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NURS 6521 Advanced Pharmacology – Week 7 – Quiz

Attempt Score

34 out of 35 points

Time Elapsed

1 hour, 8 minutes out of 1 hour and 30 minutes

Instructions

Please answer each question below and click 
Submit
 when you have completed the Quiz.

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Question 1

1 out of 1 points

A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?

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Response Feedback:

Smoking reverses the drug-induced inhibition of nocturnal gastric acid production and hinders ulcer healing. Cigarette smoking also is related closely to ulcer recurrence. Ranitidine should not be taken simultaneously with antacids and it does not eradicate 
H. pylori
. It is not necessary to eat multiple small meals during the day. NURS 6521 Advanced Pharmacology – Week 7 – Quiz.

Question 2

1 out of 1 points

A teenage boy has undergone a diagnostic workup following several months of persistent, bloody diarrhea that appears to lack an infectious etiology. The boy has also experienced intermittent abdominal pain and has lost almost 15 pounds this year. Which of the following medications is most likely to treat this boy’s diagnosis?

 

Response Feedback:

This patient’s history and presentation are strongly suggestive of ulcerative colitis, a disease for which mesalamine is an approved treatment. Lubiprostone is used for the treatment of constipation and docusate is a stool softener. Bismuth subsalicylate is an antidiarrheal but is not effective in the management of ulcerative colitis.

Question 3

1 out of 1 points

A nurse is aware that diphenoxylate HCl with atropine sulfate is an effective adjunct in the treatment of diarrhea. For which of the following patients could the administration of this drug be potentially harmful? NURS 6521 Advanced Pharmacology – Week 7 – Quiz

 

Response Feedback:

Use of diphenoxylate HCl is contraindicated for diarrhea caused by GI organisms that penetrate the gastric mucosa (such as 
C. difficile
) because the drug slows peristalsis and may aggravate and prolong the diarrhea. Diarrhea associated with stress, influenza, and tube feeding can be safely treated with the drug in most cases.

Question 4

1 out of 1 points

A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the patient’s safety. Which of the following would be an appropriate nursing diagnosis?

 

Response Feedback:

The appropriate nursing diagnosis related to safety would be Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations. Diarrhea related to adverse effects of drug therapy and Acute Pain related to adverse drug effects, headache are appropriate nursing diagnosis for a patient taking ranitidine, but are not related to safety. Potential Complication: Electrolyte Imbalance related to hypophosphatemia, secondary to drug therapy would be appropriate for a patient taking an aluminum hydroxide with magnesium hydroxide antacid (Maalox, Mylanta). NURS 6521 Advanced Pharmacology – Week 7 – Quiz.

Question 5

1 out of 1 points

It is determined that a patient, who is in a hepatic coma, needs a laxative. Lactulose is prescribed. Which of the following should the nurse monitor to assess the efficacy of the lactulose therapy?

 

Response Feedback:

Similar to the saline laxative magnesium hydroxide, lactulose pulls water into the colon. Unlike magnesium hydroxide, lactulose is a synthetic disaccharide of lactose. In the colon, bacteria metabolize lactulose into acids and carbon dioxide, increasing the oncotic pressure in the colon and drawing water into the stool. The acids formed also draw ammonia into the stool. Therefore, lactulose is used not only to treat constipation but also to decrease blood ammonia levels in patients in hepatic coma and those with hepatic encephalopathy. The other factors, although significant, would not indicate the efficacy of the lactulose therapy as accurately as blood ammonia levels. NURS 6521 Advanced Pharmacology – Week 7 – Quiz.

Question 6

0 out of 1 points

A nurse is providing discharge instructions to a patient who will be taking fludrocortisone at home. The nurse will encourage the patient to eat a diet that is

 

Response Feedback:

The patient should avoid foods that are high in sodium and eat foods that are high in potassium. The patient should eat foods rich in proteins because long-term fludrocortisone therapy promotes the deposition of liver glycogen and induces a negative nitrogen balance. NURS 6521 Advanced Pharmacology – Week 7 – Quiz. Iron-rich food is not typically shown to have therapeutic or adverse effects of fludrocortisone; therefore, it is more important to instruct the patient to avoid high-sodium foods and to eat potassium-rich ones.

Question 7

1 out of 1 points

A woman with an inflammatory skin disorder has begun taking prednisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this patient should prioritize which of the following potential nursing diagnoses in the organization of the patient’s care?

 

Response Feedback:

Treatment with glucocorticoids such as prednisone is associated with numerous adverse effects, including the risk for excess fluid volume. Constipation and impaired gas exchange are not among the most common adverse effects and CNS effects are normally limited to anxiety, mood swings, and insomnia rather than acute confusion.

Question 8

1 out of 1 points

A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is

 

Response Feedback:

Even though ranitidine generally is well tolerated, headache is a common adverse effect that can be severe. The nurse will encourage the patient to adjust lights or temperature and avoid noise if headaches occur and to contact his physician if the headache becomes intolerable. Irritability, dry mouth, and heart palpitations are not associated with this drug. NURS 6521 Advanced Pharmacology – Week 7 – Quiz.

Question 9

1 out of 1 points

A 48-year-old woman who works as an office manager is prescribed metoclopramide (Reglan) for diabetic gastroparesis. The nurse will be sure to assess the patient for

 

Response Feedback:

Depression, from mild to severe, including suicidal ideation, has occurred in patients with and without a history of depression who take metoclopramide. Use caution in administering metoclopramide to patients with a history of depression. The nurse should assess the patient for signs of depression and monitor behavior as long as the patient is on the therapy. If the patient has been depressed or is depressed, metoclopramide therapy should be given only if the benefits of the drug outweigh the potential risks from depression. Tachycardia, hypotension, and anemia are not associated with metoclopramide.

Question 10

1 out of 1 points

A 60-year-old man has scheduled a follow-up appointment with his primary care provider stating that the omeprazole (Prilosec) which he was recently prescribed is ineffective. The patient states, “I take it as soon as I feel heartburn coming on, but it doesn’t seem to help at all.” How should the nurse best respond to this patient’s statement?

 

Response Feedback:

Optimal efficacy requires that omeprazole is taken daily, not just when the patient is symptomatic. A lack of immediate symptomatic relief does not necessarily indicate that the drug is ineffective.

Question 11

1 out of 1 points

A patient who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess which of the following?

 

Response Feedback:

The nurse should monitor the patient’s serum phosphate level because aluminum binds with phosphate. This can lower phosphate levels and cause an electrolyte imbalance. Blood glucose, urine specific gravity, and aspartate transaminase levels are not affected by this drug combination.

Question 12

1 out of 1 points

Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from 
Helicobacter pylori
 infection. Which of the following medications will likely be used in an attempt to eradicate the patient’s 
H. pylori 
infection? (Select all that apply.)

 

Response Feedback:

Classic quadruple therapy for 
H. pylori 
eradication (bismuth, a PPI, 1,500 mg of metronidazole, and 1,500 mg of tetracycline) is highly effective and is frequently the regimen of choice. A newer sequential therapy (PPI plus amoxicillin followed by a PPI plus clarithromycin plus metronidazole) has been proposed and is expected to replace legacy therapy. Both regimens include PPIs and antibiotics and exclude aluminum hydroxide, ondansetron, and cisapride.

Question 13

1 out of 1 points NURS 6521 Advanced Pharmacology – Week 7 – Quiz

A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone (Mylicon) for her discomfort. Which of the following will the nurse monitor most closely during the patient’s drug therapy?

 

Response Feedback:

The nurse needs to closely monitor the patient for increased abdominal pain, nausea, fever, and vomiting. These symptoms are not indicative of excessive flatus, for which simethicone is prescribed, but indicate that the patient needs urgent medical attention for another condition. There is no risk for drug toxicity, anorexia, or increased urine output.

Question 14

1 out of 1 points

A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated?

 

Response Feedback:

Dicyclomine is contraindicated for patients with myasthenia gravis, glaucoma, GI tract obstruction, paralytic ileus, and toxic megacolon. The drug is not contraindicated for patients with hypertension, diabetes mellitus, and rheumatoid arthritis.

Question 15

1 out of 1 points

A 73-year-old woman has scheduled an appointment with her nurse practitioner to discuss her recurrent constipation. The woman states that she experiences constipation despite the fact that she takes docusate on a daily basis and performs cleansing enemas several times weekly. How should the nurse best respond to this patient’s statements?

 

Response Feedback:

Chronic use of laxatives may lead to dependency on the laxative to expel a bowel movement. This pattern is especially common among older adults. This phenomenon is more likely than a pathological condition. It would be inappropriate to suggest more (or different) laxatives.

