What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.  

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As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

• Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor for this Assignment.
• Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
• Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

• Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
• Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation. 
• Explain the process of writing prescriptions, including strategies to minimize medication errors.

four references not more than 5years

zero plagiarism

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)

  

Urinary Obstruction

Case Studies

The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary

stream for several months. Both had progressively become worse. His physical examination

was essentially negative except for an enlarged prostate, which was bulky and soft.

Studies Results

Routine laboratory studies Within normal limits (WNL)

Intravenous pyelogram (IVP) Mild indentation of the interior aspect of the bladder,

indicating an enlarged prostate

Uroflowmetry with total voided

flow of 225 mL

8 mL/sec (normal: >12 mL/sec)

Cystometry Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O)

Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O)

Electromyography of the pelvic

sphincter muscle

Normal resting bladder with a positive tonus limb

Cystoscopy Benign prostatic hypertrophy (BPH)

Prostatic acid phosphatase

(PAP)

0.5 units/L (normal: 0.11-0.60 units/L)

Prostate specific antigen (PSA) 1.0 ng/mL (normal: <4 ng/mL)

Prostate ultrasound Diffusely enlarged prostate; no localized tumor

Diagnostic Analysis

Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical

examination indicated an enlarged prostate. IVP studies corroborated that finding. The

reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the

patient was found to have a normal total voided volume, one could not say that the reduced

flow rate was the result of an inadequately distended bladder. Rather, the bladder was

appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction.

The cystogram indicated that the bladder was capable of mounting an effective pressure and

was not an atonic bladder compatible with neurologic disease. The tonus limb again

indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was

normal, again indicating appropriate muscular function of the bladder. Based on these

studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA

indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis.

Cystoscopy documented that finding, and the patient was appropriately treated by

transurethral resection of the prostate (TURP). This patient did well postoperatively and had

no major problems.

Critical Thinking Questions

1. Does BPH predispose this patient to cancer?

2. Why are patients with BPH at increased risk for urinary tract infections?

3. What would you expect the patient’s PSA level to be after surgery?

4. What is the recommended screening guidelines and treatment for BPH?

5. What are some alternative treatments / natural homeopathic options for treatment? 

 
NOTE:reference at least two updated, and APA format, with plagiarism rate 0%, if possible attach% 

Read chapters 15 and 17 of the class textbook and review the attached PowerPoint presentations.  Once done, answer the following questions:(POWERPOINTS WILL BE INCLUDED): 

1.  Describe globalization and international patterns of health and disease.

2.  Identify international health care organizations and how they collaborate to improve global nursing and health care.

3.  Identify and discuss the major indicators of women’s health.

4.  Identify and discuss the barriers to adequate health care for women.

– PLEASE cite references within text!!!! 

– APA format word document

–  Arial 12 font

– A minimum of 3 evidence-based references besides the class textbook no older than 5 years must be used.  

– A minimum of 800 words is required

 

1. Do you think that school nurse should or should not be allowed to discuss contraception and pregnancy options with students? What are the possible pros and cons . Why are some parents choosing not to vaccinate their children in recent years? How do students view this issue? Should this be a parents’ right? Discuss any current events surrounding this issue- research, lawsuits, outbreaks, CDC news. Do you feel that there are enough programs funding available for children regarding mental health promotion and development issues?  What types of programs are you familiar with?  What areas do you feel are not well addressed.  How would they improved

 APA format word document, Arial 12 font attached to the forum on the discussion board.  A minimum of 3 evidenced-based references must be used (excluding the class textbook)  References must be no older than 5 years.  A minimum of 500 words is required.  

 In the Discussion Forum, the student will select and answer ONE of the instructor questions. The response must be 300 words with two supporting references in APA format. To maximize your grade references should be peer-reviewed journal articles (see Discussion Forum Grading Rubric for more information). Additionally, in this initial response, the student will pose TWO questions related to their question topic. Please include the instructor statement or question in the response.

  

Question 1: You are the manager of a medical-surgical unit in a not-for-profit, acute care hospital that is part of a nine-hospital healthcare system. During the budget preparation process for the upcoming fiscal year, the healthcare system leadership mandated 5% cost reductions from the previous fiscal year budget. Labor costs must be evaluated thoroughly for potential cost savings. You strongly feel eliminating nursing positions is not appropriate in this budget reduction initiative. Discuss at least 3 factors you can use to justify the current nurse staffing as the most appropriate to ensure cost-effective, high-quality care for patients? List several ways to meet the budget reduction mandate without cutting nursing staff? Discuss at least 3 characteristics an emotionally intelligent leader would use in dealing with this scenario.  

Rubric attached, must be followed.