As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues. 

Post a response to each of the following:

1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.
2. Compare and contrast the actions of g couple proteins and ion gated channels.
3. Explain the role of epigenetics in pharmacologic action.
4. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medications action.

zero plagiarism

four references 

 As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues. 

 

Post a response to each of the following:

1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.
2. Compare and contrast the actions of g couple proteins and ion gated channels.
3. Explain the role of epigenetics in pharmacologic action.
4. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medications action.

ZERO PLAGIARISM

FOUR REFERENCES

For

I need between 100-120 words for each assignment, and I want individual references with each response. Please, no plagiarized work

Module 1

DQ 1  Outcome measures are significant in showing the worth of the Doctor of Nursing Practice’s role in health care. Identify a practice-level outcome study or project and describe the expectation of its effect on health care. Which outcome measure do you think aligns with your DPI project (Quality Improvement Project)? Why? Provide examples and literature support.

DQ 2  In this week’s readings, theories of accident causation, human error, foresight, resilience, and system migration were discussed. Identify a safety theory and propose quality measures to improve patient safety. Which theory or framework are you using to guide your DPI Project’s intervention and outcome? Please define what constructs of your chosen DPI Project theory will help you change/improve clinical practice to improve a specific patient outcome? Provide examples and literature support.

Resources

Read Chapter 1 in Outcome Assessment in Advanced Practice Nursing 4e.

URL:

Henneman, E. A. (2017). Recognizing the ordinary as extraordinary: Insight into the way we work to improve patient safety outcomes. American Journal of Critical Care, 26(4), 272277. doi:10.4037/ajcc2017812

URL:

 Smith, S. A., Yount, N., & Sorra, J. (2017). Exploring relationships between hospital patient safety culture and Consumer Reports safety scores. BMC Health Services Research, 17,1-9. doi:10.1186/s12913-017-2078-6

URL:

Module 2

DQ 1  Discuss economic methodology, including the concept of cost-based analysis. If you will not be addressing this in your DPI Project, provide an example of a program where it could be used to show outcomes. Provide examples and literature support.

DQ 2   Discuss a change theory and how it can be or has been applied in nursing practice to integrate care delivery sustainability. How will you use change theory in the design of your project to support the sustainability of your practice improvement intervention? Provide examples and literature support.

Resources

Read Chapters 2 and 12 in Outcome Assessment in Advanced Practice Nursing 4e.

URL:

Uluskan, M., McCreery, J. K., & Rothenberg, L. (2018). Impact of quality management practices on change readiness due to new quality implementations. International Journal of Lean Six Sigma, 9(3), 351-373. doi:10.1108/IJLSS-05-2017-0049

URL:

Steele Gray, C., Wilkinson, A., Alvaro, C., Wilkinson, K., & Harvey, M. (2015). Building resilience and organizational readiness during healthcare facility redevelopment transitions: Is it possible to thrive? HERD: Health Environments Research & Design Journal, 9(1), 10-33. doi:10.1177/1937586715593552

URL:

Allen, B. (2016). Effective design, implementation and management of change in healthcare. Nursing Standard, 31(3), 58. doi:10.7748/ns.2016.e10375

URL:

Module 3

DQ 1   New health care delivery models are being presented to accommodate the shift in health care objectives. Many of these models are community-based and focused on improving quality outcomes, population health, and reducing readmissions to acute care settings.

1. Describe a new health care delivery model and discuss whether or not it is sustainable.

2. How will you use a health care delivery model in the design of your project to support the sustainability of your practice improvement intervention? 

Provide examples and literature support.

DQ 2   Two major models of care exist: for-profit and not-for-profit. Does one or the other provide more ethical care? Why or why not? Provide examples and literature support.

Resources

Read Chapter 3 in Outcome Assessment in Advanced Practice Nursing 4e.

URL:

Largent, E. A. (2016). Health care organizations and the power of procedure. American Journal of Bioethics, 16(1), 5153. doi:10.1080/15265161.2015.1115155

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Graber, A., Carter, S., Bhandary, A., & Rizzo, M. (2017). The case for enrolling high-cost patients in an ACO. HEC Forum, 29(4), 359-365. doi:10.1007/s10730-017-9333-4

URL:

Kirby, J. (2016). Balancing legitimate critical-care interests: Setting defensible care limits through policy development. American Journal of Bioethics, 16(1), 38-47. doi:10.1080/15265161.2015.1115141

URL:

Explore the National Healthcare Quality and Disparities Reports page on the Agency for Healthcare Research and Quality website. URL:

Centers for Medicare & Medicaid Services. (n.d.). Accountable care organizations (ACOs).

