Instructions:
Scenario
You are seeing a 58-year-old African-American male who presents to the clinic for a routine follow-up.
- The patient has a past medical history of hypertension, and GERD. He is currently taking amlodipine 5mg daily and famotidine 40mg daily.
- He denies smoking or nicotine use, drinks alcohol about once a month, and has a cup of coffee once a day
- He had lab work complete prior to his visit showing: Total Cholesterol: 210; HDL: 44 Triglycerides 120; LDL 142
- His vitals are as follows: BP: 166/94, HR: 84; RR: 18; O2: 96% on room air, and T: 98.4; Height: 70 inches, Weight: 220 pounds
- Upon examination today his lung sounds are clear and heart rhythm is regular. He has just a trace of edema to both lower extremities, but skin is pink and dry. No other abnormalities are noticed on exam.
Discussion Prompt
Please develop a discussion post that responds to each of the following prompts. Where appropriate your discussion needs to be supported by scholarly resources. Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion post:
- Provide your diagnosis.
- Discuss how you would manage the patient’s current medication regimen and provide a rationale supported by scholarly reference for your treatment plan.
- Include your specific prescription(s) for the patient. (This must include the medication name, dose, route, and frequency as well as any special instructions that apply as you would include when writing a prescription).
- Describe the patient education you would provide in relation to your treatment plan.
- Provide your plan for follow-up and/or referral (if indicated)
Please be sure to validate your opinions and ideas with citations and references in APA format.
As we move through the discussions in the course you’ll notice a pattern where you are
presented with a patient case and asked for formulate a plan to share based on the case
and your assessment and plan. Here are a few helpful tips to help you be successful and
include the needed information:
 Provide your diagnosis: This is based upon what you’ve read in this case and
should be the basis for creating your treatment plan. This should be simple and
clear – ie. Hypertension, Type 2 Diabetes, etc.
ď‚· Management:
o Be sure to focus on pharmacology. You need to put yourself in the
role of the provider/prescriber in these cases and tell us what you
would prescribe the patient and provide a rationale and reference.
Do not say “I will treat the hypertension” and leave it at that. Tell me
what drug and why you choose that drug and support it with a
citation (or several citations) from scholarly sources to show that
you’ve looked at practice guidelines and know why you’re choosing
this option. This is advanced pharmacology and it’s expected that
you’re focusing on this information.
o Provide a specific and complete prescription for the patient
o Provide education associated with disease and medication — for
example, you can talk about lifestyle management, but also let the
patient know how to take their medication and side effects or other
pertinent information for the medication you’re prescribe.
o Provide a plan for follow-up and/or referral if needed
ď‚· References: This is a graduate level nursing course — this means it’s expected
that you’re researching these topics and citing sources of support. Even if you
know that you want to use a specific medication from what you’ve seen in
practice or experienced yourself, you still must cite to demonstrate that
research and existing clinical practice guidelines you’re utilizing in that plan.
The rubric for the discussion asks for comprehensive use of references — this
means you should have more than one source.
o References should come from appropriate scholarly sources:
Textbooks, nursing and medical journals, government websites, or
peer-reviewed professional organizations (ie. AHA or ACC
guidelines on hypertension or AACE guidelines on diabetes).
o Do not take your references from sites like WebMD, Mayo Clinic,
Cleveland Clinic or general websites. While the information may be
accurate in many cases, it is intended for patient and general
population education. It is not intended for making clinical practice
decisions and is not in-depth enough to support your plan as future
advanced practice nurse. (You would not want to be defending
yourself in a court of law one day and say you treated a patient
based upon what you read on WedMD).
o Additionally, be careful about what you take from organizational
sites as a general overview of hypertension on the AHA website is
created for patient review and sufficient in detail for advanced
practice like a clinical practice guideline or position statement would
be.
These are just some helpful tips based on the feedback I’ve provided students while
teaching this course, If you have questions, please don’t hesitate to reach out so I can
clarify or help.
I look forward to reading your plans in the discussion soon!