Endocrine and Musculoskeletal System

The endocrine and musculoskeletal systems play important roles in the regulation and coordination of activities throughout the body. When alterations of these systems occur, many patients require long-term drug therapies. In addition to drugs prescribed by their health care providers, patients with these disorders also often take herbal and dietary supplements. According to the American Diabetes Association, 22 percent of diabetic patients use herbal therapy and 31 percent use dietary supplements (American Diabetes Association, 2009). This may impact the effects of prescribed drugs, as well as pose a concern of adverse drug reactions in patients. When treating patients with endocrine and musculoskeletal disorders, it is important to educate patients on associated risks. As an advanced practice nurse prescribing drugs, you must carefully consider all drug, herbal, and dietary therapies prior to finalizing treatment plans.

This week you examine types of drugs prescribed to patients with endocrine and musculoskeletal disorders, as well as the impact of patient factors on the effects of drugs. You also explore ways to improve patient treatment plans including suggested drug therapies. Finally, you examine types of diabetes and the impact of diabetes drugs on patients.

Learning Objectives

By the end of this week, students will:

· Analyze types of drugs prescribed to treat endocrine and musculoskeletal disorders

· Evaluate the impact of patient factors on the effects of prescribed drugs for endocrine and musculoskeletal disorders

· Evaluate drug therapy plans to treat endocrine and musculoskeletal disorders

· Analyze patient education strategies for treatment and management of endocrine and musculoskeletal disorders

· Differentiate types of diabetes

· Evaluate the impact of diabetes drugs on patients

· Understand and apply key terms, concepts, and principles related to prescribing drugs to treat endocrine and musculoskeletal disorders

Photo Credit: Mark Hatfield/iStock / Getty Images Plus/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 36, “Osteoarthritis and Rheumatoid Arthritis” (pp. 538–559)  This chapter examines the causes, pathophysiology, and diagnostic criteria of osteoarthritis and rheumatoid arthritis. It then outlines the process of selecting, administering, and managing drug therapy for both disorders.

· Chapter 37, “Fibromyalgia” (pp. 560–567)  This chapter explores the causes, pathophysiology, and diagnostic criteria of fibromyalgia. It also covers the process of selecting, administering, and managing drug therapy for this disorder.

· Chapter 45, “Diabetes Mellitus” (pp. 696–714)  This chapter begins by identifying the causes, pathophysiology, and diagnostic criteria of diabetes mellitus. It then examines the process of selecting, administering, and managing drug therapy for patients with diabetes mellitus.

· Chapter 46, “Thyroid Disorders” (pp. 715–729)  This chapter explores the causes, pathophysiology, diagnostic criteria, and administration of drug therapy for patients with thyroid disorders, including hypothyroidism, hyperthyroidism, thyroid nodules, subclinical thyroid disease, and thyroiditis. It also discusses the mechanisms of prescribed drugs, as well as proper dosages and potential adverse reactions.

Ben-Zacharia, A. (2011). Therapeutics for multiple sclerosis symptoms. The Mount Sinai Journal of Medicine, 78(2), 176–191.

Note: Retrieved from the Walden Library databases.

This article covers the diagnosis, treatment, and management of multiple sclerosis and explores methods for treating other health issues that arise from multiple sclerosis.

Kargiotis, O., Paschali, A., Messinis, L., & Papathanasopoulos, P. (2010). Quality of life in multiple sclerosis: Effects of current treatment options. International Review of Psychiatry, 22(1), 67–82.

Note: Retrieved from the Walden Library databases.

This article examines the process of evaluating and diagnosing patients who present with symptoms of multiple sclerosis and explores treatment and rehabilitation methods.

Peterson, K., Silverstein, J., Kaufman, F., & Warren-Boulton, E. (2007). Management of type 2 diabetes in youth: An update. American Family Physician, 76(5), 658–664.

Note: Retrieved from the Walden Library databases.

This article outlines the process of diagnosing, treating, and managing youths with or at risk of type 2 diabetes. It also suggests methods for body weight management and reducing cardiovascular disease risks.

