NR 508 Week 7 Discussions 1 (Part Two) Recent

NR 508 Week 7 Discussions 1 (Part Two) Recent

NR 508 Week 7 Discussions 1 (Part Two) Recent

discussion part two

your patient returns to your office 4 weeks following his initial appointment in part one with only moderate reduction in symptomology and an increase in nightly symptoms to 1 time per week. upon closer inspection of his medical records you notice that he has also been prescribed metoprolol (25 mg/day extended release) for uncontrolled familial hypertension. NR 508 Week 7 Discussions 1 (Part Two) Recent

what is the mechanism of action of metoprolol, and why is this an important issue in this patient? be sure to contrast the differences between your prescribed/discussed medication in parts one and the metoprolol just discovered. also, include your new patient plan with medication changes and details of dose and mechanism of action.

discussion part one 

elliot is a 74 year-old male who presents to your clinic with complaints of frequent nosebleeds (4 in the past week) and several severe bruises scattered variously throughout his anatomy. the patient is also complaining of a runny nose, cough, and head/chest congestion. he has a history of chronic atrial fibrillation and is currently prescribed and taking warfarin. approximately 3 weeks previously, he started taking over-the-counter cimetidine for heartburn he was experiencing. NR 508 Week 7 Discussions 1 (Part Two) Recent  below is a list of the patient’s medications, his physical examination, and his laboratory findings:


digoxin 0.25 mg qd cimetidine otc bid

pseudoephedrine sr 120 bid warfarin 7 mg qd

allergies: nkda 

physical examination

vs: bp: 180/95, hr 75, irregularly irregular, rr 17

weight: 95 kg

heent: wnl

abd: + bowel sounds ext: bruising on arms and legs

neuro: alert & oriented x 3 gen: well developed, well-nourished male

ecg: atrial fibrillation 


na 143 meq/l k 4.5 meq/l

cl 99 mmol/l co2 25 meq/l

bun 18 mg/dl scr 0.9 mg/dl

inr 4.8 hct 42%

hbg 15 mg/dl digoxin 3.8 ng/ml

what problems should be identified in this patient? NR 508 Week 7 Discussions 1 (Part Two) Recent

what are the precise mechanisms of action of each drug?

what do you think is contributing to the patient’s hypertension?

are there any drug interactions that you can identify as associated with this current drug regimen, and if so how, mechanistically, are they occurring?

what is the clinical significance of these interactions? NR 508 Week 7 Discussions 1 (Part Two) Recent


Feedback Questions for Peer Presentation Reviews

Consider the following points when composing your review of a classmate’s presentation:

    • How effective was the presentation?
    • What did the classmate do well?
    • What elements of the presentation could be improved for future work?
    • Is the material presented in a clear and concise manner?
    • If there is one thing that you could learn from this person’s presentation and apply to your own future work, what would it be? Why did you pick that element? NR 508 Week 7 Discussions 1 (Part Two) Recent
    • Does the color scheme really work for the presentation or against it? Why?
    • How strong is the audio recording that accompanies the presentation? Is there anything you would suggest to improve next time?
    • Does the presentation make a strong first impression? Why or why not?
    • Does the presentation leave a solid lasting impression? Why or why not?
    • Summarize your general thoughts on the presentation and applaud the best parts of the work. NR 508 Week 7 Discussions 1 (Part Two) Recent


Answer the following BOLD questions. Answer does not need to exceed more than a couple of paragraphs.

What do you think of Chinua Achebe’s claim that the racism of works like Heart of Darkness precludes us from considering them great works of literary art? NR 508 Week 7 Discussions 1 (Part Two) Recent

Note that there are several ways of addressing Achebe’s claim. One might agree with it, and then explore its implications for our evaluation of other works in the traditional canon. One might agree with it, and then explore its implications for other “isms,” like sexism, heterocentrism, etc. Or one might contest Achebe’s claim, for example by arguing that the artistic merit of a work’s “technical” qualities can outweigh any moral/ethical problems with its plot/characters (as, for example, is sometimes argued on behalf of Nabokov’s novel Lolita), or even that our literary judgement should not depend on moral/ethical considerations at all.

Whichever way you choose to answer, your essay should at least mention the arguments of Edgar Allan Poe in “The Poetic Principle” and Walter Pater in Studies in the History of the Renaissance.