..heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…

—Murphy et al., 2018

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today. 

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare

• Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
• Review the case study assigned by your Instructor for this Assignment.
• Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
• Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
• Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
• Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

case study:

CASE STUDY 2: Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease.

Drugs currently prescribed include the following:

• Warfarin 5 mg po daily MWF and 2.5 mg daily T, TH, Sat, Sun 

• Aspirin 81 mg po daily 

• Metformin 1000 mg po bid 

• Glyburide 10 mg po bid 

• Atenolol 100 mg po daily 

• Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

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

• Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
• Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
• Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Rubrics:

Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.–

Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.–

Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.

Written 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.

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

References:

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

• Chapter 34, “Review of Hemodynamics” (pp. 335–340)
• Chapter 35, “Diuretics” (pp. 341–349)
• Chapter 36, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 351–362)
• Chapter 37, “Calcium Channel Blockers” (pp. 363–369)
• Chapter 38, “Vasodilators” (pp. 371–373)
• Chapter 39, “Drugs for Hypertension” (pp. 375–388)
• Chapter 40, “Drugs for Heart Failure” (pp. 389–402)
• Chapter 41, “Antidysrhythmic Drugs” (pp. 403–418)
• Chapter 42, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 419–439)
• Chapter 43, “Drugs for Angina Pectoris” (pp. 441–450)
• Chapter 44, “Anticoagulant and Antiplatelet Drugs” (pp. 451–472)

15% turnitin pls

 1.Discuss the historical trends and current conceptions of the cause and treatment of substance abuse National Institute on Drug Abuse 

2. Identify and discuss the issues related to substance abuse in various populations encountered in community health nursing practice

3. Describe and discuss the concepts of interpersonal and community violence.

4. Describe and discuss the role of the nurse in primary, secondary and tertiary prevention of violence.

Instructions

you will discuss the steps of the research process. Specifically, you’ll be sharing how your process went as you established a topic and then completed the research for your annotated bibliography. 

Provide a detailed initial post that responds to at least two of the four prompts noted below:

1. Considering the rhetorical situation: Describe your audience and your purpose. What was the “setting”? What did you need to consider at the very start of the process?
2. Identifying Research questions: Explain how you arrived at your thesis statement by creating initial questions on a topic. How did these musings – thoughts or reflections – and fuzzy questions develop into a viable research path? What makes an effective research question? How can a solid research question be transformed into a thesis?
3. Using strategic searches to conduct academic research: Explain to the reader what one must do to establish productive online searches using academic databases in the Herzing library. What is a Boolean operator? How can we use limiters to yield better results? What is a database? Which search terms and Herzing Library databases did you use for your search? In your post, provide the steps of your process.
4. Critically evaluate sources: How do we determine if a source is suitable? What is CRAAP? As you sort through your sources, what did you do to determine if they were credible or not? What did you look for?

Finally, address the following: What challenges have you overcome? What resources are available to you or what habits can you adopt to help you overcome these hurdles? What advice would you give other students? 

Please be sure to validate your opinions and ideas with citations and references in APA format.

This topic is valued at 40 points. Please review post and response expectations. Please review the rubric to ensure that your response meets criteria (Read Me First Section of the Course).

Peer Response: Unit 6, Due Sunday by 11:59 pm 

Instructions

Respond meaningfully to at least one of your peers.

• Ask a probing or clarifying question.
• Share an insight from having read your colleague’s posting.
• Offer, support, or challenge a position
• Validate an idea with your own experience.

Please be sure to validate your opinions and ideas with citations and references in APA format.

I can’t decide if I agree or disagree with this statement by the American Nursing Association. Educating nurses is so very important and learning more information is going to help expand the nurse’s knowledge. But many nurses don’t pay attention to new education. Usually there are courses that you have to complete in your job but many times nurses just click through this to get done with it and not pay attention to any of it. Nurses need to be taught in different ways to learn. If it is the nurse who is not wanting to be properly educated then I do think it is the nurse’s fault. Yes, the nurse’s level of education matters but so does experience. 

Reference

Catalano, J.T. (2015). Nursing now! Today’s issues, tomorrow’s trends (7thed.) [Bookshelf Ambassadored]. Retrieved from http://online.vitalsource.com

Respond to the discussion above.

  In your reply posts, incorporate challenges you would anticipate for the proposals, as well as arguments to overcome those challenges. Each reply should be 200  :

 Today, I believe most of the money being spent on healthcare should be used on educating patients on possible lifestyle modifications that can be made for many different disease preventions. Diet is one of the most modifiable factors for numerous diseases that the majority of the population suffers from, such as diabetes and hypertension. “The Dietary Approach to Stop Hypertension (DASH) diet, a dietary pattern, currently receiving much attention, was originally designed to reduce blood pressure13; this diet emphasizes intakes of fruits, vegetables, whole grains, nuts, legumes, moderate amounts of low-fat dairy; and underscores reduced intakes of red or processed meats, sodium, and sweetened beverages( Hossein, 2019) ” Here the author stresses the importance of DASH diet and how it can manage hypertension apart from using prescription drugs. With the stress of education on patients, they would be able to manage hypertension and save money on costs such as insurance premiums, and copays. “and higher adherence to DASH diet score was related with lower odds of metabolically unhealthy normal weight phenotype in comparison to metabolically healthy normal weight younger adults ( Hossein, 2019) “ Here, the population can avoid metabolic syndrome by following the DASH diet, which is proven to be a modifying factor. The avoidance of liquor is also a large modifying risk factor in the role of hypertension.
Other modifying factors include exercise. It has been proven that 30 mins of exercise at least 3 times a week reduces blood pressure levels. Diet and exercise have great impact in the prevention of hypertension and diabetes ( type 2) “ brings attention to the importance of healthy aging. Adoption of healthy lifestyle activities such as participating in physical activity on a daily basis is key to maintaining physical and mental health. (Norma, 2020).” Here, we can even use education to involve the elderly population to prevent any extra complications of aging. “he results indicated that the exercise intervention contributed to significant improvements in the older adults’ health-related variables for the EG when contrasted with the control group ( Norma, 2020 )” So, you see the Dash diet, and even exercise is useful at any age so this would be a modifiable factor. This method has also proved to be effective in reducing diastolic, systolic blood pressures, cholesterol, blood lipids, and even depressive symptoms. Money that is given to insurance companies should be spread out to other healthcare branches in order to spread knowledge. Health companies would be putting money towards prevention. Money should also be going towards mandatory screening of preventable diseases. Offices need to be constantly reminded of annual blood work up, lung cancer screening, and even regular blood pressure work up. As far as end of life care goes, money would be spent naturally less on chronic treatments and even procedures because of better health maintenance and wellness which was added earlier in life. In regard to policy utilizing this information we can install schools to have only healthy food option in order to prevent diabetes. The cost of diabetes is a lifelong commitment to insulin, blood checks, and doctor visits if not controlled early on. There should be no sodas, fresh squeezed juices, and more gym time. I hope to see a future that focus more on wellness to eliminate the prognosis of diseases and money spent on these diseases. A lot of diseases can be prevented by exercise, proper eating, and being active with screening. We should educate regrading things like the DASH diet to promote wellness. There should be strict polices in regards to foods in children’s school’s, and free screenings.