Question 16

1 out of 1 points

A 29-year-old female patient has been prescribed orlistat (Xenical) for morbid obesity. The nurse is providing patient education concerning the drug. An important instruction to the patient would be to

 

Response Feedback:

The nurse should instruct the patient to omit the orlistat (Xenical) for any meal that does not contain fat. The nurse should also instruct the patient to limit dietary intake of fat to 30% of calories. This drug is a reversible lipase inhibitor. By inhibiting the action of lipase, it decreases the absorption of dietary fats. The patient would be advised to take a multivitamin that contains fat-soluble vitamins to prevent imbalances from drug therapy. The administration of orlistat and multivitamins should be separated by 2 hours. Dietary protein does not interfere with the action of orlistat.

Question 17

1 out of 1 points NURS 6521 Advanced Pharmacology – Week 7 – Quiz

An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient’s risk of severe nausea, the nurse should

 

Response Feedback:

Antiemetics should be administered proactively rather than waiting until the patient’s nausea becomes unbearable. A combination approach is often effective. A low-residue diet is unnecessary and withholding food does not necessarily reduce nausea. NURS 6521 Advanced Pharmacology – Week 7 – Quiz

Nurs 6521 Pharm Week 7 Discussion – Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Discussion, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan. Nurs 6521 Pharm Week 7 Discussion – Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders.

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Consider the following case study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

To prepare:

·        Review this week’s media presentation on pharmacology for the gastrointestinal system.

·        Review the provided case study. Reflect on the patient’s symptoms, medical history, and drugs currently prescribed. Nurs 6521 Pharm Week 7 Discussion – Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders.

·        Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors such as pregnancy, drugs, or a psychological disorder.

·        Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Post 1 page page APA format  

 
an explanation of your diagnosis for the patient including your rationale for the diagnosis.

Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
(Note this is a pharmacology class make sure medicine is appropriate and will work with pt’s current med list)
Nurs 6521 Pharm Week 7 Discussion – Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders.

 

Readings

·        Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). 
Pharmacotherapeutics for advanced practice: A practical approach
 (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.

o   Chapter 28, “Nausea and Vomiting” (pp. 392–409)

This chapter focuses on the etiology of nausea and vomiting, as well as body systems that impact or trigger nausea and vomiting. It also covers various drugs used to treat nausea and vomiting including the process of selecting, administering, and managing drug therapy for patients.

o   Chapter 29, “Gastroesophageal Reflux Disease and Peptic Ulcer Disease” (pp. 410–423)

This chapter begins with an overview of risk factors, symptoms, and clinical stages of gastroesophageal reflux disease (GERD). It then examines drugs used to treat GERD and peptic ulcer disease (PUD), including proper dosages, possible adverse reactions, contraindications, and special considerations. Nurs 6521 Pharm Week 7 Discussion – Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders.

o   Chapter 30, “Constipation, Diarrhea, and Irritable Bowel Syndrome” (pp. 424–453)

This chapter begins by exploring disorders associated with constipation and diarrhea, as well as drugs used in treatment. It also covers the pathophysiology of irritable bowel syndrome and related drug therapies.

o   Chapter 31, “Inflammatory Bowel Disease” (pp. 454–471)

This chapter examines the causes, pathophysiology, and diagnostic criteria of inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis. It also identifies drugs used to treat IBD, including proper dosage, adverse reactions, and special considerations.

·        Starr, S., & Raines, D. (2011). Cirrhosis: Diagnosis, management, and prevention. 
American Family Physician
, 
84
(12), 1353–1359.

Retrieved from the Walden Library databases.

This article examines the clinical presentation, pathophysiology, diagnosis, management, and prevention of cirrhosis. It also provides methods for managing complications of cirrhosis.

·        Drugs.com. (2012). Retrieved from 
http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker. Nurs 6521 Pharm Week 7 Discussion – Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders.

Dementia Essay – NURS 6521 – Week 5 Discussion

Dementia

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life (Alzheimer’s Association, 2018). Memory loss is an example (Alzheimer’s Association, 2018). Alzheimer’s is the most common type of dementia (Alzheimer’s Association, 2018). Though most symptoms of dementia vary they include memory loss, communication and language impairment, ability to focus and pay attention, reasoning and judgment impairment, and visual perception (National Institute on Aging, 2018). The multiple psychological changes range from anxiety, depression, personality changes, inappropriate behavior, agitation, hallucinations, and paranoia (Mayo Clinic, 2017).

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Dementia is caused by damage to the brain cells through excess alcohol use, medication side effects, depression, thyroid problems, trauma to head, stroke, and vitamin deficiencies (Alzheimer’s Association, 2018). There is no one test used to diagnose dementia, so the use of an extensive medical history including familial history, physical examination; changes in how the patients’ think, function, and behave are all used to help make this diagnosis. The progressive types of dementias are Alzheimer’s disease (AD), vascular, Lewy body, frontotemporal, and mixed (Mayo Clinic, 2017). Other disorders that are linked to dementia are Huntington’s, Parkinson’s, and Creutzfeldt-Jakob (Mayo Clinic, 2017). Dementia Essay – NURS 6521 – Week 5 Discussion.

Pharmacotherapy for Dementia

The main goal for the treatment of dementia is to improve the patient’s quality of life and prolong the disease process as long as possible. According to Arcangelo and Peterson (2017) there are several possible medications that patients could be on that could cause reversible effects of dementia that include anticholinergics, antipsychotics, benzodiazepines, and histamine blockers. To treat the disease itself, one would prescribe medications such as cholinesterase inhibitors and memantine (Arcangelo & Peterson, 2017). Some of the cholinesterase inhibitors include Aricept, Exelon, and Razadyne (Arcangelo & Peterson, 2017). When used in conjunction, the cholinesterase inhibitors and memantine help to prolong the disease as long as possible thereby giving the patient greater quality of life and functionality.

It is currently unknown how long this treatment will continue to be of benefit to these patients, however once the disease reaches it’s inevitable conclusion most prescribers will remove the medications due to lack of beneficial therapeutics and cost of maintenance (Arcangelo & Peterson, 2017). The cholinesterase inhibitors have been shown to slow the progression of AD (Arcangelo & Peterson, 2017). These medications have also had positive effects on the noncognitive or behavioral symptoms of AD (Arcangelo & Peterson, 2017). They have been shown to reduce apathy, psychosis, anxiety, depression, and agitation (Arcangelo & Peterson, 2017). Dementia Essay – NURS 6521 – Week 5 Discussion.

Dementia and Age

Senior citizens are most affected by this disease process, but it can afflict those that are younger as well. Being elderly down not predispose one to this disease process, however there are risk factors that cannot be changed such as family history, Down Syndrome, age, and mild cognitive impairments. Risk factors that can be changed to either lessen the chances of acquiring the disease or stop it completely include alcohol use, depression, diabetes, cardiovascular risk factors, smoking, and sleep apnea.

In order to reduce any side effects, the APRN can include the family in all of the teaching that is done, advise them to monitor all medication administration in order to maintain compliance, and to advise them that at some point further care will need to be addressed for patient functionality and activities of daily living. Also, the elderly can be very sensitive to medications so proper dosing will need to be taken into account in order to avoid hypersensitivity. To avoid this, the prescriber should begin treating at the lowest doses and working up from that point.

 

References

Alzheimer’s Association. (2018). What is dementia. Retrieved June 27, 2018 from
https://www.alz.org/alzheimers-dementia/what-is-dementia

Mayo Clinic. (2017). Dementia. Retrieved June 27, 2018 from
https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013

National Institute on aging. (2018). What is dementia. Retrieved June 27, 2018 from
https://www.nia.nih.gov/health/what-dementia

 

I enjoyed reading your post this week and liked what you had to say on migraines and gender. The link between hormones and migraine has uncovered new details about how fluctuating estrogen levels – and the life stages when women tend to experience them – could increase their vulnerability to migraine attacks (American Migraine Foundation, 2018). Furthermore, of the more than 38 million Americans who experience migraine headaches, 28 million are women. Dementia Essay – NURS 6521 – Week 5 Discussion. Compared to men, women also experience more frequent and severe migraines and don’t respond as well to drug treatments (Science Daily, 2018). My mother-in-law suffers badly from migraines. As she has gotten older, the migraines have become fewer, which suggests there may very well be a link between hormones and migraines, however I find it an extra kick in the gut that women also don’t respond as well to medications that are made to help with this dilemma.

