rubric\u201d for grading criteria from this area.<\/li>\n