Pharmacology in Nursing

 

post has three assignments

1: Mini-Anthology

Order Description

“Choose five to seven stories from our course text/anthology, The Short Story and Its Writer (Ninth Edition), that you think represent an aspect of short fiction which warrants closer attention and collection in a mini-anthology. Carefully consider the specific ways these stories work together to make up your mini-anthology, examining and sorting the threads that connect the stories to each other. Those connections are entirely up to you to choose and explore.

Then, write an essay (1500 – 2000 words) that introduces your curated collection of short stories and uses specific examples from each to explain exactly how your choices should be read and why. You may also use the provided commentaries for your selected stories to help you in introducing this mini-anthology; just be sure to quote/cite in your essay exactly how and where they contributed to your understanding of these stories.

2: Family Physicians

Order Description

A two page Letter to the Editor in response to concerns/reservations regarding nurse practitioner practice and participation in Patient Centered-Medical Home (PCMH) Programs expressed in a White Paper by the American Academy of Family Physicians (AAFP). The White Paper is entitled, “Ensuring a Quality, Physician-Led Team for Every Patient,” published in 2012 and is posted in Canvas under Content. This new approach to primary care is likely to be a major way that primary care is provided in the future; thus it is important that nurse practitioners be seen as major players in the PCMH movement.

The format for a Business Letter should be followed such as one might use when writing a letter applying for a nurse practitioner job or for entry into graduate school. Grammar/syntax must be appropriate (Merriam Webster online dictionary defines syntax as “the way in which words are put together to form phrases or sentences.” This must be no more than two pages, and single spaced as appropriate for a business letter.

Assignment Guidelines for Letter to the Editor

After surveying the scholarly literature so that your letter can contain at least a couple of citations supporting your point of view, and from your learning from this course, write a two page single spaced Letter to the Editor of AAFP White Paper in standard business letter format regarding the concerns/reservations raised in the White Paper assigned to you. Include a Reference List of your citations though in practice one would not include a list of references in a Letter to the Editor. Note: This is an individual assignment, not a group assignment. All MSN standards for scholarly writing must be applied to this paper. APA format is NOT needed for this paper except for the Reference List and the letter should be written in the first person.

This is the white paper the letter is responding to

https://www.aafp.org/dam/AAFP/documents/about_us/initiatives/AAFP-PCMHWhitePaper.pdf

Other references

https://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs/APRNs-as-PCPs.pdf

https://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/349-the-medical-home

The goal of this letter is to advocate to the editor of this white paper why nurse practitioners are important to primary care and that we can take care of patients as well as doctors. The paper is against nurse practitioners practicing on their own and thinks there should be a doctor working with and above them.
Yes, we don’t have the same amount of school, but we are advance practice nurses who take a holistic approach when treating patients and have been doing this for years.

3: Pharmacology in Nursing

Order Description

Read this clinical summary
Case study is a summary of where a medication error contributed to the cause of death. It is a real life incident of a coronial investigation obtained from public documents. A document becomes public once the coronial investigation process has been completed and closed. All individuals and facilities are de-identified. Some details have been removed which was deemed unnecessary for this Assessment piece.

CLINICAL SUMMARY
Mrs C was a 69-year-old female with a complex medical history of stroke with a residual left side weakness and ongoing risk of aspiration, atrial fibrillation, and insulin-dependent diabetes mellitus. She was more recently diagnosed with a suspected left ear tumour. Mrs C had a planned admission to a metropolitan hospital for a biopsy.
Mrs C was commenced on oral antibiotics (ciprofloxacin) after the biopsy results suggested an infection. One day after the procedure, her oxygen saturation levels dropped and staff suspected she had aspirated. A nasogastric tube (NGT) was inserted but was pulled out by Mrs C a day later. Despite advice from healthcare professionals about the risk of further aspiration and sub-optimal oral nutrition, neither Mrs C nor her immediate family would consent to the reinsertion of a NGT.
Three days later, following another episode where Mrs C’s oxygen saturation levels dropped, x-rays showed acute pulmonary oedema with right lower lobe consolidation and an ECG demonstrated Mrs C had rapid atrial fibrillation. For these reasons, Mrs C was transferred to the Intensive Care Unit (ICU), where a NGT was re-inserted.
The nurse-in-charge (NIC) left instructions that Mrs C’s oral ciprofloxacin ought to be crushed and administered through the NGT tube. Later that same evening, blood tests were required, and the nursing staff realised that Mrs C’s evening medications, including the oral ciprofloxacin and intravenous frusemide, had not yet been administered.
The nurse (RN. R) looking after Mrs C was asked to take the bloods via a peripherally inserted central catheter (PICC), and to administer the medications. As she had not had prior experience of PICC lines, she was supervised by another nurse (RN. C). RN. R was instructed to crush the ciprofloxacin to enable NGT administration, but then drew the paste into a standard sized non-luer lock syringe even though she intended to administer the medication via the NGT, which required a larger nozzle. RN. C drew up the frusemide and both medications were placed into a kidney dish. At the bedside, RN. R took blood from the PICC line, and administered the intravenous frusemide. The NIC was present at the time, attending to Mrs C’s NGT feeding. The NIC informed RN. R that medications administered via a PICC needed to be drawn up in a luer lock syringe. RN. R returned to the drug room and transferred the crushed up ciprofloxacin into a luer lock syringe, injecting it into the PICC line.
A short time later, Mrs C became cyanosed and hypoxaemic, then unresponsive. Since Mrs C was subject to a NFR (not for resuscitation) order, a code blue was not called. She was pronounced deceased soon after.