URL:

 

Module 4

DQ 1   Explore a country that provides universal health care. What are its health outcomes? How do these outcomes compare to those in the United States? Should universal health care be a concept that the Doctor of Nursing Practice should support? Why or why not? As a nurse leader, how would you integrate your faith and work into any health care delivery concept? Provide examples and literature support.

DQ 2   The Commonwealth Fund provides an international review of health care systems. Read the Commonwealth Fund report, International Profiles of Health Care Systems, 2017. Discuss what knowledge you gained from reading the report and describe any changes you would apply to the U.S. health care system. What is the DNP’s role in the policy needed to enact the changes you identified? Provide examples and literature support.

Resources

Read Chapters 4 and 11 in Outcome Assessment in Advanced Practice Nursing 4e.

URL:

 Ruggles, B. M., Xiong, A., & Kyle, B. (2019). Healthcare coverage in the US and Japan: A comparison. Nursing, 49(4), 56-60. doi:10.1097/01.NURSE.0000553277.03472.d8

URL:

Cheng, S., Jin, H., Yang, B., & Blank, R. H. (2018). Health expenditure growth under single-payer systems: Comparing South Korea and Taiwan. Value in Health Regional Issues, 15, 149-154. doi:10.1016/j.vhri.2018.03.002

URL:

Rajfur, P., & Hys, K. (2018). Management of the healthcare system in Germany and France. Medical Science Pulse, 12(4), 55-60. doi:10.5604/01.3001.0012.7213 

URL:

Explore “Guidance: Delivering Better Integrated Care” located on the GOV.UK website.

URL:

Explore the healthcare search page located on the Government website.

URL:

Explore the Country Comparison: Health Expenditures page of the Central Intelligence Agency website. 

URL:

Mossialos, E., Djordjevic, A., Osborn, R., & Sarnak, D. (Eds.). (2017). International profiles of health care systems, 2017: Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, Taiwan, and the United States. New York, NY: Commonwealth Fund.

URL:

Module 5

DQ 1   Review one of the tutorials on quality measures from the AHRQ: National Quality Measures Clearinghouse website. Provide an overview of what you reviewed and its application in your practice. Provide examples and literature support.

DQ 2   Review “How Can Healthcare Organizations Implement Patient-Centered Care,” and discuss evaluation models that can drive large-scale cultural transformation in health care or in your current practice. What are the strengths and weaknesses of these models? Provide examples and literature support.

Resources

Re-read Chapter 4 in Outcome Assessment in Advanced Practice Nursing 4e.

URL:

Bokhour, B. G., Fix, G. M., Mueller, N. M., Barker, A. M., Lavela, S. L., Hill, J. N.,…VanDeusen Lukas, C. (2018). How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation. BMC Health Services Research, 18(168). doi:10.1186/s12913-018-2949-5

URL:

Nel, H. (2018). A comparison between the asset-oriented and needs-based community development approaches in terms of systems changes. Practice: Social Work in Action, 30(1), 33-52. doi:10.1080/09503153.2017.1360474

URL:

Lindau, S. T., Vickery, K. D., Choi, H., Makelarski, J., Matthews, A., & Davis, M. (2016). A community-powered, asset-based approach to intersectoral urban health system planning in Chicago. American Journal of Public Health, 106(10), 1872-1878. doi:10.2105/AJPH.2016.303302 

URL:

Explore the Guidelines and Measures page on the Agency for Healthcare Research and Quality website.

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Module 6

DQ 1  The Doctor of Nursing Practice/Advanced Practice Nurse role empowers nurses to create programs for improving quality outcomes. What barriers need to be alleviated to increase the DNP/APN role in health care change? Provide examples and literature support.

DQ 2   Patient-centered care has been shown to increase positive patient outcomes. Provide an example of how collaboration within the health care team (interprofessional collaboration) has enhanced patient outcomes in your practice. Provide literature support.

Resources

Read Chapters 8-10 in Outcome Assessment in Advanced Practice Nursing 4e.