References

American Migraine Foundation. (2018). Understanding the migraine gender gap. Retrieved June 29, 2018 from
https://americanmigrainefoundation.org/2017/09/21/understanding-migraine-gender-gap/

Science Daily. (2018). Potential source of gender differences in migraines. Retrieved June 29, 2018 from
https://www.sciencedaily.com/releases/2018/04/180423085434.htm

 

I enjoyed your post this week on epilepsy and age. The Epilepsy Foundation (2018) state after age 55, the rate of new cases of epilepsy starts to increase, as people develop strokes, brain tumors, or Alzheimer’s disease, which all can cause epilepsy. Furthermore, the Centers for Disease Control and Prevention (CDC) (2018) reports: About 3 million US adults aged 18 years or older have active epilepsy.
 
Nearly 1 million of those adults are aged 55 or older. With our elderly living longer, there will no doubt be more and more patients who fall victim to this disease process. What are your thoughts on this possibility? Dementia Essay – NURS 6521 – Week 5 Discussion.

References

Centers for Disease Control and Prevention. (2018). Epilepsy and seizures in older adults. Retrieved June 30, 2018 from
https://www.cdc.gov/features/epilepsy-older-adults/index.html

Epilepsy Foundation. (2018). Who gets epilepsy. Retrieved June 30, 2018 from
https://www.epilepsy.com/learn/about-epilepsy-basics/who-gets-epilepsy

Dementia Essay – NURS 6521 – Week 5 Discussion

NURS 6521 Walden University Quiz

Question 1

1 out of 1 points

A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize

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Response Feedback:

Since administration of glatiramer is by subcutaneous injection only, the nurse will teach the patient to rotate injection sites. Appropriate sites for the patient would include the thigh, stomach, and upper arm.

Question 2

1 out of 1 points

NURS 6521 Walden University Quiz

A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

 

Response Feedback:

Glatiramer should reduce the frequency of multiple sclerosis–related attacks and therefore decrease fatigue. Fatigue, weakness, spasticity, balance problems, bladder and bowel problems, numbness, vision loss, tremor, and vertigo are the most common symptoms of multiple sclerosis. Chest pain, breathing difficulties, and heart palpitations are all identified side effects of glatiramer and are not common manifestations of MS.

Question 3

1 out of 1 points

A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?

 

Response Feedback:

High consumption of meat products and seafood increases the risk of hyperuricemia, which is the root cause of gout. Purine-rich vegetables do not increase the risk of hyperuricemia, and a high dairy intake is actually protective.

Question 4

1 out of 1 points

NURS 6521 Walden University Quiz

A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?

 

Response Feedback:

Special instructions need to be given to patients with diabetes when they are prescribed syrups. A diabetic patient needs to monitor glucose levels closely because syrups contain high levels of sugars, which can cause elevated glucose levels. Increased gastrointestinal tract infections are not directly related to diabetic patients taking cough syrups. Noting the time that a medication is taken and good hand-washing are always important, but are not specific considerations for a diabetic patient taking cough syrup.

Question 5

1 out of 1 points

A nurse is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the nurse suggest if the goal is to promote absorption of the regular insulin?

 

Response Feedback:

To promote the absorption of regular insulin, one anatomic area should be selected for subcutaneous injections. Serial locations within that anatomic area are then chosen to rotate the exact injection site. Injection sites should not be rotated by using different anatomic areas each day, because this would substantially change the absorption of the insulin and the patient’s blood glucose levels. Using one injection site regularly may lead to lipodystrophy. Regular insulin is administered about 30 to 60 minutes before eating a meal, not after. NURS 6521 Walden University Quiz

Question 6

1 out of 1 points

A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of

 

Response Feedback:

Etanercept is a weekly subcutaneous injection.

Question 7

1 out of 1 points

A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring?

 

Response Feedback:

Gabapentin is not metabolized and is excreted unchanged in the urine. Therefore, it is important to monitor renal function. Hepatic, cardiac, and respiratory functions are not compromised with this drug.

Question 8

1 out of 1 points

A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?

 

Response Feedback:

Use of illicit drugs as well as an age-related decrease in renal function may have predisposed the patient to nephrotoxicity. Therefore, it is most important for the nurse to advise the patient to drink enough water to decrease the risk for nephrotoxicity when taking methotrexate. Avoiding red meat or taking the tablets before bedtime does not help reduce the risk of nephrotoxicity.

Question 9

1 out of 1 points

A 70-year-old woman who is on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. In the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to

 

Response Feedback:

During long-term ibuprofen therapy, especially in patients older than 60 years, the nurse needs to closely monitor for peptic ulcer disease or gastritis that can lead to gastrointestinal bleeding or even bowel perforation. These events can occur at any time, with or without warning. Ibuprofen may also cause excessive or abnormal bleeding, especially in patients with anemia, but it is not known to cause anemia. Interstitial nephritis is one of the less common renal toxicities associated with ibuprofen as is constipation. NURS 6521 Walden University Quiz

Question 10

1 out of 1 points

A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?

 

Response Feedback:

The CNS depression that is associated with the use of cyclobenzaprine constitutes a risk for injury. The anticholinergic effects of the drug constitute a risk for constipation, not diarrhea. Nutrition and swallowing are not typically affected by the use of cyclobenzaprine.

Question 11

1 out of 1 points

A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

 

Response Feedback:

After an early morning dose of NPH insulin, the patient should be alert for a possible hypoglycemic reaction during mid- to late-afternoon. The lengthy peak action time produces additional risks for hypoglycemic reactions.

Question 12

1 out of 1 points

A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?

 

Response Feedback:

The nurse must consider the patient’s dietary habits because foods high in purines increase uric acid concentrations in the blood, making a gouty attack more likely. Assessing the patient’s work environment, fluid intake, and ethnicity are not as important as assessing his dietary habits.

Question 13

1 out of 1 points

A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following?

NURS 6521 Walden University Quiz

Response Feedback:

If the patient is taking anticoagulant drugs, there is a risk of a drug–drug interaction with levothyroxine that can result in an increased risk of bleeding. Therefore, the nurse should assess the patient’s medical record and drug history. Bleeding times such as INR, PR, and PTT should be closely monitored if it is necessary for the two drugs to be given together. There is no evidence that an allergy to seafood, the patient’s age, or hirsutism, which is excessive hair growth, would need to be assessed in this case.

Question 14

1 out of 1 points

The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug?

 

Response Feedback:

Uricosuric drugs such as allopurinol help to balance urate levels and thus prevent gout attacks. They do not influence the remodeling of synovial membrane, provide analgesia, or affect the metabolism of purines. NURS 6521 Walden University Quiz

Question 15

1 out of 1 points

A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?

 

Response Feedback:

Since sulfinpyrazone inhibits antiplatelet action, it is important for the nurse to monitor the patient for signs of bleeding. It is also important to avoid administration of sulfinpyrazone with other drugs such as salicylates and anticoagulants (warfarin) that affect platelet aggregation. The drug does not pose a risk of hypothermia, hypotension, or renal dysfunction.

Question 16

1 out of 1 points

A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to

 

Response Feedback:

Taking aspirin with milk or food minimizes the stomach upset because it buffers the stomach wall from direct contact with the medication, decreasing gastric distress. Chewable tablets can be chewed before swallowing or crushed and then advised to be taken with food or mixed in a drink. Swallowed whole, extended-release tablets are enteric coated to delay release of the aspirin, which again buffers the stomach wall from the medication, decreasing gastric distress. Nonchewable tablets should be swallowed whole and should never be advised to be crushed or chewed.

Question 17

1 out of 1 points

NURS 6521 Walden University Quiz

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?

 

Response Feedback:

The nurse will need to caution the patient about the adverse effect of photosensitivity, especially considering his work.
 
He should be advised to wear protective clothing and sunglasses and to use sunscreen whenever he is outside on the job site. A complete blood cell count should be done before therapy begins but would not be needed again unless indicated. A nurse must check with the prescriber before advising a patient to decrease a drug dosage. A diet high in protein is not necessary with this drug.

Question 18

1 out of 1 points

A nurse is assessing a patient who has come to the emergency department complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that “puts me at risk of becoming physically dependent.” Which of the following medications would the nurse question, if ordered?

NURS 6521 Walden University Quiz

Response Feedback:

The nurse would be concerned if the physician ordered cyclobenzaprine because long-term use of this drug may result in physical dependence. The other drugs listed are not associated with physical dependence.

Question 19

1 out of 1 points

A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient’s care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient’s existing drug regimen?

 

Response Feedback:

Gabapentin is unusual in that it does not interact with other drugs and does not alter the serum concentrations of other anticonvulsants. Consequently, it is unnecessary to modify the patient’s existing drug regimen. Regular assessment of renal function is necessary in patients with diabetes, but this is not a consequence of the use of gabapentin.

Question 20

1 out of 1 points

A nurse will instruct a patient taking allopurinol to take each dose

NURS 6521 Walden University Quiz

Response Feedback:

The nurse should teach the patient to take each dose after a meal to decrease the potential for nausea and vomiting. Taking this medicine at night, in the morning, or before a meal would not help decrease the GI symptoms associated with this drug.

Question 21

1 out of 1 points

A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?

 

Response Feedback:

Taking vitamin B every day will help decrease the potential for adverse effects of methotrexate. This drug is given cautiously to very young and elderly patients, because these patients’ livers and kidneys cannot adequately clear the drug. Vitamin C is contraindicated with most antiarthritic and antigout drugs because it decreases the renal excretion of drugs. Supplements of vitamin A or D would not be necessary.

Question 22

1 out of 1 points

A 32-year-old female patient is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the patient and her husband that the adverse effect that poses the greatest safety risk to the patient is

 

Response Feedback:

Tizanidine (Zanaflex) has been associated with hypotension, which could be a safety risk, especially if the patient is also taking an antihypertensive drug. Constipation, dry mouth, and fatigue are common adverse effects that do not pose a safety risk.

Question 23

1 out of 1 points

A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?

NURS 6521 Walden University Quiz

Response Feedback:

It is most important that patients and their families know that movement disorders are chronic, that there is no cure, and that drug therapy only serves to help decrease the severity of the symptoms. Symptoms are not normally eliminated completely. Culture must be considered because of catecholamine-O-methyltransferase (COMT), which affects the absorption of levodopa in the body. Some of the drugs used to treat movement disorders can pose a risk of causing renal or hepatic dysfunction, but not all.

Question 24

1 out of 1 points

A 34-year-old male patient is prescribed methimazole (MMI). The nurse will advise him to report which of the following immediately?

 

Response Feedback:

The nurse should ask the patient to report immediately if he notices decreased cardiac rate, intolerance to cold, or weight gain. These are indications of hypothyroidism resulting from antithyroid therapy, and if the medication is continued unchanged, insidious goitrogenic hypothyroidism may occur. Vertigo, drowsiness, loss of appetite, and epigastric distress are possible adverse effects of the therapy but would not present an immediate risk to the patient’s health.

Question 25

1 out of 1 points

A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically?

 

Response Feedback:

Somatropin is used for the long-term treatment of pediatric patients who have growth failure due to an inadequate secretion of endogenous growth hormone; therefore, the nurse should check the patient’s height. If the patient’s growth rate does not exceed the pretreatment rate by at least 2 cm per year, nonadherence to therapy, antibody formation, malnutrition, or hypothyroidism may be considered as possible causes. Somatropin would not significantly affect antidiuretic hormone (ADH) levels, or cause dehydration or water retention. NURS 6521 Walden University Quiz.

Question 26

1 out of 1 points

Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)?

 

Response Feedback:

In a patient experiencing spasticity, the nurse should advise the patient to stop drinking alcohol. Alcohol consumption may increase the adverse effect of sedation, causing sleepiness, dizziness, and blurred vision. The patient should not drive or walk after taking the drug; he should learn to self-administer the drug; and constipation is a concern. However, the most important safety concern is to avoid alcohol.

Question 27

1 out of 1 points

A nurse will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months?

 

Response Feedback:

The most common adverse effects of allopurinol include pruritus, maculopapular rash, nausea and vomiting, elevated liver function tests, and acute gout symptoms. Blood sugar levels, blood pressure, and body temperature are not associated with adverse effects of allopurinol.

Question 28

1 out of 1 points

A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?

 

Response Feedback:

Subcutaneous insulin therapy for type 1 diabetes frequently consists of daily injections of mixtures of short-acting regular insulin with intermediate-acting insulins; multiple doses of regular insulin before each meal in association with one or two daily doses of long-acting insulin may also be used. Frequent, fixed doses of rapid-acting or intermediate-acting insulin may result in unsafe blood sugar levels. NURS 6521 Walden University Quiz.

Question 29

0 out of 1 points

To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

 

Response Feedback:

While it is important to monitor a patient for nausea and vomiting and help him or her into a more comfortable position, it is most important to administer supplemental carbohydrates as soon as the patient becomes conscious. Administering supplemental carbohydrates serves to restore liver glycogen and prevent secondary hypoglycemia. Calcium supplements are not necessary in this situation.

Question 30

1 out of 1 points

Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?

 

Response Feedback:

If the pulse rate is greater than 100 bpm, it is necessary to withhold a levothyroxine dose in an older adult. Anorexia, recent vaccination, and recent falls do not necessary indicate a need to withhold this medication.

NURS 6521 Syllabus

Student Support and Calendar Information

So you have all key information available to you off-line, it is highly recommended that you print the following items for your reference:

Syllabus, including the Course Schedule, located below as a linked PDF

Term Calendar

Student Support

Photo Credit: Steve Hix/Fuse/Corbis/Getty Images

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Credit Hours

5 quarter hours

Walden University assigns credit hours based on the number and type of assignments that enable students to achieve the course learning objectives. In general, each semester credit equals about 42 hours of total student work and each quarter credit equals about 28 hours of total student work. This time requirement represents an approximate average for undergraduate work and the minimum expectations for graduate work. The number and kind of activities estimated to fulfill time requirements will vary by degree level and student learning style, and by student familiarity with the delivery method and course content. NURS 6521 Syllabus.

Course Description

A solid foundation in the concepts and principles of drug therapy across the lifespan is essential to the work of advanced practice nurses. This course applies the advanced principles of pharmacology, including pharmacogenomics, pharmacokinetics and pharmacodynamics, by analysis of common drug classes prescribed by advanced practice nurses across the life span. Factors influencing successful therapy such as effectiveness, safety, acceptability, cost, genetic/environmental influences, complementary regimens, and patient behaviors are considered NURS 6521 Syllabus. Through this course, students prepare to examine complex decisions in the management and treatment of selected acute and chronic diseases across the lifespan through pharmacologic and non-pharmacologic agents. Advanced practice nursing students will have a more in-depth understanding of drug legislation and regulation for prescribing drugs.

Course Prerequisites

There are no prerequisites for this course.

Learning Objectives

By the end of this course, students will:

Evaluate the impact of patient factors on pharmacokinetic and pharmacodynamic processes

Analyze treatments for body system disorders

Analyze factors that impact patient drug therapy plans

Evaluate the impact of drug therapy on patient health outcomes

Analyze the appropriate use of drugs based on classifications, indications, and patient factors

Evaluate ethical and legal implications of prescribing drugs

Analyze current issues related to drug treatments NURS 6521 Syllabus

Click on the following link to access the SON Alignment of Learner Outcomes:

Document: NURS 6521 SON Alignment of Learner Outcomes (PDF)

 

Course Materials

Students will be provided the following course materials. For missing, incorrect, or damaged materials, please contact the Student Support Team. Contact information for the Student Support Team can be located in the
Student Support
area of the course navigation menu.

Course Texts

Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013).
Pharmacotherapeutics for advanced practice: A practical approach
(3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.

Other readings (journal articles, websites, book excerpts, etc.) are assigned throughout the course and may be found within each week and within the Course Schedule.

Course Readings List

The Course Readings List contains all of the required Walden Library resources for this course. Please click on the following link to access the list: v.

NURS 6521 Course Readings List

 

Media

Assigned course media elements are found within the weekly Learning Resources pages and are available via a streaming media player or a hyperlink to the individual item.

Dedicated Support for Course Media

You may use the following e-mail address and toll-free number for any questions or concerns you have about media in the course. NURS 6521 Syllabus

Course Assignments

Participation in weekly Discussions
: The exchange of ideas among colleagues engaged in scholarly inquiry is a key aspect of learning and is a requisite activity in this course. You are expected to participate each week by posting a response to a prompt or question in the weekly Discussion area. Discussion topics/questions are provided in the Discussion area under each weekly button. In addition, you are expected to respond to your fellow students’ postings. To count as participation, responses need to be thoughtful; that is, they must refer to the week’s readings, relevant issues in the news, information obtained from other sources, and/or ideas expressed in the postings of other class members. NURS 6521 Syllabus. You may ask questions or offer further information or links about the subject. Please pay attention to grammar and spelling, as consistently poorly written posts will receive grade penalties. In grading the required Discussion postings, your Instructor will be using the “Formative Evaluation Criteria for Discussion Board Assignments” rubric, located in the
Course Information
area.

Note:
Unless otherwise noted, initial postings to Discussions are due on or before
Day 3
, and response postings are due on or before
Day 6
. You are required to participate in the Discussion on
at least three different days
. It is important to adhere to the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward your own initial posting in a timely manner.

