Regular Blood Pressure Check-Ups Would be Necessary

Discussion: Women and Men’s Health, Infectious Disease, and Hematologic Disorders
To Prepare
Select a complex case study to focus on for this discussion (below).
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.
You will pick 1 case to discuss for your initial post during week 9.
CASE STUDY 1
HH is a 68 yo M who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.
Ht: 5’8” Wt: 89 kg
Allergies: Penicillin (rash)
BE SURE TO REVIEW THE C&S
CASE STUDY 2
A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago.
Results:
on admission Day 3
Vtals
Temp (F) 102.7 100.9
BP 138/72 136/70
HR 124 88
RR 34 20
02 Saturation 90%(4L 02) 92%( room air)
Na ( mEq/L) 144 140
K(mEq/L) 4.6 4.3
Cl (mEq/L) 103 105
HCO3 (mEq/L) 34 30
BUN (mg/dL) 30 18
Cr (mg/dL) 1.2 1.1
Glucose (mg/dL) 180 143
WBC (x 1000) 18.2 14.6
Neut 86% 83%
Bands 10% 8%
Lymph 4% 6%
Mono 0% 1%
Eos 0% 1%
Baso 0% 1%

Learning Resources
Required Readings (click to expand/reduce)
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 46, “Anticoagulant and Antiplatelet Drugs” (pp. 364–371)
Chapter 47, “Drugs for Deficiency Anemias” (pp. 389–396)
Chapter 50, “Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications” (pp. 425–436)
Chapter 51, “Birth Control” (pp. 437–446)
Chapter 52, “Androgens” (pp. 447–453)
Chapter 53, “Male Sexual Dysfunction and Benign Prostatic Hyperplasia” (pp. 454–466)
Chapter 70, “Basic Principles of Antimicrobial Therapy” (pp. 651–661)
Chapter 71, “Drugs That Weaken the Bacterial Cell Wall I: Penicillins” (pp. 662–668)
Chapter 75, “Sulfonamides Antibiotics and Trimethoprim” (pp. 688–694)
Chapter 76, “Drug Therapy of Urinary Tract Infections” (pp. 695–699)
Chapter 78, “Miscellaneous Antibacterial Drugs” (pp. 711–714)
Chapter 79, “Antifungal Agents” (pp. 715–722)
Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)
Chapter 82, “Drug Therapy of Sexually Transmitted Diseases” (pp. 763–770)
Lunenfeld, B., Mskhalaya, G., Zitzmann, M., Arver, S., Kalinchenko, S., Tishova, Y., & Morgentaler, A. (2015). Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male, 18(1), 5–15. doi:10.3109/13685538.2015.1004049
This article presents recommendations on the diagnosis, treatment, and monitoring of hypogonadism in men. Reflect on the concepts presented and consider how this might impact your role as an advanced practice nurse in treating men’s health disorders.
Montaner, J. S. G., Lima, V. D., Harrigan, P. R., Lourenço, L., Yip, B., Nosyk, B., … Kendall, P. (2014). Expansion of HAART coverage is associated with sustained decreases in HIV/AIDS morbidity, mortality and HIV transmission: The “HIV Treatment as Prevention” experience in a Canadian setting. PLoS ONE, 9(2), e87872. Retrieved from https://doi(dot)org/10.1371/journal.pone.0087872

This study examines HAART therapy and its sustainability and profound population-level decrease in morbidity, mortality, and HIV transmission.
Roberts, H., & Hickey, M. (2016). Managing the menopause: An update. Maturitas, 86(2016), 53–58. .https://doi(dot)org/10.1016/j.maturitas.2016.01.007
This article provides an update on treatments on Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction, and mood disturbance that are common during the menopause transition.
Agency for Healthcare Research and Quality. (2014). Guide to clinical preventive services, 2014: Section 2. Recommendations for adults. Retrieved from http://www(dot)ahrq(dot)gov/professionals/clinicians-providers/guidelines-recommendations/guide/section2.html

This website lists various preventive services available for men and women and provides information about available screenings, tests, preventive medication, and counseling.
Required Media (click to expand/reduce)
Pharmacology and the Immunological Disorders: Improvements in Medication and Drug Administrations
Nurse Manager, Bette Nunn discusses how technology has improved the practice of administering drugs and created new and improved drug therapies. The importance of using technology as well as a patient’s knowledge of their own drug history is also discussed.
Time Estimate: 8 minutes
Transcript - Pharmacology and the Immunological Disorders: Improvements in Medication and Drug Administrations [PDF]
Speed Pharmacology. (2018). Pharmacology – Antibiotics – Cell wall & membrane inhibitors (Made Easy) [Video]. https://www(dot)youtube(dot)com/watch?v=mMk6VWVpRpo&t=504s
Note: This media program is approximately 16 minutes.
Speed Pharmacology. (2018). Pharmacology – Antibiotics – DNA, RNA, folic acid, protein synthesis inhibitors (Made Easy) [Video].
RUBRIC:
Name: NURS_6521_Week9_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
45 (45%) - 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
40 (40%) - 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
35 (35%) - 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
0 (0%) - 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
10 (10%) - 10 (10%)
Posts main post by day 3
0 (0%) - 0 (0%)
0 (0%) - 0 (0%)
0 (0%) - 0 (0%)
Does not post by day 3
First Response
17 (17%) - 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues. .
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
15 (15%) - 16 (16%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues. .
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
13 (13%) - 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) - 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Second Response
16 (16%) - 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues. .
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English.
14 (14%) - 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
12 (12%) - 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed. .
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
0 (0%) - 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Participation
5 (5%) - 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) - 0 (0%)
0 (0%) - 0 (0%)
0 (0%) - 0 (0%)
Does not meet requirements for participation by posting on 3 different days
Total Points: 100
Name: NURS_6521_Week9_Discussion_Rubric