Assignment: Evaluate Patients for Treatment of Musculoskeletal Disorders

Assignment: Evaluate Patients for Treatment of Musculoskeletal Disorders

Assignment: Evaluate Patients for Treatment of Musculoskeletal Disorders

Learning objectives

Evaluate patients for treatment of musculoskeletal disorders

Analyze appropriate use of opioid medications in the treatment of pain

Evaluate drug treatment plans for patients

Justify drug therapy plans based on patient history and diagnosis

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Please remember to focus on the medication therapy. Yes, patient counseling is great, but your knowledge of the medication and the thought process of developing a drug therapy plan is being assessed. Do not give a lot of background information on the disease state. We are not accessing pathophysiology

Directions: For each of the scenarios below, answer the questions below using clinical practice guideline where applicable. Explain the problem and explain how you would address the problem. If prescribing a new drug, write out a complete medication order just as you would if you were completing a prescription. Use at least 3 sources for each scenario and cite sources using APA format.

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.

Chapter 32, “Substance Use Disorders I: Basic Considerations” (pp. 255a–259)

Chapter 33, “Substance Use Disorders II: Alcohol” (pp. 260–266)

Chapter 34, “Substance Use Disorders III: Nicotine and Smoking” (pp. 267–272)

Chapter 35, “Substance Use Disorders IV: Major Drugs of Abuse Other Than Alcohol and Nicotine” (pp. 273–284)

Chapter 60, “Drug Therapy for Gout” (pp. 528–536)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.

Chapter 6, “Individual Variation in Drug Responses” (pp. 43–45)

Chapter 24, “Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics” (pp. 183–194)

Chapter 57, “Cyclooxygenase Inhibitors: Nonsteroidal Antiinflammatory Drugs and Acetaminophen” (pp. 493–503)

Chapter 59, “Drug Therapy of Rheumatoid Arthritis” (pp. 513a–527)

1

Mary is a 35-year-old woman that has been diagnosed with hypothyroidism. Her labs today show a TSH of 20, MCV 78, MCHD 26, Ferritin 9, TIBC 418. She has a history of iron deficiency anemia for 2 months. Current medications include Kelp tablets daily, ibuprofen 400 mg daily as needed, and ethinyl estradiol/norgestrel one tablet daily.What medication would you start this patient on for her hypothyroidism? How would you monitor this patient’s response to the medication? What education would you provide regarding her medications and their interactions?

Joe is a 48-year-old male diagnosed with Type II Diabetes Mellitus for a year ago. He has controlled his blood glucose through dietary changes. He has hypertension and is currently on Lisinopril 20 mg po daily. He has no known allergies. His lab work includes these results: fasting BG is 225 mg/dL; HgA1C = 7.5%. Basic Metabolic Profile (BMP) is normal except for a Cr of 2.0 and eGRF of 28. What treatment plan would you implement for Joe? What medications would you prescribe and how would you monitor them? What education would you provide regarding his treatment plan?

Jose is a 55-year-old truck driver being evaluated for his commercial driver’s license. He has a known history of diabetes mellitus type II. Current medications include Metformin 1000 mg Bid, Glipizide 20 mg po daily. Diltiazem 120 mg po BID. He is allergic to sulfa. Lab results show a fasting blood glucose of 325 mg/dL, HgA1C = 10.6%. Basic metabolic Profile is normal. What treatment plan would you implement for Jose? What medications would you prescribe and how would you monitor them? What education would you provide regarding his treatment plan?

Jenny is a 63-year-old woman with complaints of heartburn 4 to 5 times a week over the past 3 months. Her symptoms are worse at night after going to bed. Her heartburn is worse, and she coughs a lot at night. She has tried OTC Prevacid 24 hour once daily for the past 2 weeks. This has helped the symptoms some, but she is still bothered by them. Current medications include Diltiazem CD 120 mg PO once daily, Hydrochlorothiazide 25 mg PO once daily, Metformin 500 mg PO twice daily, Aspirin 81 mg PO daily, Fluticasone/salmeterol DPI 100 mcg/50 mcg one inhalation twice daily. Your working diagnosis for this patient is GERD. What treatment plan would you implement for Jenny? What medications would you prescribe and how would you monitor them? What education would you provide regarding her treatment plan?

