Discussion: Women’s and Men’s Health Infectious Disease and Hematologic Disorders NURS 6521

Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders NURS 6521

Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders NURS 6521
As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?

For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.

 

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To Prepare
Review the Resources for this module and reflect on the different health needs and body systems presented.
Your Instructor will assign you a complex case study to focus on for this Discussion.
Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.
By Day 3 of Week 9
Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

You will respond to your colleagues’ posts in Week 10.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information
Grading Criteria

To access your rubric:

Week 9 Discussion Rubric

Post by Day 3 of Week 9 and Respond by Day 6 of Week 10

To Participate in this Discussion:

Week 9 Discussion

What’s Coming Up in Week 10?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will continue working on your Discussion assigned in Week 9, as you examine the types of drugs used to treat infections and disorders of the hematologic system.

Next Week

To go to the next week:

Week 10

 

Week 10: Women’s and Men’s Health/Infections and Hematologic Systems, Part II
Bacterial and viral infections may spread through the direct contact of bodily fluids such as blood or through vectors, who help to spread infections via the blood. When you think of infections and the hematologic system, what comes to mind?

Infectious diseases, such as malaria, dengue, or other hemorrhagic fevers are some examples of infections that impact the hematologic system. However, disorders of the hematologic system, such as anemia or blood clotting factor disorders, can also have a deleterious effect on a patient’s health and well-being. As an advanced practice nurse, you will need to understand the different types of pharmacotherapeutics used to treat infections and disorders of the hematologic system as you work to enhance patient-centered approaches for safe, quality, and effective care.

This week, you will examine infections and hematologic disorders, as well as the types of drugs used to treat aspects of these disorders or health systems.

Learning Objectives
Students will:

Evaluate patients for treatment of complex health issues
Evaluate patients for treatment of infections
Evaluate patients for treatment of hematologic disorders
Analyze patient education strategies for the management and treatment of complex comorbidities

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 372–388)
Chapter 47, “Drugs for Deficiency Anemias” (pp. 389–396)
Chapter 50, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 425–436)
Chapter 51, “Birth Control” (pp. 437–446)
Chapter 52, “Androgens” (pp. 447–453)
Chapter 53, “Male Sexual Dysfunction and Benign Prostatic Hyperplasia” (pp. 454–466)
Chapter 70, “Basic Principles of Antimicrobial Therapy” (pp. 651–661)
Chapter 71, “Drugs That Weaken the Bacterial Cell Wall I: Penicillins” (pp. 662–668)
Chapter 75, “Sulfonamides Antibiotics and Trimethoprim” (pp. 688–694)
Chapter 76, “Drug Therapy of Urinary Tract Infections” (pp. 695–699)
Chapter 78, “Miscellaneous Antibacterial Drugs” (pp. 711–714)
Chapter 79, “Antifungal Agents” (pp. 715–722)
Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)
Chapter 82, “Drug Therapy of Sexually Transmitted Diseases” (pp. 763–770)

Lunenfeld, B., Mskhalaya, G., Zitzmann, M., Arver, S., Kalinchenko, S., Tishova, Y., & Morgentaler, A. (2015). Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male, 18(1), 5–15. doi:10.3109/13685538.2015.1004049

This article presents recommendations on the diagnosis, treatment, and monitoring of hypogonadism in men. Reflect on the concepts presented and consider how this might impact your role as an advanced practice nurse in treating men’s health disorders.

Montaner, J. S. G., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., … Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS ONE, 9(2), e87872. Retrieved from https://doi.org/10.1371/journal.pone.0087872

 

This study examines HAART therapy and its sustainability and profound population-level decrease in morbidity, mortality, and HIV transmission.

 

Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53–58. .https://doi.org/10.1016/j.maturitas.2016.01.007

This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition.

Agency for Healthcare Research and Quality. (2014). Guide to clinical preventive services, 2014: Section 2. Recommendations for adults. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

 

This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, and counseling.

Document: Final Exam Study Guide (PDF)

 

Required Media (click to expand/reduce)

Laureate Education (Producer). (2019h). Pathopharmacology: Pharmacology and immunological disorders: Improvements in medications and drug administration [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 8 minutes.
Nurse Manager, Bette Nunn discusses how technology has improved the practice of administering drugs and created new and improved drug therapies. The importance of using technology as well as a patient’s knowledge of their own drug history is also discussed.

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6521_Week9_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3
First Response
17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
15 (15%) – 16 (16%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
13 (13%) – 14 (14%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Second Response
16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
12 (12%) – 13 (13%)
Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed. .

