Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.

                                      Main Post

Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

Patients today are much sicker than they used to be. The advanced practice nurse needs to manage all comorbidities in the plan of care. In this post, I will discuss the patient’s health care needs and a recommended treatment plan, including pharmacotherapeutic choices. Also, I will present an education strategy to assist the patient in managing their disease conditions. The patient has a history of hypertension, myocardial infarction, hyperlipidemia angina, and diabetes type two. Her needs center around the management of these comorbidities. Also, I noticed that her serum creatinine is on the high end of the range if not outside of it. This fact is not surprising considering her diabetes. The case reports that she was doing well until about a month ago. It was tempting to consider adding another medication to the regimen. However, I believe that either the metoprolol is not high enough to manage her current disease state or she has been missing doses, and I am leaning toward the latter. If withdrawn suddenly, the drug can increase the incidence and intensity of anginal attacks. Metoprolol is the first-line drug for stable angina and should be working (Rosenthal & Burchum, 2018).  

A review of her current drug therapy appears appropriate. Aspirin, simvastatin, and metformin are competent choices, and the doses are adequate. My plan would include an assessment of how she takes medication at home and manages them before making any changes. If this were in order, I would increase the metoprolol to 75 mg twice a day and set a follow-up appointment in two weeks. I prefer to increase the dose of metoprolol first before adding any new drug because of polypharmacy considerations, and the drug does not require renal adjustment (Epocrates, 2019). This fact is beneficial to consider because she has diabetes. Assuming that the patient has missed doses over the last month, the priority is to determine why. Costa et al. (2015) recommend explaining how to take medication, discussing reluctance to take drugs, and a conversation about the patient’s beliefs and knowledge about their health and treatment. I believe that this is a great strategy to use with the patient. Medication adherence is troubling and particularly so with the elderly who have multiple medications and conditions. I think it is essential for the patient and provider to be partners in the plan of care. The patient must agree to it and fully understand their conditions and the purpose of each medication. 

 

                                          References

Costa, E., Giardini, A., Savin, M., Menditto, E., Lehane, E., Laosa, O., … Marengoni, A. (2015). Interventional tools to improve          medication adherence: review of literature. Patient Preference And Adherence, 9, 1303–1314. doi:10.2147/PPA.S87551Epocrates. (2019). Metoprolol Tartrate Adult Dosing. Retrieved from https://online.epocrates.com/drugs/25501/metoprolol-        tartrate/Adult-DosingRosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO:        Elsevier.

 Write a statement of purpose explaining why you are pursuing your degree of choice and what you plan to do after graduation. Please explain what makes you the best candidate to be awarded one of the scholarships. 

Please state, if you are selected, what you would do to pay the scholarship forward.

(500 words)

 

Assignment:

For your assignment, please consider you have developed the knowledge, skills, and attitudes that enable your achievement of the nurse administrator competencies. Then write a minimum of 1000 word APA style essay, describing how this course has helped you achieve these outcomes and describe your quality improvement project that you will carry into your Capstone course. ( fall precaution on our skilled unit facility 2B). Include a minimum of ten (10) references with citations.

Courses in the Nursing Administrator specialty tract focus on achievement of these core competencies:

ASSESSMENT: The nurse administrator collects comprehensive data pertinent to the issue, situation, or trends.

IDENTIFIES ISSUES, PROBLEMS, OR TRENDS: The nurse administrator analyzes the assessment data to determine the issues, problems, or trends.

OUTCOMES IDENTIFICATION: The nurse administrator identifies expected outcomes for a plan individualized to the situation.

PLANNING: The nurse administrator develops a plan that prescribes strategies and alternatives to attain expected outcomes.

IMPLEMENTATION: The nurse administrator coordinates and implements the identified plan.

HEALTH TEACHING AND HEALTH PROMOTION: The nurse administrator employs strategies to foster health promotion, health teaching, and the provision of other educational services and resources.

CONSULTATION: The nurse administrator provides consultation to influence the identified plan, enhance the abilities of others, and effect change.

EVALUATION: The nurse administrator evaluates progress towards attainment of outcomes.

Sampling and Collecting Quantitative and Qualitative Data

Specific methods of data collection (e.g., surveys, interviews, observations) produce specific types of data that will answer particular research questions, but not others; so here too, as covered in previous weeks, the research questions inform how the data will be obtained.  Furthermore, the method used to collect the data may impact the reliability and the validity of that data.

For this Discussion, you will first consider sampling strategies. Then, you will turn your attention to data collection methods, including their strengths, limitations, and ethical implications. Last, you will consider measurement reliability and validity in the context of your discipline (Healthcare Science).

With these thoughts in mind, use Position A, to complete your discussion.

Position A: Probability sampling represents the best strategy for selecting research participants.

Write a Post: A restatement of your assigned position on sampling strategies. Explain why this position is the best strategy for selecting research participants. Support your explanation with an example and support from the scholarly literature. Next, select a data collection method (e.g., surveys, interviews, observations) and briefly explain at least one strength and at least one limitation. Then, identify a potential ethical issue with this method and describe a strategy to address it. Last, explain the relationship between measurement reliability and measurement validity using an example from your discipline.

Be sure to support your Main Issue Post and Response Post with reference to the week’s Learning Resources and other scholarly evidence in APA Style.

Resources for the week:

Teddlie, C., & Yu, F. (2007). Mixed methods sampling: A typology with examples. Journal of Mixed Methods Research, 1(1), 77–100. 

Mixed Methods Sampling: A Typology with Examples by Teddlie, C., & Yu, F., in Journal of Mixed Methods Research, Vol. 1/Issue 1. Copyright 2007 by Sage Publications Inc. Reprinted by permission of Sage Publications Inc. via the Copyright Clearance Center.

Onwuegbuzie, A. J., & Collins, K. M. (2007). A typology of mixed methods sampling designs in social science research. The Qualitative Report, 12(2), 281–316. Retrieved from http://nsuworks.nova.edu/tqr/vol12/iss2/9

Drost, E. A. (2011). Validity and reliability in social science research. Education Research and Perspectives, 38(1), 105–124.

Walden University: Center for Research Quality. (2015a). Data resources & support: Home. Retrieved from http://academicguides.waldenu.edu/researchcenter/dataresources 

Download the “Sources of Data for Research: A Research Primer” document.

Walden University: Center for Research Quality. (2015d). Research resources: Walden University participant pool. Retrieved from http://academicguides.waldenu.edu/researchcenter/resources/participantpool 

Walden University. (2015a). How do I find an article that reports on research that uses a specific methodology? Retrieved from http://academicanswers.waldenu.edu/faq/72633  

Walden University: Writing Center. (2015). Common course assignments: Annotated bibliographies. Retrieved from http://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies