NSG 6005 Week 3 Assignment 1 & 2

NSG 6005 Week 3  Assignment 1 Discussion – Select one of the two questions from the discussion questions listed below .By Week 3, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

CF is a sixty-year-old African American male who presents as a new patient for initial evaluation and follow-up .He has been diagnosed with hypertension for the last twelve years and Type 2 diabetes for the same period of time .His current blood pressure is 162/90, with a pulse of 76 .His body mass index (BMI) is 32 .He is currently taking Maxzide 37 .5/25 mg every morning .This is the only antihypertensive medication he has taken .

For this question, focus on the treatment of hypertension .Discuss the influences of his age, gender, and ethnicity on hypertensive medications .On the basis of an analysis of those factors, provide one option for improvement of his blood pressure and provide a clear and specific justification for that choice .Be sure to include dosage and scheduling .Include highlights of patient teaching and/or recommendations for any lifestyle changes .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

Discussion Question 2

MT is a fifty-six-year-old obese (BMI 31 .5) Caucasian female with a significant family history of cardiovascular disease .She has uncontrolled hypertension and is currently taking metoprolol 50 mg twice daily .She has dyslipidemia and is taking exetimibe 10 mg daily and garlic .Her current cholesterol is 240 mg/dL, HDL is 41 mg/dL, LDL is 163 mg/dL, and triglycerides are 183 mg/dL .Her blood pressure today is 174/94, and her pulse is 90 .

Review the medications she is taking for hypertension and dyslipidemia .Evaluate the efficacy of these medications .Review them in terms of her age, gender, and ethnicity .Suggest any changes you would recommend, with clear justification for those choices .For medications, include dosages and schedules .Include highlights of patient teaching and/or lifestyle alterations .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

NSG 6005  Week 3 Assignment 2 Quiz

Question 1 .Ray has been diagnosed with hypertension, and an ACE inhibitor is determined to be needed .Prior to prescribing this drug, the nurse practitioner should assess for:

• Hypokalemia
• Impotence
• Decreased renal function
• Inability to concentrate

Question 2 .A potentially life-threatening adverse response to ACE inhibitors is angioedema .Which of the following statements is true about this adverse response?

• Swelling of the tongue and hoarseness are the most common symptoms .
• It appears to be related to a decrease in aldosterone production .
• The presence of a dry, hacky cough indicates a high risk for this adverse response .
• Because it takes time to build up a blood level, it occurs after being on the drug for about one week .

Question 3 .Rodrigo has been prescribed procainamide after an episode of MI .He is monitored for dyspnea, jugular venous distention, and peripheral edema because they may indicate:

• Widening of the area of infarction
• Onset of congestive heart failure
• An electrolyte imbalance involving potassium
• Renal dysfunction

Question 4 .Which of the following is true about procainamide and its dosing schedule?

• It produces bradycardia and should be used cautiously in patients with cardiac conditions that a slower heart rate might worsen .
• GI adverse effects are common, so the drug should be taken with food .
• Adherence can be improved by using a sustained-release formulation that can be given once daily .
• Doses of this drug should be taken evenly spaced around the clock to keep an even blood level .

Question 5 .Furosemide is added to a treatment regimen for heart failure, which includes digoxin .Monitoring for this combination includes:

• Hemoglobin
• Serum potassium
• Blood urea nitrogen
• Serum glucose

NSG 6005 Week 8 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 8, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

There are multiple issues to consider in caring for someone with diabetes II .Your course textbook lists these as:

• Race and Ethnic Group
• Obesity
• Coronary Artery Disease and Heart Failure
• Hyperlipidemia
• Hypertension
• Nephropathy
• Neuropathy
• Retinopathy

From this group, select two specific issues and explain the importance of that variable in the treatment of diabetes .Explain how a provider needs to approach the patient and how these considerations would influence the selection of agents for the treatment of diabetes and related complications .

Discussion Question 2

AG is a sixty-nine-year-old male who presents for an initial visit with a complaint of blurred vision, fatigue, and lack of energy .He is currently being treated for hypertension, hypothyroidism, and gouty arthritis .He is currently retired and married, with three adult children .His vital signs are unremarkable, with a body mass index (BMI) of 30 .His current medications include lisinopril 20 mg daily, allopurinol 300 mg daily, and levothyroxine 0 .088 mg daily .