An autopsy performed later found foreign material in the vessels of the brain, lungs and heart.

INVESTIGATION
Looking primarily at the circumstances in which Mrs C had died, the coroner at inquest focussed on several issues. 1 of these specifically included:
• The adequacy of remedial measures taken by the health service to minimise the risk of such errors in drug administration.
The Director of Medical Services gave evidence that a number of safety measures had since been implemented by the hospital following an internal investigation.
. Write 500-600 words addressing the following questions:
a) Discuss and describe the type of medication error that occurred in this scenario.
b) The Director of Medical Services gave evidence that a number of measures had been
implemented following an investigation using a root cause analysis of this incident.
Discuss 1 (one) or 2 (two) safety measures that you feel would have been implemented to
minimise the risk of such an error in drug administration occurring again.

2nd Topic- Understanding pharmacokinetics (PK) is important for safety administrating medications to patients.
However the PK of drugs are altered by age i.e. in the elderly population group, when compared to
adults.
Discuss PK i.e. absorption, distribution, metabolism and excretion that includes one aspect (for each
part) that differs in the elderly in comparison to adults. Include in your discussion at least 2 (two) to 3 nursing implications/interventions to ensure safety in administering medications to this population group.

post has three assignments

1: Mini-Anthology

Order Description

“Choose five to seven stories from our course text/anthology, The Short Story and Its Writer (Ninth Edition), that you think represent an aspect of short fiction which warrants closer attention and collection in a mini-anthology. Carefully consider the specific ways these stories work together to make up your mini-anthology, examining and sorting the threads that connect the stories to each other. Those connections are entirely up to you to choose and explore.

Then, write an essay (1500 – 2000 words) that introduces your curated collection of short stories and uses specific examples from each to explain exactly how your choices should be read and why. You may also use the provided commentaries for your selected stories to help you in introducing this mini-anthology; just be sure to quote/cite in your essay exactly how and where they contributed to your understanding of these stories.

2: Family Physicians

Order Description

A two page Letter to the Editor in response to concerns/reservations regarding nurse practitioner practice and participation in Patient Centered-Medical Home (PCMH) Programs expressed in a White Paper by the American Academy of Family Physicians (AAFP). The White Paper is entitled, “Ensuring a Quality, Physician-Led Team for Every Patient,” published in 2012 and is posted in Canvas under Content. This new approach to primary care is likely to be a major way that primary care is provided in the future; thus it is important that nurse practitioners be seen as major players in the PCMH movement.

The format for a Business Letter should be followed such as one might use when writing a letter applying for a nurse practitioner job or for entry into graduate school. Grammar/syntax must be appropriate (Merriam Webster online dictionary defines syntax as “the way in which words are put together to form phrases or sentences.” This must be no more than two pages, and single spaced as appropriate for a business letter.

Assignment Guidelines for Letter to the Editor

After surveying the scholarly literature so that your letter can contain at least a couple of citations supporting your point of view, and from your learning from this course, write a two page single spaced Letter to the Editor of AAFP White Paper in standard business letter format regarding the concerns/reservations raised in the White Paper assigned to you. Include a Reference List of your citations though in practice one would not include a list of references in a Letter to the Editor. Note: This is an individual assignment, not a group assignment. All MSN standards for scholarly writing must be applied to this paper. APA format is NOT needed for this paper except for the Reference List and the letter should be written in the first person.