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.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). The endocrine system and diabetes. Baltimore, MD: Author.

This media presentation explores the endocrine system and diabetes including diagnosis and treatment of the disease.

Note: The approximate length of this media piece is 5 minutes.

Laureate Education, Inc. (Executive Producer). (2012). Advanced pharmacology – Mid-course review. Baltimore, MD: Author.

This media is an interactive mid-course review covering course content.

ASSIGNMENT

Diabetes and Drug Treatments

Diabetes is an endocrine system disorder that affects millions of children and adults (ADA, 2011). If left untreated, diabetic patients are at risk for several alterations including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations. In this Assignment, you compare types of diabetes including drug treatments for type 1, type 2, gestational, and juvenile diabetes.

To prepare:

· Review this week’s media presentation on the endocrine system and diabetes, as well as Chapter 45 of the Arcangelo and Peterson text and the Peterson et al. article in the Learning Resources.

· Reflect on differences between types of diabetes including type 1, type 2, gestational, and juvenile diabetes.

· Select one type of diabetes.

· Consider one type of drug used to treat the type of diabetes you selected including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.

· Think about the short-term and long-term impact of the diabetes you selected on patients including effects of drug treatments.

By Day 7

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

· Explain the differences between types of diabetes including type 1, type 2, gestational, and juvenile diabetes.

· Describe one type of drug used to treat the type of diabetes you selected including proper preparation and administration of this drug. Include dietary considerations related to treatment.

· Explain the short-term and long-term impact of this diabetes on patients including effects of drugs treatments.

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.

Re:Topic 5 DQ 1

I am currently treating a child that is immobile.  I provide care to her in multiple ways, but one specific way is ulcer prevention.  When I first started treating her, she had a stage 1 ulcer.  Treatment included wound care with antiseptics.  When I treated her, I was given a prescription and I investigated what the benefits of this ointment was on ulcers. I always like to inform myself and make sure the doctor has prescribed what is best and most effective for my patients.  An example of implementing EBD and its effects on ulcers, would be the article Antibiotics and antiseptics for pressure ulcers by Christie, Dumville, Goto, Tanner, Moore, and Norman. When applying EBP practice, I can consider whether to use antiseptics and/or antimicrobial treatment. In doing so, I research the effects and outcome on both types of treatments.  Per Christie, Dumville, Goto, Tanner, Moore, and Norman (2016) when comparing both of ointments on ulcers, “There was no consistent evidence of a benefit to using any particular antimicrobial treatment for pressure ulcers. However, there was some limited evidence that more ulcers healed when treated with some types of alternative dressings without antimicrobial properties than when treated with povidone iodine”. This research can be used by myself and nurses to treat ulcers, avoid unnecessary procedures, be a voice to our patients and physicians, and explore other possibilities of treatments of ulcers.

According to Youngblut and Brooten (2001) “Evidence-based practice (EBD) provides opportunities for nursing care to be more individualized, more effective, streamlined, and dynamic, and to maximize effects of clinical judgment.” Evidence based practices are the latest advances and knowledge developments, not supporting existing practices. In addition, it includes nurses being active and taking part in the clinical data and application of evidence.  In my opinion, applying EBD in practice will increase the value and reputation of nurses.  One way nurses can promote evidence based research is to be an “opinion leader” (Flodgren , Parmelli , Doumit , Gattellari , O’Brien , Grimshaw , Eccles 2011).

Flodgren, G., Parmelli, E., Doumit, G., Gattellari, M., O’Brien, M., Grimshaw, J., & Eccles, M. (2011). Effectiveness of the use of local opinion leaders to promote evidence-based practice and improving patient outcomes. Cochrane. Retrieved from http://www.cochrane.org/CD000125/EPOC_effectiveness-of-the-use-of-local-opinion-leaders-to-promote-evidence-based-practice-and-improving-patient-outcomes

Norman, G., Dumville, J. C., Moore, Z. E., Tanner, J., & Christie, J. (2015). Antibiotics and antiseptics for pressure ulcers. Protocols, 12(4), 468-76. doi:10.1002/14651858.cd011586