American Sentinel N521-19B_21 Module 7 Assignment 3

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Assignment 3

L. P., age 23, is a Hispanic woman who graduated from college last year. She reports to the CNP in her local community mental health center. American Sentinel N521-19B_21 Module 7 Assignment 3 She began working as an accountant 1 month after graduating. Approximately 2 months ago, she moved into a two-bedroom apartment with another woman who works at the same accounting firm. She states that her roommate recommended that she see a doctor to find out if she has anemia or “some sort of fatigue syndrome.” She states that she has felt “restless” and “on edge” for most of the past 9 months. She becomes easily fatigued and irritable and has difficulty concentrating and falling asleep. She states that sometimes her mind “just goes blank,” and she is worried that her work performance is no longer excellent. She reports that all her life she had good grades in school and was very successful in everything she attempted. Although she has been “a worrier from the day I was born,” now she worries more than she ever has and feels nervous “all the time.” L. P. reports that she has a good relationship with her boyfriend but they do not get to see each other very often because he is attending graduate school 100 miles away. She reports having a satisfying sexual relationship with him. She denies having any problems with relationships with her parents, roommate, or peers. She denies having any financial worries unless she is fired from her job for poor work performance. She reports that she has always been healthy and has taken good care of herself. The only medication she takes is birth control pills, which she has taken for the past 4 years without any adverse effects.

In a paper not to exceed six pages, excluding title and reference pages, submit your answers to the following in an MS Word document:

What is L. P.’s likely diagnosis?
List specific pharmacotherapeutic treatment goals for L. P.
Should the CNP order any labs for L. P. at this time? Why?
What drug therapy would the CNP likely prescribe? Why?
What are the parameters for monitoring the success of the therapy?
Describe specific patient monitoring based on the prescribed therapy.
List one or two adverse reactions for the selected agent that would cause the CNP to change therapy.
L. P. returns to see the CNP after six weeks, complaining of still feeling anxious and had heard of a medication called Klonopin that she would like to try; how should the CNP respond to her request?
What health promotion activities should be recommended for this patient?
What is L. P.’s long-term prognosis?

Please use the Case Study Analysis rubric provided to guide you in completing this assignment. It will be used to evaluate your submitted work.

Rubric – American Sentinel N521-19B_21 Module 7 Assignment 3

Competency	40	36	33	0	Points Earned
Case Study questions completely and thoroughly answered with accurate evidence-based supported rationales	Accurate and well defined discussion of all 10 questions for the case study using current evidence-based resources.	Accurate discussion of nine case study questions presented with use of current evidence-based resources. American Sentinel N521-19B_21 Module 7 Assignment 3	Accurate discussion of 8 questions using current evidence-based resources	Missing response to questions or inappropriate answers to questions. No use of evidence-based resources.	/40
	40	36	33	0
Evidence of critical thinking therapeutic decision-making in drug selection and evaluation of patient care pathophysiology and current pharmacological research assessment of the effectiveness of drug therapy formulation of clinical care and teaching plans for persons from diverse populations	Well-defined evidence of critical thinking therapeutic decision-making in drug selection and evaluation of patient care pathophysiology and current pharmacological research assessment of the effectiveness of drug therapy formulation of clinical care and teaching plans for persons from diverse populations	Evidence of critical thinking in prescriptive therapy, monitoring and adverse events. May have lacked a teaching plan or pathophysiologic discussion. American Sentinel N521-19B_21 Module 7 Assignment 3	Evidence of critical thinking but incompletely described therapeutic decision making and omitted teaching plan and pathophysiology.	Multiple bulleted points are absent or poorly defined in the assignment. There is no demonstration of critical thinking.	/40
Competency	10	9	8	0	Points Earned
Grammar, spelling, and punctuation	There are no errors in grammar, spelling, and punctuation	There are a few minor errors in grammar, spelling, and punctuation that do not detract from the meaning (1-3 errors)	There are major errors in grammar, spelling, and punctuation .(4-5 errors)	No content or more than 5 errors	/10
Competency	10	9	8	0
APA Compliance	The paper meets APA formatting guidelines	There are a few minor errors (1-3 errors)	There are significant errors in the format of the paper (4-5 errors)	No content or more than 5 errors	/10
Total Points					/100

Competency

Points Earned

Case Study questions completely and thoroughly answered with accurate evidence-based supported rationales

Accurate and well defined discussion of all 10 questions for the case study using current evidence-based resources.

Accurate discussion of nine case study questions presented with use of current evidence-based resources.