To Prepare:

Review the case study posted in “Announcements” by your Instructor for this Assignment

Review the information provided and answer questions posed in the case study

When recommending a medication, write out a complete prescription for the medication

Whenever possible, use clinical practice guidelines in developing your answers when possible

Include at least three references to support your answer and cite them in APA format.

CriteriaRatingsPts

This criterion is linked to a Learning OutcomeScenario 1: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15 to >11.0 pts

Excellent

Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11 to >7.0 pts

Good

Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7 to >3.0 pts

Fair

Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3 to >0 pts

Poor

Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15 pts

This criterion is linked to a Learning OutcomeScenario 1: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

3 pts

Complete

Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0 pts

Poor

The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3 pts

This criterion is linked to a Learning OutcomeScenario 1: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

4 pts

Excellent

References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3 pts

Good

References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2 pts

Fair

References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0 pts

Poor

No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4 pts

This criterion is linked to a Learning OutcomeScenario 1: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

2 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3 pts

This criterion is linked to a Learning OutcomeScenario 2: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15 to >11.0 pts

Excellent

Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11 to >7.0 pts

Good

Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7 to >3.0 pts

Fair

Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3 to >0 pts

Poor

Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15 pts

This criterion is linked to a Learning OutcomeScenario 2: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

3 pts

Complete

Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0 pts

Poor

The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3 pts

This criterion is linked to a Learning OutcomeScenario 2: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

4 pts

Excellent

References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3 pts

Good

References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2 pts

Fair

References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0 pts

Poor

No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4 pts

This criterion is linked to a Learning OutcomeScenario 2: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

2 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3 pts

This criterion is linked to a Learning OutcomeScenario 3: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15 to >11.0 pts

Excellent

Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11 to >7.0 pts

Good

Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7 to >3.0 pts

Fair

Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3 to >0 pts

Poor

Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15 pts

This criterion is linked to a Learning OutcomeScenario 3: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

3 pts

Complete

Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0 pts

Poor

The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3 pts

This criterion is linked to a Learning OutcomeScenario 3: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

4 pts

Excellent

References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3 pts

Good

References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2 pts

Fair

References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0 pts

Poor

No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4 pts

This criterion is linked to a Learning OutcomeScenario 3: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

2 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3 pts

This criterion is linked to a Learning OutcomeScenario 4: Appropriate medication is prescribed or changed. Rationale provided and includes current literature to support decision. All aspects of the patient history are considered in making the medication selection.

15 to >11.0 pts

Excellent

Medication selected is appropriate and considers all of the unique patient characteristics. Rationale for selection is clear, complete, and appropriate.

11 to >7.0 pts

Good

Medication selected might be appropriate but conflicts with the unique patient characteristics. Rationale for selection is clear but lacks discussion about potential prescribing issues.

7 to >3.0 pts

Fair

Medication selected is not appropriate for this patient unique characteristics. Rationale provided is not correct or is flawed in applying the medication to this patient.

3 to >0 pts

Poor

Medication selected is inappropriate or would not be provided based on patient unique characteristics.

15 pts

This criterion is linked to a Learning OutcomeScenario 4: Written medication orders include all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

3 pts

Complete

Written medication orders includes all 5 aspects required for a valid order. The order is complete, accurate, and appropriate.

0 pts

Poor

The prescription is incomplete. Aspects of a complete order are missing. The order is either incomplete, inaccurate, or inappropriate.

3 pts

This criterion is linked to a Learning OutcomeScenario 4: References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable.

4 pts

Excellent

References for the scenario are within past 5 years and include the appropriate clinical practice guideline if applicable. Correct APA format is used.

3 pts

Good

References for the scenario are within past 5 years but do not include the appropriate clinical practice guideline if applicable. Contains a few (1 or 2) APA format errors.

2 pts

Fair

References for the scenario are not from within the past 5 years or do not reflect the content of this scenario and do not include the appropriate clinical practice guideline if applicable. Contains several (3 or 4) APA format errors.

0 pts

Poor

No references are included. References do not reflect the content of this scenario. Appropriate clinical practice guideline is not include. Contains many (≥ 5) APA format errors.

4 pts

This criterion is linked to a Learning OutcomeScenario 4: Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

3 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

2 pts

Good

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

1 pts

Fair

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

3 pts

Total Points: 100