NURS 6512 Assignment: Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.

Photo Credit: Getty Images/Caiaimage

Every day, as an advanced practice nurse prescribing drugs, you are held accountable for people’s lives. Because of your position, patients and their families will frequently place their trust in you. This trust brings with it power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is critical that you are aware of the most recent professional, legal, and ethical standards for advanced practice nurses with prescribing authority. Furthermore, it is critical to ensure that treatment plans and drug administration/prescribing are in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of specific drugs in various states may have a significant impact on your patient’s treatment plan. You must complete this assignment.

To Prepare

• Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor for this Assignment.
• Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
• Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

• Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
• Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
• Explain the process of writing prescriptions, including strategies to minimize medication errors.

Reminder: 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 ). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
• Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 1 Assignment Rubric

 

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 1 Assignment draft and review the originality report.

 

Submit Your Assignment by Day 7 of Week 1

To participate in this Assignment:

Week 1 Assignment

 

What’s Coming Up in Module 2?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In the next module, you will examine the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders and the types of drugs prescribed to patients with respiratory disorders.

Looking Ahead: Week 2 Assignment

In Week 2, your Instructor will assign you a case study related to Assignment 1 by Day 1 of the week. Please make sure to review the “Course Announcements” area of the course to verify your assigned case study. Please plan ahead to ensure you have time to review your case study and Learning Resources in order to complete your Assignment on time.

Also Check Out:

Practicum – Upcoming Deadline

In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, you will need to submit your application via  .

For information on the practicum application process and deadlines, please visit the  web page.

Please take the time to review the  for your courses.

Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the  web page.

Next Week

 

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

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

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

This week, you will examine factors that may influence a patient’s pharmacokinetic and pharmacodynamic processes, as well as the specifics of a personalized plan of care that you create based on the influencing factors and patient history. You will also evaluate and analyze the ethical and legal implications and practices associated with drug prescribing, including disclosure and nondisclosure, as well as the prescription writing process to avoid medication errors.

Learning Objectives

Students will:

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

Learning Resources

 

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

• Chapter 1, “Prescriptive Authority” (pp. 1–3)
• Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
• Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
• Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
• Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
• Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)

 

 

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

 

 

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

 

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

NURS 6512 Assignment: Ethical and Legal Implications of Prescribing Drugs

Introduction to Advanced Pharmacology

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

 Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Content

Name: NURS_6521_Week1_Assignment_Rubric

		Excellent	Good	Fair	Poor
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family.		Points Range: 23 (23%) – 25 (25%) The response accurately and thoroughly explains in detail the ethical and legal implications of the scenario selected on all stakeholders involved. The response includes accurate, clear, and detailed explanations as to how these implications affect the prescriber, pharmacist, patient, and the patient’s family.	Points Range: 20 (20%) – 22 (22%) The response explains the ethical and legal implications of the scenario selected on all stakeholders involved. The response includes accurate explanations as to how these implications affect the prescriber, pharmacist, patient, and the patient’s family.	Points Range: 18 (18%) – 19 (19%) The response inaccurately or vaguely explains the ethical and legal implications of the scenario selected for all stakeholders involved. The response includes vague explanations as to how these implications affect the prescriber, pharmacist, patient, and the patient’s family.	Points Range: 0 (0%) – 17 (17%) The response vaguely and inaccurately explains the ethical and legal implications of the scenario selected for all stakeholders involved, or the response is missing. The response vaguely and inaccurately explains how these implications affect the prescriber, pharmacist, patient, and the patient’s family, or is missing.
Describe strategies to address disclosure and nondisclosure as identified in the scenario selected. Be sure to reference laws specific to your state.		Points Range: 18 (18%) – 20 (20%) An accurate, detailed, and clear description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided. The response includes specific, detailed, and accurate reference to state laws related to the scenario.	Points Range: 16 (16%) – 17 (17%) An accurate description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided. The response includes accurate reference to state laws related to the scenario.	Points Range: 14 (14%) – 15 (15%) A vague or inaccurate description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided. The response includes inaccurate or vague reference to state laws related to the scenario.	Points Range: 0 (0%) – 13 (13%) A vague and inaccurate description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided, or is missing. The response includes vague and inaccurate reference to state laws related to the scenario, or is missing.
Explain two strategies that you, as an advanced practice nurse would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.		Points Range: 18 (18%) – 20 (20%) The response accurately and thoroughly explains in detail at least two strategies that an advanced practice nurse would use to guide decision making in the scenario. The response accurately and completely explains whether they would disclose the error, including an accurate, detailed, and clear justification for the explanation provided.	Points Range: 16 (16%) – 17 (17%) The response accurately explains at least two strategies that an advanced practice nurse would use to guide decision making in the scenario. The response accurately explains whether they would disclose the error, including an accurate justification for the explanation provided.	Points Range: 14 (14%) – 15 (15%) The response inaccurately or vaguely explains at least two strategies that an advanced practice nurse would use to guide decision making in the scenario, or only explains one strategy. The response inaccurately or vaguely explains whether they would disclose the error, including a justification that is vague, inaccurate, or misaligned to the explanation provided.	Points Range: 0 (0%) – 13 (13%) The response inaccurately and vaguely explains only one strategy that an advanced practice nurse would use to guide decision making in the scenario, or is missing. The response inaccurately and vaguely explains whether they would disclose the error, with no justification provided, or is missing.
Explain the process of writing prescriptions including strategies to minimize medication errors.		Points Range: 18 (18%) – 20 (20%) The response provides an accurate, detailed, and thorough explanation of the process of writing prescriptions, including detailed strategies to minimize medication errors.	Points Range: 16 (16%) – 17 (17%) The response provides an accurate explanation of the process of writing prescriptions, including some strategies to minimize medication errors.	Points Range: 14 (14%) – 15 (15%) The response provides an inaccurate or vague explanation of the process of writing prescriptions, including inaccurate or vague strategies to minimize medication errors.	Points Range: 0 (0%) – 13 (13%) The response provides an inaccurate and vague explanation of the process of writing prescriptions, including inaccurate and vague strategies to minimize medication errors, or is missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs 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.		Points Range: 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity.	Points Range: 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.	Points Range: 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation		Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors	Points Range: 4 (4%) – 4 (4%) Contains a few (1–2) grammar, spelling, and punctuation errors	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) grammar, spelling, and punctuation errors	Points Range: 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.		Points Range: 5 (5%) – 5 (5%) Uses correct APA format with no errors	Points Range: 4 (4%) – 4 (4%) Contains a few (1–2) APA format errors	Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) APA format errors	Points Range: 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors
Total Points: 100

Name: NURS_6521_Week1_Assignment_Rubric

Pharmacokinetics and Pharmacodynamics

            When prescribing medication, it is crucial to consider several individual patient factors that might affect the pharmacokinetic and pharmacodynamic process (Reeve et al., 2017). For instance, while working with the geriatric population, I encountered an 85-year-old female patient with a history of atrial fibrillation and serum creatine of 1.8mg/dl. The patient was prescribed digoxin to help manage the rapid heart rate. A maintenance dose of 125mcg tabs once a day was decided based on the patient’s pharmacodynamic and pharmacokinetic processes.

Advanced age is characterized by reduced functionality of several regular body processes responsible for functional integration between different cells and organs. The 85-year-old patient displayed several pharmacokinetic changes, with the main ones being a reduction in hepatic and renal clearance and decreased distribution volume of water-soluble drugs leading to higher serum levels (Drenth‐van Maanen et al., 2019). Consequently, some of the pharmacokinetic changes associated with the patient’s advanced age include increased sensitivity to drugs like digoxin.

Serum creatine of 1.8mg/dl is quite high indicating that the patient’s kidneys are not functioning properly. However, since approximately 67% of digoxin undergoes renal clearance, it was necessary to calculate the standard renal clearance of the drug, which is 6 liters per hour per 70 kg body weight, with a creatinine clearance of 100 mL/min (Holford, 2017). The patient’s creatinine clearance is however reduced hence the need to administer a lower dose of the drug. A once-daily dosing frequency is thus recommended with a bioavailability of 0.7 that requires 127 mcg/day as the daily maintenance dose. The dose should however be monitored closely for further changes.

 

 

References

Drenth‐van Maanen, A. C., Wilting, I., & Jansen, P. A. F. (2019). Prescribing medicines to older people—How to consider the impact of aging on human organ and body functions. British Journal of Clinical Pharmacology, 86(10), 1921–1930.

Holford N.G. (2017). Pharmacokinetics & pharmacodynamics: rational dosing & the time course of drug action. Katzung B.G.(Ed.), Basic & Clinical Pharmacology, 14e. McGraw Hill. 

Reeve, E., Trenaman, S. C., Rockwood, K., & Hilmer, S. N. (2017). Pharmacokinetic and pharmacodynamic alterations in older people with dementia. Expert Opinion on Drug Metabolism & Toxicology, 13(6), 651–668. https://doi.org/10.1080/17425255.2017.1325873