82-year-old male presenting with cognitive decline. He had always been a very active individual. Over the past year, he has become less active in the community. Previously, he played cribbage weekly
Special Considerations for Patient Populations Paper
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To complete this assignment, you will utilize the case study assigned to you by faculty for a patient population for special consideration during prescribing practices. You will consider the specific patient and determine the appropriate medication to prescribe, based on the patient specifics and medication attributes in various case studies. You will construct a 4- to 5-page paper in which you determine the medication, the dosing, necessary patient education, and potential side effects. You will also indicate why the other medications would not be appropriate, as well as any necessary labs or diagnostics that might be needed. You will develop a plan to enhance medication adherence for the nonadherent patient.
Special Considerations for Patient Population Cases:
- Patient 1: 82-year-old male presenting with cognitive decline. He had always been a very active individual. Over the past year, he has become less active in the community. Previously, he played cribbage weekly with friends at the local senior center but has been struggling with the math involved with the game and no longer attends the weekly card game. He had also volunteered as a crossing guard for the local public school. He quit doing that after he took the wrong turn to get home and drove around the town feeling lost. He acknowledges he is “sensitive” to this and can be irritable towards his children when they bring up these concerns. He was diagnosed with mild neurocognitive disorder after completing neuropsychological testing. Of the following medications, which would be the most appropriate to prescribe? Explain why you chose this medication. What would be the dosing schedule for this patient? Provide education to the patient and review risks, benefits, and potential side effects of the medication. In addition, explain why the other medications listed are not appropriate for this patient. Med List: lorazepam, olanzapine, memantine
- Patient 2: 76-year-old female who recently moved from her home to an assisted living. After 1 week of moving in, she has become extremely confused. Staff have attempted to re-orient her, and she struggles to focus on what they are saying. She is only oriented to self. She has become very agitated and has even thrown breakable objects in her room. Her family is concerned stating she is “out of it.” The PCP ordered labs and UA. Labs are unremarkable outside of mild leukocytosis and positive dipstick analysis for nitrite and red blood cells. Med List: valproate, alprazolam, trimethoprim
- Patient 3: A 33-year-old female that is 6 weeks postpartum. She presents with depressed mood, sadness, easily emotional, difficulties with sleep even when the infant is sleeping. She has lost weight and has a poor appetite. You note psychomotor retardation. She has limited interests in hobbies or bonding with the infant. Her partner is concerned and reports she is typically active and “bubbly” and enjoys the outdoors. She is diagnosed with major depressive disorder, with postpartum onset. She denies suicidal ideation, homicidal ideation, or infanticidal ideation. No psychotic symptoms are present. She is nursing the infant and wants to continue this hoping it will assist with bonding with the infant. Med List: lithium, paroxetine, sertraline
- Patient 4: 10-year-old male who comes in with his father. He has been diagnosed with generalized anxiety disorder. He has constant worries that he cannot control. He feels nervous and tense. He is easily irritable. He struggles to settle down or relax. He is also quite fidgety and restless. He and his father are interested in medications to manage these symptoms. Med List: quetiapine, duloxetine, fluoxetine
- Patient 5: 27-year-old male with a diagnosis of schizophrenia. He has been hospitalized three (3) times in the past 1 year due to symptoms. When symptomatic, he becomes disorganized and paranoid. He will respond to auditory hallucinations. He will scream out at night after seeing a shadow in his room. He has delusions that the CIA is poisoning food and will not eat for multiple days. He has unintentionally hurt his mother after “slapping” food out of her hand, as he did not want her to ingest the “poisoned food.” Symptoms are treated very well with paliperidone, but he struggles to remember to take it. Med List: paliperidone palmitate, clozapine, lamotrigine
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
To Prepare:
- Review the Learning Resources.
- Carefully review your assigned vulnerable population patient.
- Carefully review the medication list to determine the best medication to prescribe.
- Consider the implications, impact, advantages, and disadvantages of the listed medications.
The Assignment (4–5 pages)
Construct a paper concerning your assigned vulnerable population patient case. In your paper include the following:
- Determine which medication would be most appropriate to prescribe from the assigned vulnerable population patient case medication choices.
- Explain your rationale for choosing this medication. Explain why the other medications listed are not appropriate for this patient.
- Explain the dosing schedule for the specific patient including the therapeutic endpoint.
- Provide necessary education to the patient to review risks, benefits, and potential side effects of the medication.
- Describe any necessary labs or additional diagnostics needed prior to prescribing this medication.
- Explain how you might monitor efficacy or side effects of the medication.
- Include any additional collaboration or education to others that would be necessary for this patient. Consider family members, home health care, primary care providers, etc.
- What would you need to include in your assessment for a patient who may become nonadherent with your prescribing plan for your scenario? What are alternative treatment solutions based upon how you assessed? Describe your new treatment plan.
This Assignment requires a minimum of five (5) peer-reviewed, evidence-based scholarly references outside of course resources.
Note: You will need to include the APA style formatting.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Walden Writing Center Sample PaperLinks to an external site. provides an example of those required elements. All papers submitted must use this formatting.
NURS_6630_Week10_Assignment2_Rubric
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NURS_6630_Week10_Assignment2_Rubric |
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Criteria |
Ratings |
Pts |
|
This criterion is linked
to a Learning OutcomeDescribes the selected
medication and explains the selection, dosing, and necessary patient
education. |
20 to >18.0 ptsExcellentThe response comprehensively and
clearly describes the selected medication, dosing, and patient education
information. The response includes relevant, specific, and appropriate
examples that fully support the selection, dosing, and patient education
information. 18 to
>15.0 ptsGoodThe
response clearly describes the selected medication, dosing, and patient
education information. The response includes relevant, specific, and accurate
examples that support the selection, dosing, and patient education
information. 15 to
>10.0 ptsFairThe
response inaccurately and vaguely describes the selected medication, dosing,
and patient education information. The response includes inaccurate and
irrelevant examples that may support the selection, dosing, and patient
education information. 10 to
>0 ptsPoorThe response includes
inaccurate and vague examples that does not describe the selected medication,
dosing, and patient education information, or some or all are missing. The
response includes inaccurate and vague examples that do not support the
selection, dosing, and patient education information, or it is missing. |
20 pts |
|
This criterion is linked
to a Learning OutcomeDescribes any
necessary labs or diagnostics needed prior to prescribing, as well as how side
effects and efficacy will be monitored. |
20 to
>18.0 ptsExcellentThe response comprehensively and clearly describes needed
labs and other diagnostics. The response comprehensively and clearly
describes monitoring of efficacy and side effects. The response includes
relevant, specific, and appropriate examples that fully support the
descriptions. 18 to
>15.0 ptsGoodThe
response clearly describes needed labs and other diagnostics. The response
clearly describes monitoring of efficacy and side effects. The response
includes relevant, specific, and accurate examples that support the
descriptions. 15 to
>10.0 ptsFairThe
response inaccurately or vaguely describes needed labs and other diagnostics.
The response inaccurately or vaguely describes monitoring of efficacy and
side effects. The response includes inaccurate and irrelevant examples that
may support the descriptions. 10 to
>0 ptsPoorThe response
inaccurately and vaguely describes needed labs and other diagnostics, or it
is missing. The response inaccurately and vaguely describes monitoring of
efficacy and side effects, or it is missing. The response includes inaccurate
and vague examples that do not support the descriptions, or it is missing. |
20 pts |
|
This criterion is linked
to a Learning Outcome20 Explains why the other
medications are not appropriate |
20 to
>18.0 ptsExcellentThe response comprehensively and fully details why other
medications are not appropriate. The response includes relevant, specific,
and appropriate examples that fully support the explanation. 18 to
>15.0 ptsGoodThe
response clearly details why other medications are not appropriate. The
response includes relevant, specific, and accurate examples that support the
explanation. 15 to
>10.0 ptsFairThe
response inaccurately or vaguely details why other medications are not
appropriate. The response includes inaccurate and irrelevant examples that
may support the explanation. 10 to
>0 ptsPoorThe response includes
inaccurate and vague examples that do not support why other medications are
not appropriate, or it is missing. The response includes inaccurate and vague
examples that do not support the explanation, or it is missing. |
20 pts |
|
This criterion is linked
to a Learning OutcomeProvides any
additional collaboration or education necessary for the patient. Discussion
includes: what would be needed to include in the assessment for a patient who
may become nonadherent with the prescribing plan. Discussion includes what
are alternative treatment solutions based upon assessment. Describes a new treatment
plan based upon these factors. |
20 to
>18.0 ptsExcellentThe response accurately and clearly provides all
additional necessary information. The response includes relevant, specific,
and appropriate examples the information. 18 to
>15.0 ptsGoodThe
response accurately provides all additional necessary information. The
response includes relevant, specific, and accurate examples that support the
information. 15 to
>10.0 ptsFairThe
response inaccurately or vaguely provides all additional necessary information.
