As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.

· Review the interactive media piece assigned by your Instructor. 

· Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.

· Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.

· You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

Write a  2-page summary paper that addresses the following:

· Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.

· Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.

· What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.

· Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

You will analyze the decisions you will make in the decision tree exercise and reflect on your experiences in proposing the recommended actions to address the health needs in the patient case study.

 

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As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?

For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.

Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago. 

 

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ITS IMPORTANT TO MEET THE COMPETENCIES !!!

Write for your organization a 3–5-page impact report regarding the health concerns of a new immigrant population. Describe the population’s health concerns and issues, explain current pharmacological treatments, and explain how culture and traditional practices may affect use of pharmacology. Identify evidence-based strategies for the organization and nursing staff to use to educate the population and promote health and wellness.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Apply practice guidelines and standards of evidence-based practice related to pharmacology for safe and effective nursing practice.       
  • (IMPORTANT) -Describe current pharmacological treatment regimens for the health concerns and issues of a population.
• Competency 2: Explain the relationship between quality patient outcomes, patient safety, and the appropriate use of pharmacology and psychopharmacology.       
  • (IMPORTANT) -Explain traditional beliefs and practices of a population with regard to health concerns and issues.
  • (IMPORTANT) -Explain how the cultural values and traditional practices of a population affect the acceptance and use of pharmacology.
• Competency 3: Apply the principles and practices of cultural competence with regard to pharmacological interventions.       
  • (IMPORTANT) -Identify evidence-based, culturally sensitive strategies an organization can use to educate a population about the appropriate use of pharmacology.
  • (IMPORTANT) -Identify evidence-based, culturally sensitive strategies nurses can use with a population to promote health and wellness.
• Competency 4: Communicate in a manner that is scholarly, professional, and consistent with expectations of a nursing professional.       
  • (IMPORTANT) -Describe the health concerns and issues for a specific population.
  • (IMPORTANT) -Write content clearly and logically with correct use of grammar, punctuation, and mechanics.
  • (IMPORTANT) -Correctly format citations and references using current APA style. 

Assessment Instructions 

  

Imagine the county health department notifies your organization that a large number of immigrants are expected to be resettled in your area. The organization, wanting to be prepared to handle any health concerns of the population, tasks each department with readying for the influx of immigrants. Your supervisor asks you to prepare an impact report on the pharmacological needs of the population that can be shared with other departments.

Preparation

Complete the following as you prepare for your impact report:

1. Choose one of the global areas below as the area from which the population will be coming.      
   • Sub-Saharan Africa.
   • India.
   • China.
   • Dominican Republic.
   • Guatemala.
   • Jamaica.
   • Bangladesh.
   • Saudi Arabia.
   • Pakistan.
   • Mexico.
2. Research the most common health concerns and issues for immigrants from your chosen global area, the pharmacological treatments that will likely be prescribed, and any cultural values or traditional practices that may impact patient outcomes.

Requirements

Once you have identified the population you will be using for this assessment, include the following in your impact report:

• Describe the health concerns and issues for the population.
• Describe current pharmacological treatment regimens for the main health concerns and issues.
• Explain any traditional beliefs and practices associated with the health concerns and issues. Does the population engage in culturally based methods of treating the health concern?
• Explain how cultural values and traditional practices might affect acceptance and use of prescribed pharmacological treatments. Be sure to consider the relationship between quality patient outcomes, patient safety, and the appropriate use of pharmacology.
• Identify evidence-based, culturally sensitive strategies the organization can use to educate the population about the correct use of the pharmacology treatments.
• Identify evidence-based, culturally sensitive strategies the nursing staff can employ with the population to promote health and wellness.

Write this assessment as an impact report formatted as other reports of a similar nature in your organization or an organization with which you are familiar. Include a title page and reference page and follow APA guidelines for your in-text citations and references.

Additional Requirements

• Number of pages: 3–5
• At least 3 current scholarly or professional resources.
• Times New Roman font, 12 point, double-spaced font.

 

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APA 6th edition format.

At least 3 peer reviewed references less than 5 years old.  Cited in text.

 Pharmacology Case Study

A 63 years old obese female presents with 4 to 5 months history of mid-epigastric pain that is worse after eating. She is unable to identify any specific foods that may be triggering the symptoms. She denies excessive gas, denies regurgitation of food or a water brash. She has normal daily bowel movements but states that sometimes her stools are very dark. She denies nausea and vomiting. She has no previous history of these symptoms and they are becoming disruptive in her daily life. She has been taking TUMs, “like they are candy.”

Past Medical History: surgical menopause at age 35 secondary to endometriosis, hypertension (HTN), diabetes mellitus Type II, morbid obesity, dyslipidemia. Surgical History: T&A as child, total abdominal hysterectomy with bilateral salpingo-oophorectomy, appendectomy, cholecystectomy. Her medication regimen includes Premarin 0.625mg q day, lisinopril 10mg q day, metformin 500mg bid, and atorvastatin 40mg q HS. VS: BP 145/94, P 90, R 18, T 98.2. The patient’s height is 5’4” and her weight is 225 lbs., consequently her BMI is 38.6.  Physical examination is within normal limits.

Questions for response:

1. What additional history would you like for this patient?

2. If you plan to start drug treatment today

a. what is your choice, the dose, and the duration of the treatment?

b. what are some alternatives to this choice

c. what is your rationale for this choice

3. What risk factors for this patient will guide your choice?

4. Are there any major drug-to-drug interactions, side effects or adverse reactions to this drug?

Provide patient education regarding the use of this drug. Besides drug therapy, are there any other interventions you would consider or recommend? 

 

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