URL:

Will, K. K., Johnson, M. L., & Lamb, G. (2019). Team-based care and patient satisfaction in the hospital setting: a systematic review. Journal of Patient-Centered Research and Reviews, 6(2), 158-171. doi:10.17294/2330-0698.1695

URL:

Brown, L., & Overly, F. (2016). Simulation-based interprofessional team training. Clinical Pediatric Emergency Medicine, 17(3), 179-184. doi:10.1016/j.cpem.2016.06.001

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Van der Biezen, M., Wensing, M., Poghosyan, L., Van der Burgt, R., & Laurant, M. (2017). Collaboration in teams with nurse practitioners and general practitioners during out-of-hours and implications for patient care; a qualitative study. BMC Health Services Research, 17, 1-9. doi:10.1186/s12913-017-2548-x

URL:

Barratt, J., & Thomas, N. (2018). Nurse practitioner consultations in primary health care: A case study-based survey of patients pre-consultation expectations, and post-consultation satisfaction and enablement. Primary Health Care Research & Development, 20, 1-8. doi:10.1017/S1463423618000415

URL:

Module 7

DQ 1   Utilize the National Committee for Quality Assurance (NCQA) website to examine the criteria that a Patient Centered Medical Home (PCMH) must meet to be credentialed. What is the value of the PCMH to patient outcomes? How does the NCQA website help you define and measure the results of your DPI Project intervention on patient outcomes? Provide examples and literature support.

DQ 2   What are some of the current assessment tools to improve patient understanding and adherence to prescribed treatment? What assessment tools are available to determine a level of health literacy and how can these tools help improve patient outcomes? Provide examples and literature support.

Resources

Read Chapter 6 in Outcome Assessment in Advanced Practice Nursing 4e.

URL:

Tucker, C., Arthur, T., & Roncoroni, J. (2013). Patient-centered, culturally sensitive health care. American Journal of Lifestyle Medicine, 9(1), 63-77. doi:10.1177/1559827613498065

URL:

Park, Y., & Martin, E. G. (2018). Geographic disparities in access to nursing home services: Assessing fiscal stress and quality of care. Health Services Research, 53, 2932-2951. doi:10.1111/1475-6773.12801

URL:

Barsell, J., Everhart, R. S., Miadich, S. A., & Trujillo, M. A. (2018). Examining health behaviors, health literacy, and self-efficacy in college students with chronic conditions. American Journal of Health Education, 49(5), 305-311.

URL:

Nguyen, T. H., Park, H., Han, H-R., Chan, K. S., Paasche-Orlow, M. K., Haun, J., & Kim, M. T. (2015). State of the science of health literacy measures: Validity implications for minority populations. Patient Education & Counseling, 98(12), 1492-1512. doi:10.1016/j.pec.2015.07.013

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Pronovost, P. J., Cleeman, J. I., Wright, D., & Srinivasan, A. (2016). Fifteen years after To Err is Human: A success story to learn from. BMJ Quality & Safety, 25(6), 396. doi:10.1136/bmjqs-2015-004720

URL:

Mitchell, I., Schuster, A., Smith, K., Pronovost, P., & Wu, A. (2016). Patient safety incident reporting: A qualitative study of thoughts and perceptions of experts 15 years after “To Err is Human.” BMJ Quality & Safety, 25(2), 92. doi:10.1136/bmjqs-2015-004405

URL:

Califf, R. M., Robb, M. A., Bindman, A. B., Briggs, J. P., Collins, F. S., Conway, P. H., & Sherman, R. E. (2016). Transforming evidence generation to support health and health care decisions. The New England Journal of Medicine, 375(24), 2395-2400. doi:10.1056/NEJMsb1610128

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AHRQ: Agency for Healthcare Research and Quality. (n.d.). Health literacy measurement tools (revised).

URL:

Explore the National Committee for Quality Assurance website.

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Institute of Medicine. (1999). To err is human: Building a safer health system. Washington, DC: National Academy Press.

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Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.

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Explore the Patient Centered Medical Home: Resource Center page on the Agency for Healthcare Research and Quality website.

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Explore the Primary Care Collaborative website.

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Explore the Health Literacy page on the National Network of Libraries of Medicine website.

URL:

Explore the Health Literacy Online page on the Office of Disease Prevention and Health Promotion website.

URL:

Module 8

DQ 1   Discuss effective means for translating and disseminating research by discussing the role of the DPI Project (Quality Improvement) and the opportunities for its dissemination. Include a discussion of the role of inter-professional collaboration. Provide examples and literature support.

DQ 2   Discuss recent health care innovations in your practice and your role in implementation. Provide examples and literature support.

Resources

Re-read Chapter 12 in Outcome Assessment in Advanced Practice Nursing 4e.