Application Assignments
: The Application Assignments provide you with the opportunity to apply the skills and knowledge gained through the Learning Resources. See the
Assignment
area of specific weeks for detailed descriptions of the assignments. In grading the required Application Assignments, your Instructor will be using the “Formative Evaluative Criteria for Applications and Formal Papers” rubric located in the
Course Information
area. NURS 6521 Syllabus.

Quizzes
: The course contains 11 graded, open-book quizzes that have been designed to assess your understanding of the course topics. The quizzes are due by
Day 7
each week.

Grading Criteria and Total Components of a Grade

Course grades will be based on participation (postings) and completion of assignments listed below.

A = 90% or better

B = 80%–89%

C = 70%–79%

F = 69% or below

Please see below for the policy on Incomplete (I) grades.

Important Note:
This course contains weighted grading. Assignments are weighted
differently
depending on their type. The total points achieved for each assignment will be weighted based on the percentage values noted in the
Weighted Total (%)
column of the table that follows.

Assignment

Total Points

Percentage

Discussions

Participation in Discussions*

Weeks 1-11 (100 points each)

Rubric:

Discussion Rubric

1,100

30%

Application Assignments

(5 Assignments, each worth 100 points)

Week 2 Application Paper

Week 4 Application Paper

Week 6 Application Paper

Week 8 Application Paper NURS 6521 Syllabus

Week 10 Application Paper

Rubric
:
Application Assignment Rubric

500

45%

Quizzes

Completion of Weekly Quizzes

Week 1, 10 and 11 (40 points)

Week 2 and 3 (25 points)

Week 4, 5, and 6 (30 points)

Week 7, 8 and 9 (35 points)

365

25%

*Note:
Each Discussion requires that you make one initial posting and at least two response postings to colleagues. Refer to the “Formative Evaluation Criteria for Discussion Board Assignments” rubric for posting details.

Incomplete Grade Policy

Per University policy, Incomplete grades can be granted only to students who have already met the minimum criteria for active weekly participation in a course (including weekly postings in online courses) and have completed at least 80% of other coursework. Incompletes can be awarded when, because of extenuating circumstances, a student has not met additional course requirements, including but not limited to written assignments, group projects, and research papers, as applicable. All Incomplete grades are awarded at the discretion of the course faculty. (Reproduced from Student Catalog) NURS 6521 Syllabus.

Students who are eligible for an Incomplete must contact the course faculty to request the grade as soon as possible. Students who do not meet the criteria listed above will not be allowed to earn an Incomplete. If the Incomplete is approved, the Faculty Member will work with the student to outline the due date(s) for remaining work. Under no circumstances will the new due dates extend beyond 50 days from the last day of the term. Faculty will then have 10 days to assess the work and post the permanent grade before the University-allotted Incomplete time limit of 60 days expires. All Incomplete grades not resolved within the time allotted will convert to permanent grades of F.

Feedback Schedule

The Instructor will log into the course at least 3–4 times during the week to monitor the weekly
Discussion
area. Feedback will be provided via the
Discussion
area and/or the
Announcements
page. Requests for more specific feedback may be made in the
Discussion
area or in the
Contact the Instructor
thread.

The Instructor will respond to at least one main post each week but will usually not respond to all posts.

Feedback on all assignments will be provided by
Day 7
of the week following the one in which the assignment was due. For example, if your assignment was due in
Week 3
, you would receive feedback on that assignment by
Day 7
of
Week 4
. NURS 6521 Syllabus.

Each Instructor has a unique way of providing feedback. If you think that you are not getting enough feedback, you are strongly encouraged to contact your Instructor and ask for more. Contact information for your Instructor can be found under the
Contact the Instructor
area. For more information on Instructor feedback, go to the Faculty Accessibility section of Faculty and Student Guidelines for Online Courses, located in the
Guidelines and Policies
area.

Course Procedures

All class Discussions take place in the weekly
Discussion
areas.

Questions related to course content must be posted in the
Discussion
area or in the
Contact the Instructor
or
Class Café
areas. Please do not e-mail course-related questions to the Instructor or fellow classmates, as your questions are probably of interest to others in the class. Also, expect that feedback on your work may be posted in the
Discussion
area for the benefit of the entire class. However, private e-mailing between student and Instructor may be used for personal, confidential situations. NURS 6521 Syllabus.

Please feel free to use the
Class Café
to initiate and participate in conversations not directly related to the course. This is an excellent opportunity to get to know other students better. The Instructor will browse the Café occasionally but generally will not respond to conversations posted there unless students have specific questions for the Instructor.

Check the e-mail account that you use for official Walden University business on a regular basis. The expectation is that you are checking this e-mail account daily during the week. If you experience difficulty sending or receiving Walden e-mail, please contact the Student Support Team right away. Contact information for the Student Support Team is located in the
Student Support
area.

Review all materials in the Course Information area, as well as the materials contained under each of the weekly buttons.
Please note
: There may be Optional Readings located within the Learning Resources section of each week in the course. You are encouraged to explore these readings as needed in order to enhance your understanding of the course content.

Here are the steps to follow to begin this course successfully:

Review all the information contained in the links in the navigation area to the left.

Click on the button for
Week 1
, and read the Introduction and Learning Outcomes for the week.

Review the
Resources
,
Discussion
, and
Assignment
areas for the week. Note that some weeks may have none or more than one of these types of activities. It is your responsibility to complete all the required activities. Use the
Course Schedule
as a guide NURS 6521 Syllabus.

Follow this procedure for each week throughout the term

Preferred Methods for Delivering Assignments

Discussion postings
: All postings need to be made in each week’s Discussion area or, when applicable, the Groups area of the course. Please do not send copies of postings to the Instructor or students via e-mail.

Assignments
: Be sure that all documents are saved and submitted as “.doc” files. You may also submit “.rtf” files, but formatting in these files may be lost, so “.doc” files are preferred. Assignments are named according to the week in which the Assignments is submitted NURS 6521 Syllabus. Directions for naming assignment files are given in each
Assignments
area. Please name your files as directed.

E-Mail
: All e-mail correspondence
must
contain in the subject line
course number-XX – Your Name
(XX is the section number) followed by a brief description of the subject. This subject line convention ensures that your e-mail will be easily identified and responded to in a timely manner.

Policies on Late Assignments

Discussion postings
: Much of the learning in this class depends on participation in weekly Discussions; you are expected to contribute to them in the
Discussion
area. If you have problems and need to have a small extension (defined as 1–2 days), contact the Instructor and arrange this in advance. If you have not received permission from the Instructor, do not assume that an extension has been granted. No Discussion post will count for credit once the week has ended.

Assignments
: Assignments are due on the day of the week assigned in this syllabus.
Failure to meet the deadline without prior approval from the instructor will result in zero points.

Approval to submit an assignment late is at the sole discretion of the instructor and may be given only for certifiable reasons such as an illness. The instructor may require that you provide relevant documentation NURS 6521 Syllabus.

If you have not received permission from the instructor, do not assume that an extension has been granted.

Assignments must be submitted according to the instructions and must be in a format that your instructor can open and read.

Failure to comply with submission instructions, to provide a document that your instructor can open and read.

Technology issues are not valid reasons for missing deadlines.

No Assignment will be accepted after the last day of the term (Week 8, Day 7) unless prior approval is obtained from the instructor.

Keeping Your Coursework

ou will have access to the course and your coursework from the course start date until 60 days after the course ends. After this time, you will no longer be able to access the course or related materials.
For this reason, we strongly recommend that you retain copies of your completed assignments and any documents you wish to keep.
The University is not responsible for lost or missing coursework NURS 6521 Syllabus.

Course Evaluation

At or near the end of the course, you will receive an e-mail inviting you to submit an online evaluation of the course and instruction. All submitted course evaluations are confidential, and only aggregate data and comments will be shared with the Instructor and Program Director. Your feedback is vitally important to Walden University in its efforts to continuously improve programs.

Students With Disabilities

Students in this course who have a disability that might prevent them from fully demonstrating their abilities should contact the director of disability services at
disability@waldenu.edu
or at 1-800-925-3368, ext. 312-1205 and +1-612-925-3368 or
http://www.waldenu.edu/contact
for international toll-free numbers as soon as possible to initiate disability verification and discuss accommodations that may be necessary to ensure full participation in the successful completion of course requirements NURS 6521 Syllabus.

disability@waldenu.edu

http://www.waldenu.edu/contact

Classroom Participation

In accordance with US Department of Education guidance regarding class participation, Walden University requires that all students submit their required Week 1 assignments within each course(s) during the first 7 calendar days of class. The first calendar day of class is the official start date of the course as posted on your myWalden academic page.

