Discussion 1
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
· By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
· How would your communication and interview techniques for building a health history differ with each patient?
· How might you target your questions for building a health history based on the patient’s social determinants of health?
· What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
· Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
· Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
· Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
New Patients profile
Patient Profiles:
#1: 26-year-old Lebanese female living in graduate-student housing:
Assigned to Last names starting with A-H
#2: 14-year-old biracial male living with his grandmother in a high-density public housing complex
Assigned to Last names starting with I-Q
#3: 38-year-old Native American pregnant female living on a reservation
Assigned to Last names starting with R-Z
Resources for reference
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
- Chapter 1, “The History and Interviewing Process”
This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.
- Chapter 5, “Recording Information”
This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
- Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–29)
Discussion 2
Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.
When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.
For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.
To Prepare
· Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
· Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
· Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
· Think about a personalized plan of care based on these influencing factors and patient history in your case study.
Resources for reference
Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.
- Chapter 1, “Prescriptive Authority” (pp. 1–3)
- Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 5–9)
- Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 11–16)
- Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 17–40)
- Chapter 5, “Adverse Drug Reactions and Medical Errors” (pp. 41–49)
- Chapter 6, “Individual Variation in Drug Response” (pp. 51–56)
American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767
American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.
This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.
This website outlines the code of federal regulations for prescription drugs.
This website details key aspects of drug registration.
This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.
This article provides NPs with information regarding state-based laws for NP prescribing.
The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.