This is the white paper the letter is responding to

https://www.aafp.org/dam/AAFP/documents/about_us/initiatives/AAFP-PCMHWhitePaper.pdf

Other references

https://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs/APRNs-as-PCPs.pdf

https://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/349-the-medical-home

The goal of this letter is to advocate to the editor of this white paper why nurse practitioners are important to primary care and that we can take care of patients as well as doctors. The paper is against nurse practitioners practicing on their own and thinks there should be a doctor working with and above them.
Yes, we don’t have the same amount of school, but we are advance practice nurses who take a holistic approach when treating patients and have been doing this for years.

3: Pharmacology in Nursing

Order Description

Read this clinical summary
Case study is a summary of where a medication error contributed to the cause of death. It is a real life incident of a coronial investigation obtained from public documents. A document becomes public once the coronial investigation process has been completed and closed. All individuals and facilities are de-identified. Some details have been removed which was deemed unnecessary for this Assessment piece.

CLINICAL SUMMARY
Mrs C was a 69-year-old female with a complex medical history of stroke with a residual left side weakness and ongoing risk of aspiration, atrial fibrillation, and insulin-dependent diabetes mellitus. She was more recently diagnosed with a suspected left ear tumour. Mrs C had a planned admission to a metropolitan hospital for a biopsy.
Mrs C was commenced on oral antibiotics (ciprofloxacin) after the biopsy results suggested an infection. One day after the procedure, her oxygen saturation levels dropped and staff suspected she had aspirated. A nasogastric tube (NGT) was inserted but was pulled out by Mrs C a day later. Despite advice from healthcare professionals about the risk of further aspiration and sub-optimal oral nutrition, neither Mrs C nor her immediate family would consent to the reinsertion of a NGT.
Three days later, following another episode where Mrs C’s oxygen saturation levels dropped, x-rays showed acute pulmonary oedema with right lower lobe consolidation and an ECG demonstrated Mrs C had rapid atrial fibrillation. For these reasons, Mrs C was transferred to the Intensive Care Unit (ICU), where a NGT was re-inserted.
The nurse-in-charge (NIC) left instructions that Mrs C’s oral ciprofloxacin ought to be crushed and administered through the NGT tube. Later that same evening, blood tests were required, and the nursing staff realised that Mrs C’s evening medications, including the oral ciprofloxacin and intravenous frusemide, had not yet been administered.
The nurse (RN. R) looking after Mrs C was asked to take the bloods via a peripherally inserted central catheter (PICC), and to administer the medications. As she had not had prior experience of PICC lines, she was supervised by another nurse (RN. C). RN. R was instructed to crush the ciprofloxacin to enable NGT administration, but then drew the paste into a standard sized non-luer lock syringe even though she intended to administer the medication via the NGT, which required a larger nozzle. RN. C drew up the frusemide and both medications were placed into a kidney dish. At the bedside, RN. R took blood from the PICC line, and administered the intravenous frusemide. The NIC was present at the time, attending to Mrs C’s NGT feeding. The NIC informed RN. R that medications administered via a PICC needed to be drawn up in a luer lock syringe. RN. R returned to the drug room and transferred the crushed up ciprofloxacin into a luer lock syringe, injecting it into the PICC line.
A short time later, Mrs C became cyanosed and hypoxaemic, then unresponsive. Since Mrs C was subject to a NFR (not for resuscitation) order, a code blue was not called. She was pronounced deceased soon after.

An autopsy performed later found foreign material in the vessels of the brain, lungs and heart.

INVESTIGATION
Looking primarily at the circumstances in which Mrs C had died, the coroner at inquest focussed on several issues. 1 of these specifically included:
• The adequacy of remedial measures taken by the health service to minimise the risk of such errors in drug administration.
The Director of Medical Services gave evidence that a number of safety measures had since been implemented by the hospital following an internal investigation.
. Write 500-600 words addressing the following questions:
a) Discuss and describe the type of medication error that occurred in this scenario.
b) The Director of Medical Services gave evidence that a number of measures had been
implemented following an investigation using a root cause analysis of this incident.
Discuss 1 (one) or 2 (two) safety measures that you feel would have been implemented to
minimise the risk of such an error in drug administration occurring again.

2nd Topic- Understanding pharmacokinetics (PK) is important for safety administrating medications to patients.
However the PK of drugs are altered by age i.e. in the elderly population group, when compared to
adults.
Discuss PK i.e. absorption, distribution, metabolism and excretion that includes one aspect (for each
part) that differs in the elderly in comparison to adults. Include in your discussion at least 2 (two) to 3 nursing implications/interventions to ensure safety in administering medications to this population group.

Anthology