As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?

For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.

To Prepare:

• Review the Resources for this module and reflect on the different health needs and body systems presented.
• Your Instructor will assign you a complex case study to focus on for this Discussion.Links to an external site.
• Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.

BY DAY 3 OF WEEK 9:

Post a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

You will respond to your colleagues’ posts in Week 10.

BY DAY 6 OF WEEK 10:

Read a selection of your colleagues’ responses from Week 9 and respond to at least two of your colleagues on two different days who were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.

SOLUTION:

A 46-year-old woman, with a bodyweight of 230lbs, who has a family record of breast cancer and is up to date with her yearly mammograms, visited her gynecologist while experiencing episodes of hot flushes, night sweats, and genitourinary issues. She had been in good health until approximately a month ago and was there for her yearly gynecology’s examination, with her last menstrual period (LMP) being a month prior. Her past medical record includes hypertension (HTN) for which she is taking Norvasc 10mg daily and hydrochlorothiazide (HCTZ) 25mg daily. Her blood pressure today was recorded at 150/90. Five years ago, her Pap smear revealed atypical squamous cells of undetermined significance (ASCUS), but her following Pap smears have all been normal.

This patient is faced with a tough medical situation, as she is at high risk for both cancer and cardiovascular disease. Her hypertension has not been properly controlled, thus raising her chances of a stroke, heart attack, or heart failure. Therefore, a third antihypertensive medication is needed to reduce the potential danger. Recent studies have pointed out that women who have vasomotor symptoms are more prone to cardiovascular incidents and connected with poor cardiovascular risk profiles, as well as minor heart disease signs. Adding an angiotensin receptor blocker (ARB) or a direct renin inhibitor such as Aliskiren or a powerful vasodilator similar to hydralazine would be the most advisable course of action. Atacand (candesartan) and Avapro (irbesartan) can be taken into consideration.

Due to the patient’s high risk for breast cancer, further diagnostic testing should be initiated. Estrogen receptor (ER) and Progesterone receptor (PR) testing should be done.………………..KINDLY CLICK THE PURCHASE ICON BELOW TO ACCESS THE ENTIRE SOLUTION FOR $12