Assignments submitted prior to the official start date will not count toward your participation.

Financial Aid cannot be released without class participation as defined above.

Students who have already taken, and successfully completed, at least
one or more
class(es) with Walden will be dropped
ONLY
from any class(es) in which they are
not participating
if they do not complete their assignments by the end of the 7
th
day.

Students who
are taking their first class with Walden,
and do not complete their assignments by the end of the 7
th
day, will be administratively withdrawn from the university NURS 6521 Syllabus.

If you have any questions about your assignments, or you are unable to complete your assignments, please contact your faculty member.

Checklist

The weekly course checklist below outlines the assignments due for the course.

All assignments are due by
11:59 p.m. Mountain Time (MT)
on the day assigned (which is 1:59 a.m. Eastern Time (ET) the next day). The time stamp in the classroom will reflect Eastern Time (ET), regardless of your time zone. As long as your submission time stamp is no later than 1:59 a.m. Eastern Time (ET), you have submitted on time.

To View the Calendar

To view the Course Calendar:

Course Calendar

 

To View a Printable Course Schedule

For full assignment details and directions, refer to each week of the course.

Click on the
NURS 6521 Course Schedule (PDF)
link to access the Course Schedule.

Document: NURS 6521: Course Schedule (PDF)

 

Checklist

Module

Assignment

Title

Week 1

Basic Pharmacotherapeutic Concepts

Learning Resources

Required Readings

Optional Readings

Discussion

Pharmacokinetics and Pharmacodynamics

Quiz

Week 1 Quiz

Week 2

Ethical and Legal Aspects of Prescribing

Learning Resources

Required Readings

Optional Readings

Discussion

Ethical and Legal Implications of Prescribing Drugs

Assignment

The Ethics and Legalities of Medication Error Disclosure

Quiz

Week 2 Quiz NURS 6521 Syllabus

Week 3

Cardiovascular System

Learning Resources

Required Readings

Optional Readings

Discussion

Pharmacotherapy for Cardiovascular Disorders

Quiz

Week 3 Quiz

Week 4

Respiratory System

Learning Resources

Required Readings

Optional Readings

Discussion

Pharmacotherapy for Respiratory Disorders

Assignment

Asthma and Stepwise Management

Quiz

Week 4 Quiz

Week 5

Neurological System NURS 6521 Syllabus

Learning Resources

Required Readings

Optional Readings

Discussion

Pharmacotherapy for Neurological Disorders

Quiz

Week 5 Quiz

Week 6

Endocrine and Musculoskeletal System

Learning Resources

Required Readings

Optional Readings

Discussion

Pharmacotherapy for Endocrine and Musculoskeletal Disorders

Assignment

Diabetes and Drug Treatments

Quiz

Week 6 Quiz

Week 7

Gastrointestinal and Hepatobiliary System

Learning Resources

Required Readings

Optional Readings

Discussion

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Quiz

Week 7 Quiz

Week 8

Infections

Learning Resources

Required Readings

Optional Readings

Discussion

Drug Treatments for HIV/AIDS

Assignment

Antimicrobial Agents

Quiz

Week 8 Quiz

Week 9

Hematologic System

Learning Resources

Required Readings

Optional Readings

Discussion

Pharmacotherapy for Hematologic Disorders

Quiz

Week 9 Quiz

Week 10

Women’s and Men’s Health

Learning Resources

Required Readings

Optional Readings

Discussion

Hormone Replacement Therapy

Assignment

Cancer and Women’s and Men’s Health

Quiz

Week 10 Quiz

Week 11

Pediatrics

Learning Resources

Required Readings

Optional Readings

Discussion

Off-Label Drug Use in Pediatrics

Quiz

Week 11 Quiz

Bibliography

The bibliography contains the references for all learning materials in the course. For your convenience, a link has been provided to download and save the bibliography. NURS 6521 Syllabus

To access the Bibliography:

NURS 6521 Bibliography (PDF)

NURS 6521 Syllabus

NURS 6521: ADVANCED PHARMACOLOGY – Week 8: Infections

Week 8: Infections

Prior to the H1N1 influenza pandemic in 2009, it had been more than 40 years since an infectious virus had resulted in such substantial illness, hospitalizations, and deaths on a global scale (CDC, 2010). This can be attributed to improved prevention such as proper hygiene, as well as vaccinations and other drug therapies. However, as the H1N1 pandemic illustrates, infections are sometimes unavoidable even when appropriate prevention methods are implemented. In clinical settings, patients present with various infections including common disorders such as flus and colds, as well as disorders that require more extensive treatment and care such as the human immunodeficiency virus (HIV) or tuberculosis (TB). As an advanced practice nurse, you must evaluate patients presenting with symptoms of infections and recommend appropriate drug treatments.

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This week you begin to explore infections by considering issues surrounding the prevalence, management, and education about HIV/AIDS. You also examine viral and bacterial infections, as well as the appropriate use of antimicrobial agents.

Learning Objectives

By the end of this week, students will:

· Analyze reasons for the prevalence of HIV/AIDS

· Analyze ways health care professionals can change society’s perceptions of HIV/AIDS

· Analyze strategies to educate HIV positive patients on treatment and management

· Analyze categories of antimicrobial agents NURS 6521: ADVANCED PHARMACOLOGY – Week 8: Infections

· Differentiate between viral and bacterial infections

· Analyze the relationship between infections and antimicrobial agents

· Understand and apply key terms, concepts, and principles related to prescribing drugs to treat infections and infestations

Photo Credit: E.M. Pasieka/ Science Photo Library/Getty Images

Learning Resources

This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media player below.

Required Readings

Note:
 
 To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
 
Course Materials
 
 section of your Syllabus.

Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). 
Pharmacotherapeutics for advanced practice: A practical approach
 (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.

· Chapter 8, “Principles of Antimicrobial Therapy” (pp. 96–117)  This chapter covers factors that impact the selection of an antimicrobial treatment regimen. It also examines the clinical uses, adverse events, and drug interactions of various antimicrobial agents such as penicillin. NURS 6521: ADVANCED PHARMACOLOGY – Week 8: Infections

 

· Chapter 12, “Fungal Infections of the Skin” (pp. 141–149)  This chapter explores the pathophysiology of several fungal infections of the skin as well as related drug treatments and examines the importance of patient education when managing these infections.

 

· Chapter 14, “Bacterial Infections of the Skin” (pp. 158–172)  This chapter begins by examining causes of bacterial infections. It then explores the importance of selecting an appropriate agent for treating bacterial infections.

 

· Chapter 32, “Urinary Tract Infection” (pp. 474–480)  This chapter covers drugs used to treat urinary tract infections and identifies special considerations when treating geriatric patients, pediatric patients, and women.

 

· Chapter 35, “Sexually Transmitted Infections” (pp. 512–535)  This chapter outlines the causes, pathophysiology, and drug treatment of six sexually transmitted infections, including gonorrhea, syphilis, and human papilloma virus infection (HPV). It also examines the importance of selecting the proper agent and monitoring patient response to treatment. NURS 6521: ADVANCED PHARMACOLOGY – Week 8: Infections.

 

· Chapter 48, “Human Immunodeficiency Virus” (pp. 748–762)  This chapter presents the causes, pathophysiology, diagnostic criteria, and prevention methods for HIV. It also covers various methods of drug treatment and patient factors to consider when selecting, administering, and managing drug treatments.

Krummenacher, I., Cavassini, M., Bugnon, O., & Schneider, M. (2011). An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring. 
AIDS Care, 23
(5), 550–561.

Note:
 Retrieved from the Walden Library databases.

 

This article analyzes medication adherence in HIV patients and examines factors that increase adherence as well as factors that contribute to termination or discontinuation of treatment.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

 

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker. NURS 6521: ADVANCED PHARMACOLOGY – Week 8: Infections.

Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? 
Expert Review of Anti-Infective Therapy, 9
(11), 1001–1011.

Note:
 Retrieved from the Walden Library databases.

 

This article examines current therapies and strategies for treating HIV patients. It also examines factors that impact selection of therapy, including drug interactions, personalization of therapy, costs, management of comorbidities, and patient response.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). 
Antimicrobials
. Baltimore, MD: Author.

 

This media presentation outlines principles of antimicrobial therapy

 

Note:
 The approximate length of this media piece is 7 minutes.

Optional Resources

Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication and HIV prevention: New steps forward and New Questions. Annals of Internal Medicine, 156(4), 312–314.