Accurate discussion of 8 questions using current evidence-based resources

Missing response to questions or inappropriate answers to questions. No use of evidence-based resources. American Sentinel N521-19B_21 Module 7 Assignment 3

/40

Evidence of

critical thinking
therapeutic decision-making in drug selection and evaluation of patient care
pathophysiology and current pharmacological research
assessment of the effectiveness of drug therapy
formulation of clinical care and teaching plans for persons from diverse populations

Well-defined evidence of

Evidence of critical thinking in prescriptive therapy, monitoring and adverse events. May have lacked a teaching plan or pathophysiologic discussion.

Evidence of critical thinking but incompletely described therapeutic decision making and omitted teaching plan and pathophysiology.

Multiple bulleted points are absent or poorly defined in the assignment. There is no demonstration of critical thinking. American Sentinel N521-19B_21 Module 7 Assignment 3

/40

Competency

Points Earned

Grammar, spelling, and punctuation

There are no errors in grammar, spelling, and punctuation

There are a few minor errors in grammar, spelling, and punctuation that do not detract from the meaning (1-3 errors)

There are major errors in grammar, spelling, and punctuation .(4-5 errors)

No content or more than 5 errors

/10

Competency

APA Compliance

The paper meets APA formatting guidelines

There are a few minor errors (1-3 errors)

There are significant errors in the format of the paper (4-5 errors)

No content or more than 5 errors

/10

Total Points

/100

Discussion 3

M. L. is a 15-year-old Hispanic female who plays soccer for her school team. She has noticed that when running, she sometimes has trouble catching her breath. She also reports an increased runny nose and itchy eyes. She has a frequent dry cough and is awakened with coughing spells at least four times a week. Her mother and father have seasonal allergies and her mother has asthma. This morning she woke up and heard “funny sounds” when she took a breath. Her coughing increased when she took a deep breath. In her nose, the mucosa is pale and swollen bilaterally. Her lungs have bilateral expiratory wheezing; respirations are 22 and PEF is 400. Her heart shows a normal sinus rhythm, with no murmurs or gallops; pulse is 72; and there is no cyanosis.

Diagnosis: Mild Persistent Asthma

In this discussion forum:

Discuss specific goals of pharmacotherapy for treating M. L.’s mild persistent asthma.
Discuss the drug therapy a CNP would likely prescribe and why.
Discuss the parameters for monitoring the success of the therapy.
Discuss age appropriate health promotion recommendations you would consider for M. L.

Remember to respond to at least two of your peers. Please see the Course Syllabus for Discussion Participation Requirements and Grading Criteria. American Sentinel N521-19B_21 Module 7 Assignment 3

Example Discussion 3 Approach

Patients with chronic asthma are treated with inhalers, long acting beta2 agonist, for relief of their symptoms. A specific goal for a 15-year-old would include adherence to their medication regimen. Goals would also include avoidance of known triggers The CNP would most likely prescribe a fast-acting reliever and an inhaled glucocorticoid component PRN for symptoms and risk of exacerbation (Bateman, et al., 2018). The patient’s PEF is WNL, vital signs are stable, normal sinus rhythm, no signs of cyanosis. The patient is experiencing acute distress with bilateral expiratory wheezing and continuing episodes of dry cough. She is experiencing asthma exacerbation possibly triggered by seasonal allergies. This is an assumption since both parents have seasonal allergies and she is playing an outdoor sport. Symptoms of allergic rhinitis, such as those experienced by the patient, include wheezing, nasal congestion or drainage, coughing, and shortness of breath (Kerr, 2019). The patient should also take an OTC antihistamine for allergies, such as Claritin or Zyrtec. An article I read discussed using a form or log every day to record the peak flow and any asthma symptoms. This would be an excellent tool to record and log and have available at the follow up appointment with the CNP to discuss when, how often, and how long asthma symptoms occurred. Important information would need to include how often the prescribed medications were used and how effective the medications were (Bass, 2020). This tool would assist in monitoring therapy and determine if changes needed to be made. Most children at age 15 have a cell phone so I would suggest that the mobile phone be used to record the daily log.

References

Bass, P. (2020, August 20). 6 essential steps to monitoring asthma for better control. Verywell Health. Retrieved March 31, 2021, from https://www.verywellhealth.com/what-are-the-essential-steps-in-monitoring-asthma-200928

Bateman, E. D., Reddel, H. K., O’Byrne, P. M., Barnes, P. J., Zhong, N., & Keen, C. (2018). As-needed budesonide–formoterol in mild asthma. New England Journal of Medicine, 379(9), 897-898. https://doi.org/10.1056/nejmc1808073

Kerr, M. (2019, March 8). Seasonal allergies: Symptoms, causes and treatment. Healthline. Retrieved March 31, 2021, from https://www.healthline.com/health/allergies/seasonal-allergies