URL:

Hassan, A., Scherer, E. A., Pikcilingis, A., Krull, E., McNickles, L., Marmon, G.,…Fleegler, E. (2015). Improving social determinants of health: Effectiveness of a web-based intervention. American Journal of Preventive Medicine, 49(6), 822-831. doi:10.1016/j.amepre.2015.04.023 

URL:

Curtis, K., Fry, M., Shaban, R., & Considine, J. (2016). Translating research findings to clinical nursing practice. Journal of Clinical Nursing, 26(5-6), 862-872. doi:10.1111/jocn.13586

URL:

Tabak, R. G., Padek, M. M., Kerner, J. F., Stange, K. C., Proctor, E. K.,…Brownson, R. C. (2016). Dissemination and implementation science training needs: Insights from practitioners and researchers. American Journal of Preventative Medicine, 52(3), S322-S329. doi:10.1016/j.amepre.2016.10.005

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Bender, M., Williams, M., Su, W. & Hites, L. (2016). Clinical nurse leader integrated care delivery to improve care quality: Factors influencing perceived success. Journal of Nursing Scholarship, 48(4), 414-422. doi:10.1111/jnu.12217 

URL:

Neta, G., Glasgow, R. E., Carpenter, C. R., Grimshaw, J. M., Rabin, B. A., Fernandez, M. E., & Brownson, R. C. (2015). A framework for enhancing the value of research for dissemination and implementation. American Journal of Public Health, 105(1), 49-57.

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Explore “AHRQ Health Care Innovations Exchange” located on the Agency for Healthcare Research and Quality website.

URL:

Brownson, R. C., Proctor, E. K., Luke, D. A., Baumann, A. A., Staub, M., Brown, M. T., & Johnson, M. (2017). Building capacity for dissemination and implementation research: One universitys experience. Implementation Science, 12(1), 1-12. doi:10.1186/s13012-017-0634-4

URL:

Discussion: Where in the World Is Evidence-Based Practice?

March 21, 2010, was not EBPs date of birth, but it may be the date the approach grew up and left home to take on the world.
When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.
In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.
To Prepare:
Review the Resources and reflect on the definition and goal of EBP.
Choose a professional healthcare organizations website (e.g., a reimbursing body, an accredited body, or a national initiative).
Explore the website to determine where and to what extent EBP is evident.

Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organizations work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organizations website has changed your perception of the healthcare organization. Be specific and provide examples.

Discussion: The Application of Data to Problem-Solving

In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioners and the disciplines body of knowledge.

Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.

In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

To Prepare:

• Reflect on the concepts of informatics and knowledge work as presented in the Resources. 
• Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

 

Refer back to the interview and evaluation you conducted in the Topic 2 Family Health Assessment assignment. Identify the social determinates of health (SDOH) contributing to the family’s health status. In a 750-1,000-word paper, create a plan of action to incorporate health promotion strategies for this family. Include the following:

1. Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family.
2. Based on the information gathered through the family health assessment, recommend age-appropriate screenings for each family member. Provide support and rationale for your suggestions. 
3. Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning.
4. Using the model, outline the steps for a family-centered health promotion. Include strategies for communication.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

In order to write a case study paper, you must carefully address a number of sections in a specific order with specific information contained in each. The guideline below outlines each of those sections.

Section

Information to Include

Introduction (patient and problem)

• Explain who the patient is (Age, gender, etc.)
• Explain what the problem is (What was he/she diagnosed with, or what happened?)
• Introduce your main argument (What should you as a nurse focus on or do?)

Pathophysiology

• Explain the disease (What are the symptoms? What causes it?)

History

• Explain what health problems the patient has (Has she/he been diagnosed with other diseases?)
• Detail any and all previous treatments (Has she/he had any prior surgeries or is he/she on medication?)

Nursing Physical Assessment

• List all the patients health stats in sentences with specific numbers/levels (Blood pressure, bowel sounds, ambulation, etc.)

Related Treatments

• Explain what treatments  the patient is receiving because of his/her disease

Nursing Diagnosis & Patient Goal

• Explain what your nursing diagnosis is (What is the main problem for this patient? What need to be addressed?)
• Explain what your goal is for helping the patient recover (What do you want to change for the patient?)

 Nursing Interventions

• Explain how you will accomplish your nursing goals, and support this with citations (Reference the literature)

 Evaluation

• Explain how effective the nursing intervention was (What happened after your nursing intervention? Did the patient get better?)

