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As the leading cause of death in the United States for both men and women, cardiovascular disorders account for 7 million hospitalizations per year (NCSL, 2012). This is the result of the extensive treatment and care that is often required for patients with these disorders. While the incidences of hospitalizations and death are still high, the mortality rate of cardiovascular disorders has been declining since the 1960s (CDC, 2011). Improved treatment options have contributed to this decline, as well as more knowledge on patient risk factors. As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Consider the following case studies:

Case Study 1:

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:
Atenolol 12.5 mg daily
Doxazosin 8 mg daily
Hydralazine 10 mg qid
Sertraline 25 mg daily
Simvastatin 80 mg daily

Case Study 2:

Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following:
Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun
Aspirin 81 mg daily
Metformin 1000 mg po bid
Glyburide 10 mg bid
Atenolol 100 mg po daily
Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

Case Study 3:

Patient CB has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following:              
Glipizide 10 mg po daily
HCTZ 25 mg daily
Atenolol 25 mg po daily
Hydralazine 25 mg qid
Simvastatin 80 mg daily
Verapamil 180 mg CD daily

To prepare:

·        Review this week’s media presentation on hypertension and hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson text.

·        Select one of the three case studies, as well as one the following factors: genetics, gender, ethnicity, age, or behavior factors.

·        Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.

·        Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.

·        Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

Post a 1 page paper APA format 

1.      an explanation of how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you selected.

2.      Then, describe how changes in the processes might impact the patient’s recommended drug therapy.

3.      Finally, explain how you might improve the patient’s drug therapy plan.

Readings

·        Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.  

o   Chapter 19, “Hypertension” (pp. 230–246)

This chapter examines the relationships between the cardiovascular, nervous, and renal systems. It then describes diagnostic criteria for hypertension patients, drugs used to treat hypertension and possible adverse reactions, monitoring patient response, and patient education.

o   Chapter 20, “Hyperlipidemia” (pp. 247–262)

This chapter explores causes of hyperlipidemia, treatments for hyperlipidemia patients, and methods for monitoring patient response. It also reviews strategies for risk assessment and patient education.

o   Chapter 21, “Chronic Stable Angina” (pp. 263–277) 

This chapter begins by exploring factors that contribute to chronic stable angina, types of drugs used in treatment, and diagnostic criteria for initiating drug therapy. It also examines methods for monitoring patient response to treatment and educating patients on self-care.

o   Chapter 22, “Heart Failure” (pp. 278–297) 

This chapter examines the process of prescribing drugs to treat heart failure and explores effects of prescribed drugs, proper dosages, and possible adverse reactions.

o   Chapter 49, “Anticoagulation Disturbances” (pp. 764–803) 

This chapter covers drug therapy options for three disorders requiring anticoagulants: venous thromboembolism, atrial fibrillation, and ischemic stroke. It also explains the process of initiating and managing drug therapy for patients with these disorders.

·        Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Media

·        Laureate Education, Inc. (Executive Producer). (2012). Hypertension and hyperlipidemia. Baltimore, MD: Author.

This media presentation outlines hypertension and hyperlipidemia including contributing factors, evaluation, treatment, and implications.

Note: The approximate length of this media piece is 10 minutes.

Legal Aspects of U.S. Health Care System Administration

Prevailing wisdom reinforces the fact that working in U.S. health care administration in the 21st Century requires knowledge of the various aspects of health laws as they apply to dealing with medical professionals. Further, because U.S. health care administrators have to potentially interact with many levels of professionals beyond the medical profession, it is prudent that they are aware of any federal, state, and local laws that may be applicable to their organizations. Thus, their conduct is also subject to the letter of the law. They must evaluate the quality of their professional interactions and be mindful of the implications and ramifications of their decisions.

You are employed as a top health administrator at the hypothetical Well Care Hospital in Happy Town. When you were hired, your pre-employment screening involved background checks into any violation of hospital medical misconduct during the last five (5) years. The results showed that you were in good standing with the hospital administration community. During the past year, you had to undergo training in personnel conduct, as well as in inter-employee conduct with medical staff, nurses, technologists, etc. During the past six (6) months, the hospital has been under scrutiny for breach of medical compliance.

Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.

Write a three to four (3-4) page paper in which you:

1. Articulate your position as the top administrator concerned about the importance of professional conduct within the health care setting. Justify your position.

2. Ascertain the major ramifications of having professional staff compromise the boundaries of ethics and medical conduct.

3. Analyze the four (4) elements required of a plaintiff to prove medical negligence.

4. Discuss the overarching duties of the health care governing board in mitigating the effects of medical non-compliance, as they apply to the rules of practice set forth in the Well Care Hospital governing board’s manifesto.

5. Use at least five (5) quality academic resources in this assignment. Note: Wikipedia and other Websites do not quality as academic resources.

Your assignment must follow these formatting requirements:

 _Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.

 _Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

 _Describe the sources of law in America, the relative legal procedure, and the related court system.

 _Examine the various applications of the law within the health care system.

 _Use technology and information resources to research issues in health care policy, law, and ethics.

This is a series of 4 questions. I need these back by Monday no later then 11:00 P.M Eastern Time.  No Plagiarism Please!!! All instructions included in attachment..

Learning Resources

Required Resources

• Course Text: Teaching and Learning in a Diverse World
• • Chapter 7, “The Context of Gender and Sexual Orientation” (pp. 125–136, up to “How to Learn What Children Know, Think, and Feel about Gender and Sexual Orientation”)
  • Chapter 8, “The Context of Abilities and Disabilities” (pp. 141–150, up to “How to Learn What Children Know, Think, and Feel about Abilities and Disabilities Orientation”)
• Article: Raising and Educating Healthy Boys: A Report on the Growing Crisis in Boys’ Education

• Web Article: Perspectives on Deaf People
  http://www.signmedia.com/info/adc.htm

• Web Article: Deaf Culture
  http://www.lexibridges.com/deaf_culture.html

Optional Resources

• Web Article: National Association of the Deaf (NAD)
  
  http://www.nad.org/
  wk4

  The Deaf Culture

   

  Throughout this course you have been considering many aspects, characteristics, and ramifications of culture and diversity You have been learning that culture and diversity can be both visible and invisible at times; yet always complex. For this Discussion, you will be keeping in mind what you have learned as you consider a culture that has to do with abilities and disabilities. In preparation, review both of the following articles:
  

  •  
  • Perspectives on Deaf People
    http://www.signmedia.com/info/adc.htm
    
  • Deaf Culture
    http://www.lexibridges.com/deaf_culture.html

  By Day 3:
  
  Post responses to the following questions:
  

  •  
  • What did you learn about people who are deaf in relationship to what you have been learning about culture?
  •  
  • How has this information expanded your idea of culture?
  •  
  • How has this information expanded and deepened your idea of diversity in relation to abilities and disabilities?