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days
Total Points: 100
Name: NURS_6521_Week9_Discussion_Rubric

Wk9 Main Discussion – Case Study #2

Wk9 Main Discussion Post

Case Study #2

A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS (atypical squamous cells of undetermined significance) about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg daily and HCTZ 25mg daily. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago.

Perimenopause

The patient is presenting with marked symptoms for perimenopause. Perimenopause is the transitional period between productive and nonproductive years, a transition lasting 2 to 8 years. Perimenopause to each woman age of onset and time span is different.  Some women start experiencing these symptoms a little early, while others start in their 40’s. Perimenopause is that period in a phase of a woman’s life during which she starts experiencing some estrogen imbalance, leading up to the final cessation of her menstrual cycle.  Change in the hormonal occur during this time including erratically higher estradiol levels, decreased progesterone levels, and a disturbed ovarian-pituitary-hypothalamic feedback relationship with higher LH levels (McCance & Huether, 2019, p747).

The patient is experiencing the genitourinary symptoms that can include urethral tone decline along with muscle tone throughout the pelvic area leading to urinary frequency/urgency, urinary tract infections, and incontinence may occur (Huether & McCance, 2019, p750).  Because of the decrease of  estrogen levels, vasomotor systems present as hot flashes, sweating (night sweats) due to peripheral blood vessels dilating, other symptoms that can ensue are palpitations, dizziness, headaches, and increase the risk for cancers of the breast, uterus, and ovaries (Huether & McCance, 2019).

The transition time in the perimenopause phase also varies from one woman to another.  Some women go through this period briefly, while some last several years before they finally achieve menopause.  Women are still having menstrual cycles during this time and can get pregnant.  The menopause-like symptoms start manifesting during the perimenopause phase because the ovaries are slowly regressive in the amount of estrogen it produces. This patient needs to be made aware that perimenopause to menopause modification is a midlife neuroendocrine switch ceremony unique to each woman that occurs on the background of aging biology.

Treatment Regimen

Based on the symptoms the patient is exhibiting, it may be beneficial to start her on hormone replacement therapy (HRT).  According to Akter and Shirin (2018), HRT is considered the most effective treatment for women who are suffering from perimenopausal and menopausal symptoms.  HRT should be discussed thoroughly with patient and is individualized to each woman based on history and symptoms.  The recommended HRT for the patient would be to start her on an estrogen and progestin combination daily.  The estrogen would be prescribed for the treatment of her symptoms of hot flashes and night sweats.  According to Rosenthal and Burchum (2018), low dose estrogen is given to replace the loss of estrogen from perimenopause and reduce the symptoms of hot flashes and night sweats.  Progestin is giving in combination with estrogen because the patient still has her uterus.  Progestin is needed to prevent endometrial cancer during menopause because it offsets the estrogen-mediated stimulation of the endometrium (Rosenthal & Burchum, 2018).  The patient should be aware of the risk related to HRT and whether the risk outweighs the benefit of the relief of symptoms associated with menopause.

Education Strategy

The patient has a history of hypertension which needs to be considered when educating the patient about HRT.  According to Rosenthal and Burchum (2018), HRT can help with reducing cardiovascular disease (CD), but it is important that HRT is not used for that purpose and the patient continues to take prescribed medications related to CD.  The patient takes medications for her hypertension and her current blood pressure is elevated.  The education of continuing to take her antihypertensive medications and maintaining a healthy diet is important in maintaining her cardiovascular health.  According to Ozcan (2019), healthy lifestyle behaviors such as physical activity, healthy diet, and stress management can reduce the menopausal symptoms.  The patient also has a family history of breast cancer and the risk of harm could increase with HRT (Rosenthal & Burchum, 2019).  The patient should always be informed of the risks and educated about the importance of breast screenings.  Overall, at the end of the day the risk versus benefits need to be evaluated with the patient thoroughly. The patient needs to be part of the treatment decisions with proper educational material provided.

 

References

Akter, M. J., & Shirin, E. (2018). Latest evidence on using hormone replacement therapy in the   menopause. Journal of Bangladesh College of Physicians & Surgeons, 36(1), 26-32. https://doi-

org.ezp.waldenulibrary.org/10.3329/jbcps.v36i1.35508.

McCance, K. L., & Huether, S.E. (2019). Understanding Pathophysiology (8th ed.). Mosby.

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s Pharmacotherapeutics for Advanced Practice Providers. Elsevier.

Ozcan, H. (2019). Healthy lifestyle behaviors and quality of life at menopause. International  Journal of Caring Sciences, 12(1), 492-500. https://search-ebscohost-

com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=136698218&site=eds- live&scope=site.

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