The response includes inaccurate and irrelevant examples that may support the
information. 10 to
>0 ptsPoorThe response
inaccurately and vaguely provides all additional necessary information, or it
is missing. The response includes inaccurate and vague examples that do not
support the information, or it is missing. |
20 pts |
|
This criterion is linked
to a Learning OutcomeWritten Expression and
Formatting—Paragraph Development and Organization: Paragraphs make clear
points that support well-developed ideas, flow logically, and demonstrate
continuity of ideas. Sentences are carefully focused—neither long and
rambling nor short and lacking substance. A clear and comprehensive purpose
statement and introduction is provided which delineates all required criteria.
Writes succinctly 4–5 page paper. |
10 to
>7.0 ptsExcellentParagraphs
and sentences follow writing standards for flow, continuity, and clarity. A
clear and comprehensive purpose statement, introduction, and conclusion is
provided, which delineates all required criteria. Writes succinctly 4–5 page
paper. 7 to
>4.0 ptsGoodParagraphs
and sentences follow writing standards for flow, continuity, and clarity 80%
of the time. Purpose, introduction, and conclusion of the Assignment is
stated yet is brief and not descriptive. Writes succinctly 4–7 page paper. 4 to
>1.0 ptsFairParagraphs
and sentences follow writing standards for flow, continuity, and clarity
60%–79% of the time. Purpose, introduction, and conclusion of the Assignment
is vague or off topic. Writes succinctly 8–9 page paper. 1 to
>0 ptsPoorParagraphs and
sentences follow writing standards for flow, continuity, and clarity less
than 60% of the time. No purpose statement, introduction, or conclusion was
provided. Does not write succinctly 10+ page paper. |
10 pts |
|
This criterion is linked
to a Learning Outcome5 Written Expression and
Formatting—English writing standards: |
5 to
>4.0 ptsExcellentUses
correct grammar, spelling, and punctuation with no errors. 4 to
>3.0 ptsGoodContains
a one or two grammar, spelling, and punctuation errors. 3 to
>1.0 ptsFairContains
three or four grammar, spelling, and punctuation errors. 1 to
>0 ptsPoorContains five or more
grammar, spelling, and punctuation errors that interfere with the reader’s
understanding. |
5 pts |
|
This criterion is linked
to a Learning Outcome5 Written Expression and
Formatting: The paper follows correct APA format for title page, headings,
font, spacing, margins, indentations, page numbers, parenthetical/in-text
citations, and reference list. |
5 to
>4.0 ptsExcellentformat
with no errors. Contains a minimum of 5 peer-reviewed, evidence-based
scholarly references outside of course resources. 4 to
>3.0 ptsGoodContains
a one or two APA format errors. Contains a minimum of 3-4 peer-reviewed,
evidence-based scholarly references outside of course resources. 3 to
>1.0 ptsFairContains
three or four APA format errors. Contains a minimum of 1-2 peer-reviewed,
evidence-based scholarly references outside of course resources. 1 to
>0 ptsPoorContains five or more
APA format errors. Contains no peer-reviewed, evidence-based scholarly
references outside of course resources. |
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