As per his blood work today, his A1c level is 7 .8%, his fasting blood sugar is 202, his total cholesterol is 180 mg/dL, his high-density lipoprotein (HDL) is 27 mg/dL, his low-density lipoprotein (LDL) is 193 mg/dL, and his triglycerides are 302 mg/dL .Answer the following questions:

• What additional blood work would you like to complete at this point? Is there any additional information that should be collected from the patient?
• Evaluate the current therapy and make recommendations concerning any needed changes .
• What lifestyle modifications or changes do you think would be appropriate for this patient?

NSG 6005 Week 7 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 7, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

EP is a fifty-year-old woman who reports experiencing two to three hot flashes per day, occasionally associated with insomnia .She also states she is awakened from sleep about two to three times per week, needing to change her bedclothes and linens due to sweating .Her symptoms began about three months ago, and over that time, her symptoms have worsened to the point where they have become very bothersome .She is concerned about starting any hormonal treatment because she has read news stories that the medication is not safe .She has been successfully treated for depression and is currently doing well on paroxetine .Her current medications include omeprazole 20 mg daily, paroxetine 20 mg, Synthroid 0 .075 mg daily, and hydrochlorothiazide 25 mg daily .Her physical exam is normal; her blood pressure is 128/86, her pulse is 78, and her body mass index (BMI) is 30 .5 .Answer the following questions:

• Is there any additional information you would want to collect?
• What are the variables you would take into account before deciding how to help her?
• What treatment will you recommend?
• What nonpharmacological treatment would you suggest?

For medications, include dosages and schedules .Include highlights of patient teaching and/or lifestyle alterations .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

Discussion Question 2

VG is a thirty-one-year-old female who comes in for a routine follow-up .She reports that she has been feeling excessive fatigue over the last month .She also notes that she is having some problems at work, not only because of her fatigue but also because of difficulty concentrating .She also notes that she has gained 10 pounds over the last month, and she is unable to identify the cause of the weight gain .She also notes that her periods are a little heavier and more irregular .She is currently taking daily ferrous sulfate and over-the-counter calcium .According to her medical record, she had a TSH level of 4 .2 mIL/L about a year ago .Although this is slightly elevated, no further follow-up was deemed necessary at the time .Repeat blood work today reveals a TSH level of 9 .8 mIL/L and a free T4 of 0 .72 ng/dL .Answer the following questions:

• What additional findings on the physical exam would you look for?
• What implication does the previous TSH level have?
• What therapy would you institute?
• If VG becomes pregnant, what adjustment, if any, would be needed in her thyroid medication?

NSG 6005 Week 7 Assignment 2 Quiz

1 .Question : A twenty-two-year-old woman receives a prescription for oral contraceptives .Education for this patient includes:

• Counseling regarding decreasing or not smoking while taking oral contraceptives
• Advising a monthly pregnancy test for the first three months she is taking the contraceptive
• Advising that she may miss two pills in a row and not be concerned about pregnancy
• Informing her that her next follow-up visit is in one year for a refill and “annual exam”

Question 2 .Sallie has been diagnosed with osteoporosis and is asking about the once-a-month pill to treat her condition .How do bisphosphonates treat osteoporosis?

• By selectively activating estrogen pathways in the bone
• By reducing bone resorption by inhibiting PTH
• By reducing bone resorption and inhibiting osteoclastic activity
• By increasing PTH production

Question 3 .Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for:

• Excessive sedation
• Tachycardia and angina
• Weight gain
• Cold intolerance

Question 4 .Intranasal calcitonin is used in the treatment of osteoporosis .For which patient is Calcitonin therapy appropriate?

• Thin, Caucasian perimenopausal women
• Men over the age of sixty-five years with osteoporosis
• Women over the age of sixty-five years with osteopenia
• Women over the age of sixty-five years with severe osteoporosis

Question 5 .The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is:

• Annual dual energy X-ray absorptiometry (DEXA) scans
• Annual vitamin D level
• Annual renal function evaluation
• Electrolytes every three months