NSG 6005 Week 4 Assignment 1 & 2

NSG 6005 Week 4 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 4, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

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NSG 6005 Week 4 Assignment 1: Discussion Question 1

SE is a twenty-two-year-old Caucasian woman who was diagnosed with asthma at age seven .According to her medical record, she has “mild persistent” asthma .Today, she reports that she has been using her albuterol metered-dose inhaler (MDI) approximately three to four days per week over the last two months .Over the past week, she admits to using albuterol once daily .She has been awakened by a cough three nights during the last month .She states she especially becomes short of breath when she exercises .However, she also admits that the shortness of breath is not always brought on by exercise .She also has a fluticasone MDI, which she uses “most days of the week .” She has been hospitalized twice in the last year for poorly controlled asthma and has been to the emergency department (ED) three times in the last six months for the same problem .Her lab work is all within normal limits, with the exception of a positive human chorionic gonadotropin (HCG) .Answer the following questions:

• What information in the case study suggests that her asthma is not well controlled?
• What factors could possibly lead to this?
• How would you classify the symptoms based upon the National Institutes of Health (NIH) guidelines?
• With the recognition that she is pregnant, how would you alter her treatment for asthma?

Support your responses with guidelines, including the NIH guidelines, for management of asthma during pregnancy .Use other peer-reviewed articles as needed to support specific aspects of your plan .

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NSG 6005 Week 4 Assignment 1: Discussion Question 2

TJ is a fifty-five-year-old police officer who presents to the clinic with complaints of epigastric pain for two weeks .He has been taking over-the-counter (OTC) Zantac without relief .He was diagnosed about a year ago with a bleeding ulcer, and he expresses concerns that the current symptoms remind him of that event .At that time, he was given “multiple prescriptions” for his stomach, but he did not complete the course of therapy because he began to feel better .He also has osteoarthritis in his wrists and hips, for which he takes OTC NSAIDs .He smokes one to two packs per week and drinks an average of one alcoholic beverage daily .His vital signs and blood work are all within normal limits .Answer the following questions:

• What additional testing would you suggest at this point?
• Describe any and all variables that could be contributing to his symptoms .
• What alterations would you suggest in his treatment? Be sure to consider additional diagnoses and whether prophylaxis would be appropriate for NSAID-induced ulcers .

Support your responses with guidelines you locate in the literature and peer-reviewed articles as needed to support your ideas .

NSG 6005 Week 4 Assignment 2 Quiz

1 .Question : Many patients self-medicate with antacids .Which patients should be counseled to not take calcium carbonate antacids without discussing with their providers or a pharmacist first?

• Patients with kidney stones
• Pregnant patients
• Patients with heartburn
• Postmenopausal women

Question 2 .A patient with a COPD exacerbation may require:

• Doubling of inhaled corticosteroid dose
• Systemic corticosteroid burst
• Continuous inhaled beta 2 agonists
• Leukotriene therapy

Question 3 .When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be instructed as follows:

• Montelukast twice a day is started when there is an asthma exacerbation .
• Patients may experience weight gain on montelukast .
• Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking montelukast .
• Lethargy and hypersomnia may occur when taking montelukast .

Question 4 . Lifestyle changes are the first step in the treatment of GERD .A food that may aggravate GERD is:

• Eggs
• Honey Dew
• Chocolate
• Chicken

Question 5 .Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea .Loperamide:

• Can be given to patients of all ages, including infants and children, for viral gastroenteritis
• Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
• Is the treatment of choice for the diarrhea associated with E .coli 0157
• May be used in pregnancy and by lactating women

NSG 6005 Week 5 Assignment 1 Discussion

Select one of the two questions from the discussion questions listed below .By Week 5, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

GF is a forty-one-year-old woman who arrives for her first visit at the clinic .She reports that she has been feeling sad and depressed, with crying spells, trouble sleeping, increased appetite, impaired concentration, and fatigue .She has experienced depression in the past but was able to overcome the symptoms without medication .Upon physical exam, she appears to be poorly groomed and with minimal facial expression .She is slow to respond to questions .She admits to being very anxious and worried about “everything .” She denies any current suicidal ideation .However, she expresses concerns about the future and that it may not be an improvement .She has tried over-the-counter medications to help with sleep, but they have not been effective .Answer the following questions:

• What additional information would you like before making a decision about what to do with GF?
• What approach would you suggest for this patient? Which of her symptoms would concern you and require intervention?
• Does she need to be referred to another provider, or can she be managed in a primary care setting?
• Are there any nonpharmacological strategies that might be appropriate for her?

For medications, include dosages and schedules .Include highlights of patient teaching and/or lifestyle alterations .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

Discussion Question 2

ST is a twenty-five-year-old male who presents to the clinic with a major complaint of insomnia .He has been experiencing problems sleeping for the past month .He has been “borrowing” medication from his mother and friends, such as diazepam and alprazolam, and he finds that these are helpful in allowing him to sleep .He was also diagnosed with asthma at the age of ten .He has been using an inhaler, as needed, but he cannot recall the name of the inhaler .He is currently working part-time through a temporary agency, and he has not been able to find any full-time work .Answer the following questions:

• What additional information would you like to obtain from ST?
• What are the possible reasons for his insomnia?
• What are the possible strategies you can use to help him with the insomnia?

NSG 6005 Week 6 Assignment 1 Discussion

Assignment 1: Discussion Questions

Select one of the two questions from the discussion questions listed below .By Week 6, Day 3, respond to the selected discussion question and submit your response to this Discussion Area .

Be sure to respond to the question using the lessons and vocabulary found in the reading .Justify your answers using examples and reasoning .Support your answers with examples and research and cite your research using APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible .Respond to at least two of your classmates’ posts .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .

Discussion Question 1

MP is a sixty-five-year-old male who has recently retired .He is coming in today for a complaint about pain in his back, knees, and hips .He reports that he has been experiencing this pain for the past six months, and he has been able to control the symptoms with OTC Advil .He describes the pain as stiffness and occasional shooting and aching pains radiating all over .He denies any swelling of his joints .However, the OTC medications are not working well, and he is here to see whether there are any other options he might try .On physical exam, he has tenderness on palpation on the right and left hips and both knees are positive for crepitus .All blood work is within normal limits .Answer the following questions:

• What additional information would you like to have? Does MP need any additional testing?
• What possible issues could contribute to his symptoms?
• He asks about injections to both knees to increase his comfort .How would you respond to that?
• What would your treatment plan be?

For medications, include dosages and schedules .Include highlights of patient teaching and/or lifestyle alterations .Support your decisions with at least one reference to a published clinical guideline and one peer-reviewed publication .

Discussion Question 2

EP is a twenty-five-year-old African American female who has just moved to town and comes to the clinic for her first visit .She has been diagnosed with fibromyalgia .She reports that her previous primary care physician (PCP) was treating her with opiates only .She has been taking hydrocodone/ibuprofen 7 .5 mg/200 mg four times daily but notes that this is not helping her .She is asking you for a refill of this medication and any additional treatment you can advise .On physical exam, she is in moderate distress and reports pain when being touched .Answer the following questions:

• How would you validate the diagnosis of fibromyalgia?
• How would you handle EP’s request for ongoing hydrocodone? Locate any evidence of the efficacy of this treatment for fibromyalgia .
• Assuming that the diagnosis is , what would your treatment plan be?
• Would you recommend any nontraditional therapies?