(Commentr 1 ). reference, citation, 150 words 

Two external stressors that are unique to adolescents are moving/changing school and too of high of expectations from parents. Moving schools is exceptionally difficult for adolescents, as they have to leave the security of their well-known school, their routine, friends they have known since the beginning, and sometimes, the city they were raised in. I have some experience with this, as I transitioned from Private Education to Public in high school and it was pretty rough. I remember the most stressful part being my initial lack of friends and lack of support from my peers. Another external stressor that I knew all too well were high expectations from my parents. My parents expected me to achieve exceptional grades, participate in orchestra and sports, while maintaining a high school job, an experience that is likely more common than I felt at the time.

Several studies have pointed to adolescent stress leading to impulsivity, stating that low-levels of stress allow adolescents to think, plan, absorb and remember but when stress is high, the brain interprets this as a life-threat and decisions are no longer thoughtful, but hasty (Duckworht, Kim, & Tsukayama, 2013). Impulsive, hasty decisions lead to risk-taking behaviors such as: alcohol and drug use, unsafe sex leading to teen pregnancy, or even suicide. When reflecting back on my transition to Public Education, it was really easy to make friends with my peers that were already smoking cigarettes, smoking pot, drinking, having sex, and several of them were cutters. I wasn’t always the best at resisting those activities but I was able to break into a “higher” level of social standing with athletics and those friends, who were mostly just drinkers at parties on the weekend. Another study on adolescent substance abuse demonstrates a link between adolescent substance use as a predictor of adult substance use, I would agree with their findings in reference to a large number of my graduating class that appear to suffer from alcoholism (Charles, Mathias, Acheson, & Dougherty, 2017).

When it comes to support and coping for adolescents, I feel this is high variable. For instance, adolescents who don’t play sports might benefit from sports as a coping mechanism but for an adolescent who has too much on their plate, eliminating a sport or activity might be best to reduce stress. Tutoring services might be helpful to help an adolescent cope by helping them with their studies, keeping them on track and helping them retain information. Lastly, psychiatric services like seeing a psychiatrist or therapist might also be helpful for the adolescent but also helpful for parents placing too much pressure and too high of expectations on their kids. Lastly, providing secondary prevention services is valuable, these being information on crisis resources like call or text crisis lines to prevent suicide (Falkner, 2018).

Charles, N.E., Mathias, C.W., Acheson, A., & Dougherty, D.M. (2017). Preadolescent sensation sensation seeking and early adolescent stress related to at-risk adolescents’ substance use by age 15. Addictive Behaviors, 69(6), 1/7. Retrieved from https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0306460317300060?via%3Dihub

Duckworth, A.L., Kim, B., & Tsulayama, E. (2013). Life stress impairs self-control in early adolescence. Frontiers in Psychology, 3, 1-12. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyg.2012.00608/full

Falkner, A. (2018). Health Assessment, Foundations for Effective Practice. Grand Canyon University. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/3

(Comment2 ).  150 WORDS CITATION, REFERENCE, NO PLAGIO

External Stressors unique to teens

Two external stressors that are unique to adolescents are coping with parents getting divorced, and moving to different cities not by choice. I have been in the situation where parents getting divorced can raise all new obstacles for a teen. When parents split up, the child may have to move into a new home, bounce back and forth between parents with shared custodies, adjust to a single-parent home where the parent may be constantly working and even struggle financially. Teens who don’t know how to cope with their parent’s divorce can take part in risk-taking behavior and may act out, perform poorer in school, and have behavior changes. I have worked with adolescents who have begun cutting, burning, or other self-harm methods to draw attention from both parents in attempts to see them together. When teens must adjust to moving cities it can be incredibly hard to leave behind lifelong friends, childhood home, schools, teams, and relatives. Risk-taking behaviors for these teens include engaging in potentially dangerous activities to get acceptance by new peers like drinking, partying, sex, or even drug use. Teens could try and run away and hitchhike to travel back to their friends or families in their home city which can be dangerous.

Risk taking behavior related to stressors

Teens who don’t know how to cope with their parent’s divorce can take part in risk taking behavior and may act out, perform poorer in school, and have behavior changes. I have worked with adolescents who have begun cutting, burning, or other self-harm methods to draw attention from both parents in attempts to see them together. . Risk taking behaviors for teens who move to different cities include engaging in potentially dangerous activities to get acceptance by new peers like drinking, partying, sex, or even drug use. Teens could try and run away and hitchhike to travel back to their friends or families in their home city which can be dangerous.

Coping Mechanisms and Support

Coping methods and support for children adapting to newly divorced parents include learning relaxation and distraction techniques, journaling, seeking peer support, maintaining communication with both parents, creating a routine (Boring, J. L.,2015). For adolescents adjusting to a new city and living environment soping methods include the use journaling, family-centered activities (bowling, game-nights, dinners, etc.), enrollment in sports or extracurricular activities to help build relationships, and keeping in touch with old friends through the use of cell phones, social media, or video chats (Elsevier October 2019).

References

Boring, J. L. (2015). Children of divorce–coping with divorce: A randomized control trial of an online prevention program for youth experiencing parental divorce. Retrieved from https://eds-b-ebscohost-com.lopes.idm.oclc.org/eds/detail/detail?vid=18&sid=15cf096a-da95-4c5c-b526-eb12753c87d8%40sessionmgr103&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=2015-33904-001&db=pdh

Elsevier. (October 2019). Purpose and Coping with Adversity. Journal of Adolescence. Retrieved from https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0140197119301290

..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)

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