Note:
Retrieved from the Walden Library databases. NURS 6521: ADVANCED PHARMACOLOGY – Week 8: Infections

NURS 6521: ADVANCED PHARMACOLOGY Assignment: Antimicrobial Agents

Assignment:  Antimicrobial Agents

Antimicrobial agents are essential components in the treatment of various bacterial infections as they help to kill or prevent the growth of microbes such as bacteria, fungi, and protozoans. Prior to the discovery of antimicrobial agents, treatment options for patients with bacterial infections were limited. For many patients, treatment often resulted in the amputation of limbs or even death. Today, treatment options for bacterial infections typically have a more positive prognosis. Due to the various types of infections presented in patients, it is essential to be able to identify the underlying cause of the infection—whether bacterial or viral—before recommending drug treatments. This will help you identify whether or not an antimicrobial agent would be appropriate and which specific agent would target the infection. In this Assignment, you consider the appropriate use of antimicrobial agents for infections. NURS 6521: ADVANCED PHARMACOLOGY Assignment: Antimicrobial Agents.

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To prepare:

· Review this week’s media presentation on principles of antimicrobial therapy, as well as Chapter 8 of the Arcangelo and Peterson text.

· Consider the categories of antimicrobial agents.

· Think about differences between viral and bacterial infections.

· Reflect on why proper identification of the infection is key to selecting the proper antimicrobial agent.

By Day 7

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

· Describe the categories of antimicrobial agents. NURS 6521: ADVANCED PHARMACOLOGY Assignment: Antimicrobial Agents.

· Describe differences between viral and bacterial infections.

· Explain why proper identification of viral and bacterial infections is key to selecting the proper antimicrobial agent.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting. v.

NURS 6441 – Team Project Part 3: Sequence and Schedule Project Activities and Resources

 

Team Project Part 3: Sequence and Schedule Project Activities and Resources

Walden University

Nurs-6441, Section 1

Project Management: Healthcare Information Technology

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Sequence and Schedule Project Activities and Resources

The purpose of this paper is to provide my perspective on the group experience while creating our project plan using Microsoft Project (MS Project). Creation of the project plan required the identification of resources needed for each activity, scheduling those resources, assigning staff to the project schedule, and leveling those resources. This paper will describe successes achieved, challenges faced, and discoveries made during part 3 of our group project that can be applied to future projects. NURS 6441 – Team Project Part 3: Sequence and Schedule Project Activities and Resources.

Success Achieved

Part 3 of this project was relatively easy for this group. We used the project charter and WBS we created in the earlier parts of this project as a guideline for our project plan and schedule. Because of the attention to detail put into the charter and the hierarchical decomposition of the scope of work or work breakdown structure (WBS) (PMI, 2017), we had everything we needed to complete our project plan in MS Project for this assignment. A project charter is a document that authorizes a project as summarized by its principle project components such as the project objectives, scope, roles and responsibilities, costs, and risks (Coplan & Masuda, 2011). Our group used the resources outlined in the charter to assign resources to the project deliverables and tasks as we created our WBS. Using these two tools made it much easier to develop the project plan. NURS 6441 – Team Project Part 3: Sequence and Schedule Project Activities and Resources.

Each member contributed to the project plan by developing deliverable tasks and subtasks, establishing start and end dates for these activities, and assigning resources to these areas. None of the team members expressed any difficulty sequencing their tasks in the MS Project application and during our review sessions, the group was generally in agreeance with the schedule suggestions each team member presented. Dependencies were easy to identify on the WBS, and the command tools in the ribbon of MS application made it simple to show these links in throughout the plan.

Our group worked well together as one cohesive unit. We used all accessible means of communication to connect with one another. Being able to review one another’s work, receive feedback from team members, and collectively make decisions also aided in the success of this team project. Our team had members with varying familiarity with the subject matter, yet we treated each other with respect and used the expertise and knowledge of each team member to achieve the objectives set before us. NURS 6441 – Team Project Part 3: Sequence and Schedule Project Activities and Resources.

Challenges Faced

Individually and as a team, we did have our fair share of problems while completing this project. However, we worked as a team to try to resolve these system issues. One challenge faced by all was a thorough understanding of lead and lag time. Every team member verbalized that they understood this to mean the earliest or latest time a task can start without affecting the project deadline. We referred to course materials several times to review the textbook meaning of the terms and instructions on how to apply them in the MS Project planning tool. According to Biafore (2010), lead time is when tasks overlap, and one function can start ahead of its scheduled time; and lag time is the delay between linked tasks. Although we know how and where to input this information, we struggle with correctly apply this concept using the application. NURS 6441 – Team Project Part 3: Sequence and Schedule Project Activities and Resources.

Another challenge we faced as a group while creating the project plan schedule, was resource leveling. We could not understand why the system would indicate that a resource was overallocated when assigned to more than one task. In the real world, we know that some activities start simultaneously, and resources are used to assist with the completion of more than one operation, but we could not reflect that in our project plan. Therefore, we did not assign any resources to more than one task.

New Discoveries for Future Projects

In MS Project, there are several ways data can be input into the system, arranged, rearranged, and edited. There is the conventional way of clicking on the data field in which you are working on and type in the data, using the commands in the ribbon, or using dropdown boxes in the areas (where applicable). I experimented with each of these and found that by double clicking on a specific task row, a dialogue box would open that would allow you to enter all information about that task while in the dialogue box. This shortcut alleviated the need to click on each field related to that task to insert data. I also discovered that MS Project uses the lag field for entering both lead and lag time. To differentiate between the two, you must add a (+) or (-) sign before the numerical entry in this field (Biafore, 2010). The (+) sign indicates the lead time and the (-) sign indicates the lag time. Discovering these two advantages can reduce the amount of time spent on data entry in future projects. NURS 6441 – Team Project Part 3: Sequence and Schedule Project Activities and Resources.

Overall, this assignment has taught me that effective communication is a vital tool when working on a project, primarily as a project manager. It is essential to stay informed and keep your team members informed of the status of each project phase. Another takeaway that I will reference in my future endeavors is the importance of detailed planning. As I stated before, the effort and detail applied to create the founding documentation for the preparation of this project; we were able to develop a project plan with limited challenges. I started using the insight gleaned from this assignment to a personal project I am working on for a massive home renovation project.

 

References

Biafore, B. (2010). 
Microsoft Project 2010: The missing manual
. Sebastopol, CA: O’Reilly.

Coplan, S., & Masuda, D. (2011). 
Project management for healthcare information technology
. New York, NY: McGraw-Hill.

Project Management Institute. (2017).
A guide to the project management body of knowledge
(PMBOK® guide) (6th ed.). Newtown Square, PA: Author. NURS 6441 – Team Project Part 3: Sequence and Schedule Project Activities and Resources.

Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT

The purpose of this paper is to provide a first-hand account of the activities and responsibilities of the role of Project Manager based on interview responses from one who is currently in that role during an active project within a healthcare organization. In the world today, the things that project managers are responsible for is ever increasing. Since these activities are important to the success of the project and the team involved, it is therefore just as important understand the core activities project managers are responsible for. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT. It is the intention of this writer to gain an empirical understanding of activities involved in the role of a project manager and the impact this role has on projects in the environment of a healthcare organization.

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Context of the Interview

The professional selected as the informant for the interview is currently in the role of project manager (PM) at a healthcare organization in Austin, Texas. The selection process for this interview was rather simple since there is a mutual acquaintance between the interviewee and this author. This individual has managed electronic health record (EHR) implementations for various hospitals and is actively managing the implementation of computerized physician order entry (CPOE) and Cerner clinical documentation system throughout the organization’s NICU departments. It is this extensive background that qualifies this healthcare professional to provide competent insight into the role of a PM. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT. Due to the distance between residential landmarks, the interview was arranged through email contact and conducted by phone.

Roles and Functions

The interviewee expressed aside from ensuring that the objectives met as proposed to the stake holders, her role as a PM in her organization means structure and prioritization of resources to meet government or organizational policies, needs, or wants of providers for automated workflow. PMs are assigned to specific projects based on their strengths, abilities, and even their weaknesses. Often a PM may be assigned to a project to train for future projects. The role of a PM in her organization is responsible for coordinating weekly update meetings and design sessions, collaborating with various project committees, allocating resources, and ensuring that all project processes and activities remain on track. Keeping a running log of the organization’s policies close at hand is one tip the PM considers extremely helpful for ensuring that both state and government policy requirements are met throughout the project.