 Recommendations

• Explain what the patient or nurse should do in the future to continue recovery/improvement

Background and Physical Examination

J. P.  is a 46-year-old man presents to the emergency department with a 5-day history of progressively worsening breathlessness on exertion and mild, general flulike symptoms. He also complains about night sweats and an intermittent low-grade fever, both of which started about 2 weeks ago.

Upon physical examination, the patient does not appear to be in any acute distress. His vital signs are measured as a pulse of 89 beats/min, blood pressure of 140/85 mm Hg, and a respiratory rate of 19 breaths/min. He is afebrile, with a temperature of 99.8F (37.7C).

The chest examination reveals nothing out of the ordinary, and his cardiovascular and respiratory examinations, including auscultation, are unremarkable. The abdominal examination reveals no fluid thrill, shifting dullness, or bruit. The liver and the spleen are not enlarged. No lymph nodes are palpable.

Multiple areas of hyperpigmentation are noted; otherwise, the skin inspection is unremarkable, with no hematomas, bruises, wounds, or scars noted. Electrocardiography (ECG) reveals a sinus rhythm with a heart rate of 84 beats/min, and the T waves are somewhat flattened in leads V1, aVL, and III, but they are otherwise unremarkable.

Laboratory Test Results and Other Findings

Significant laboratory findings include a white blood cell count of 9.1 x 103/L (9.1 x 109/L; reference range, 3.5-8.8 x 109/L), a platelet count of 429 x 103/L (429 x 109/L; reference range, 140-350 109/L), a C-reactive protein level of 91 mg/L (reference range, < 10 mg/L), a lactate dehydrogenase (LDH) level of 4.7 microkatals (kat)/L (reference range, < 3.5 kat/L), an erythrocyte sedimentation rate (ESR) of 30 mm (reference range, 1-12 mm), and a D-dimer of 2.2 mg/L (reference range, < 0.25 mg/L).

A spiral CT scan is performed, which shows no . It does, however, reveal the presence of a significant  (1 cm ventral x 2.5 cm dorsal) and a multilobular substernal mass occupying the anterior superior mediastinum that is about 2.5 cm in thickness and 7 cm in length, with high absorption. Additionally, the mediastinal lymph nodes are enlarged; some are as large as 2 cm in size. No other pertinent findings on spiral CT are reported.

An emergent bedside echocardiogram is obtained. The echocardiographic findings confirm the presence of pericardial effusion, without signs or symptoms of a ; additionally, a retrosternal mass is detected

Which of the following is the most likely diagnosis?

B. Thymoma

Your paper should be 3-4 pages in length and will be graded on how well you complete each of the above sections. You will also be graded on your use of APA style and on your application of nursing journals into the treatments and interventions. For integrating nursing journals, remember the following: 

• Make sure to integrate citations into all of your paper
• Support all claims of what the disease is, why it occurs and how to treat it with references to the literature on this disease
• Always use citations for information that you learned from a book or article; if you do not cite it, you are telling your reader that YOU discovered that information (how to treat the disease, etc.)

Review the rubric for specific grading criteria. 

Points possible: 60

APA format. 350 words and use only scholar authors. Please read all information.

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

To Prepare:

• Reflect on the concepts of informatics and knowledge work as presented in the Resources.
• Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

 Reference

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

• Chapter 1, Nursing Science and the Foundation of Knowledge (pp. 719)
• Chapter 2, Introduction to Information, Information Science, and Information Systems (pp. 2133)
• Chapter 3, Computer Science and the Foundation of Knowledge Model (pp. 3562)

2. Article 

3, Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
Note: You will access this article from the Walden Library databases.

 

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

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

Photo Credit: Getty Images/Ingram Publishing

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

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

To Prepare

• Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
• Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
• Consider factors that might have influenced the patients pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
• Think about a personalized plan of care based on these influencing factors and patient history in your case study.

 

An 83-year-old resident of a skilled nursing facility presents to the emergency department with generalized edema of extremities and abdomen. History obtained from staff reveals the patient has history of malabsorption syndrome and difficulty eating due to lack of dentures. The patient has been diagnosed with protein malnutrition.  

For this Discussion, you will examine the above case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts. 

To prepare:

By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

• The role genetics plays in the disease.
• Why the patient is presenting with the specific symptoms described.
• The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
• The cells that are involved in this process.
• How another characteristic (e.g., gender, genetics) would change your response.

REQUIRED READINGS

 

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Chapter 1: Cellular Biology; Summary Review
Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
Chapter 7: Innate Immunity: Inflammation and Wound Healing
Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
Chapter 10: Infection (pp. 289303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review