Synthesis of NICU Project and Literature Comparison

In this section of the paper this author will synthesize the information collected from the PM during the interview pertaining to how the goals and administration of the project were addressed and compare it to that found in project management literature. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT. The PM begins with identifying the goal of the project to be the implementation of CPOE and Cerner documentation in the departments within the neonatal intensive care unit (NICU). The objective is to have full deployment of thin charts, bar-code medication administration (BCMA), and bedside medical device interface (BMDI) within a 9-10-month timeline. To meet this goal project managers, use a universal management template when working on a project to promote continuity and minimize deviation from the organization’s expectations. According to Project Management Institute (2017, p. 1), managers of successful projects use a key set of skills and knowledge to satisfy the customer and others involved or effected by the project. Positive project outcomes are the result of the application of established project management practices, principles, processes, tools, and techniques by managers and leaders (Project Management Institute, 2017, p.1). Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT.

Once the need or want is established and funding secured, authorization to initiate the project is received. The PM is then given the contact info for the project sponsor. The role of the project sponsor is to support the PM in the negotiations with stakeholders by commiting to identify and assign the best suited candidates for the project assignment and further negotiating with the the candidates and their supervisors (Coplan & Mastrian, 2018, p. 83). Since the sponsors are well aware of the time line and overall budget, their support is invaluable to mitigating potential resistance from supervisors to free up the time of their most valued staff.

Along with the help of the project sponsor, the PM proceeds to form a steering committee. Literature defines the steering committee as a collective of chief organizational leaders (e.g., CMO, CNO, CFO, CIO) responsible for successfully guiding the project to completion by supporting, reviewing, and approving all activities of the project (Coplan & Mastrian, 2018, p. 82). The steering committee for the NICU project at this organization is comprised of approximately 18 members, six of which were non-voting members, including stakeholders, such as department leaders, physicians, nurses, educators, and other high-level organizational leaders. It is the responsibility NICU steering committee to outline the project goal, timeline, required resources (people and equipment), dependencies and cost. They are also responsible for approving the charter and set up a kick off to tell interested or affected parties about the upcoming project. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT.

When asked what is contained in the NICU project charter, the PM explained that it lists the project requestor, the project sponsor, project description, the contractual services needed, and the timeline. It further details the project funding, hardware cost and labor description, the sites impacted, the major dependencies, effects on the end user, and who would need training on what was discussed with the steering committee. The project charter is like the press release for a project as a charter announces the project and the responsibilities and authority of the PM (Biafore, 2010, p. 35). Biafore (2010, p. 35), expresses that a project charter carries little weight unless it is delivered by someone to grant authority, like the project sponsor. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT. Typical charter elements are project name, purpose, name of PM and their duties, authority of the PM, and official commitment to the project (Biafore, 2010, p. 36). The NICU charter described in the interview includes these appears to include these elements as well.

Upon execution of the NICU project, weekly update meetings were arreanged with a set agenda to review project objectives such as timeline, resources, dependencies, and deliverables. Design sessions are also arranged where stakeholders, builders, physicians, nurses, and ancillary work together to make design decisions based on portions of the current build presented during this session. Reports are often generated by the project team to help the track the current stages of project which allows active budget data to be presented when looking at the organizations upcoming budget. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT. During project execution, the PM coordinates operation of all taskes performed by project team memebers including deliverables, performance, change requests to the baseline project documents, and project document updates related to a project issue but unrelated to baseline documents (Coplan & Mastrian, 2018, p. 45).

The NICU project is currently in the closing phase where the designed system has been tested and implemented, and the optimization period has commenced. Budgeted resources are used to run reports that allow us to see if the system is being used as expected, errors that are being made because of the new system tasks are not staff, and to provide additional education sessions to the end-users. The project team also sends out news flashes, with tips and tricks, and manuals to let the staff know they are still engaged in the making new implementation a success. Once the project is complete the PM will review the goals with the steering committee to ensure that they are met within the timeline and cost stated in the charter. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT. This report will then be given to the PMO where it will be used to create a document detailing lessons learned during this project to be filed with the other project documents. According to Coplan & Mastrian (2018, p. 49), the project closeout is when tasks are finished, deliverables accepted, work is transferred to operations, users are trained, and the project is signed off by the steering committee. A closeout report is also a requirement of the closing process. This report includes things discovered by the team throughout the experience that had a positive or negative effected the project and is used to lessons learned document (Coplan & Mastrian, 2018, p. 49). Coplan & Mastrian (2018, p. 49), further explains that documenting these learned lessons is a formal way of capturing gained experience and institutional knowledge to be passed on for the next project. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT.

Impact on My Success as a Project Management

Based on the responsibilities and activities undertaken during the project by the PM interviewed, it is obvious that healthcare IT (HIT) can be quite complex and challenging. From the information collected during the interview, this author has identified skills and characteristics that will need to improve and mastered to be successful. Organizational skills appear to be a crucial skill required to fill this role. However, the success of the NICU project can in part be contributed to the use of a standardized management template. It would be advantageous to make it a personal goal to work toward the development of such a template in whichever healthcare organization this author has the pleasure of servicing. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT.

References

Biafore, B. (2010). 
Microsoft Project 2010: The missing manual
. Sebastopol, CA: O’Reilly.

Coplan, S., & Masuda, D. (2011). 
Project management for healthcare information technology
. New York, NY: McGraw-Hill.

Project Management Institute. (2017).
A guide to the project management body of knowledge
(PMBOK® guide) (6th ed.). Newtown Square, PA: Author. Managing Projects Essay – Nurs-6441C, Section 1, Project Management: Healthcare IT.

NURS 6052N-25:
Essentials of Evidence-Based Practice

INITIAL POST

Questions

Patient Satisfaction Survey:

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How easy was it to schedule an appointment at our clinic?

Very easy

Easy

Somewhat easy

Difficult

Very difficult

How long did you wait (beyond your appointment time) to see your provider?

5-15 minutes

15-30 minutes

30-45 minutes

45-60 minutes

Over an hour

How satisfied are you with the overall cleanliness/appearance of our clinic?

Very satisfied

Satisfied

Somewhat satisfied

Dissatisfied

Very dissatisfied

How would you rate the overall care you received from your provider?

Very satisfied

Satisfied

Somewhat satisfied

Dissatisfied

Very dissatisfied

How likely are you to recommend our clinic to a family member or friend?

Very likely

Likely

Somewhat likely

Unlikely

Highly unlikely

Instrument Reliability and Validity

Using a patient satisfaction survey is an exceptional tool to gather relevant data easily, and from a large patient population. Patient Satisfaction Survey – NURS 6052: Essentials of Evidence-Based Practice. Although, it may lack complexity and rigor and rank low on the hierarchy of research methodologies, it is still widely accepted and used as an effective data collection instrument (Keough & Tanabe, 2011).  Patients can feel comfort in knowing that the survey is anonymous and therefore may be more honest in their answers.  A convenient method of distributing this survey would be through the mail, but it can also result in a decreased response rate from patients (Polit & Beck, 2017).  The type of scale used in the patient satisfaction survey is a semantic differential scale, which is comprised of one of more items rated on a series of bipolar adjectives scale (Fawcett & Garity, 2009).  To guarantee a high standard of reliability and validity, measures must be taken prior to the research study.  One effective way to ensure reliability is to score the data in the same way two or more times, or check intrarater reliability (Fawcett & Garity, 2009).  The result will be the percentage agreement between the codes.  The validity of the survey can best be maintained by making sure the concept is a valid measure of a middle-range theory (Polit & Beck, 2017). Patient Satisfaction Survey – NURS 6052: Essentials of Evidence-Based Practice.

Sample Size

It is crucial to define the appropriate sample size prior to conducting a survey, to find the correct number of participants to include, that will give an accurate result.  Judging by the hundreds of patients seen on a weekly basis in our clinic, I chose a sample size of 200 patients to receive the survey over a month period.  If only 50% of the patients return the survey, that will still be a decent sample of the patient population served by the clinic.  An acceptable response rate is between 30 to 75 percent (as cited in Keough & Tanabe, 2011).  One way to increase the number of surveys returned, would be to provide a pre-addressed envelope with paid postage to send them back to the clinic.

References

Fawcett, J., & Garity, J. (2009). 
Evaluating Research for Evidence-based Nursing Practice
. Philadelphia: F.A. Davis.

Keough, V. A., & Tanabe, P. (2011). Survey research: An effective design for conducting nursing research. 
Journal of Nursing Regulation,
 
1
(4), 37-44. doi:10.1016/s2155-8256(15)30315-x

Polit, D. F., & Beck, C. T. (2017). 
Nursing research: Generating and assessing evidence for nursing practice
(10th ed.). Philadelphia, PA: Wolters Kluwer. Patient Satisfaction Survey – NURS 6052: Essentials of Evidence-Based Practice.