1) Minimum  8 pages

           Part 1: Minimum 2 pages

          Part 2: Minimum 4 pages

          Part 3: Minimum 1 page

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references not older than 5 years

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: Pharmacology

Topic: Ubrelvy  

You must add at least 2 pages to the file “Part 1 Template”. To do this, you must take into account the document “Part 1 Feedback” and meet each of the criteria in red and add them in “Part1 template”

Part 2: Physiology

Topic:  Case Study 

See Part 2 Case Study

 1. What is the transmission and pathophysiology of TB?

2. What are the clinical manifestations?

3. After considering this scenario, what are the primary identified medical concerns for this patient?

4. What are the primary psychosocial concerns?

5. What are the implications of the treatment regimen, as far as likelihood of compliance and outcomes? Search the Internet to research rates of patient compliance in treatment of TB, as well as drug resistant TB.

6. Identify the role of the community clinic in assisting patients, particularly undocumented patients, in covering the cost of TB treatment. What resources exist for TB treatment in community health centers around the United States? Compare the cost for treatment between, subsidized as it would be for a community health center, and unsubsidized.

7. What are the implications of TB for critical care and advanced practice nurses?

Part 3: Primary Care

A 29-year-old single, sexually active woman reporting that she is in a monogamous relationship, has experienced five attacks of acute cystitis in the past year, all characterized by dysuria, increased frequency, and urgency. Each case was diagnosed on the basis of the clinical picture and a laboratory finding of bacteriuria. The urine bacterial counts in these cases ranged from 104 to 106 organisms/ml. Lab tests indicated that the third and fourth infections were caused by Escherichia coli, while the fifth infection was caused by an enterococcus and the second infection was caused by Proteus mirabilis. Each infection responded to short-term treatment with trimethoprim sulfamethoxazole. The recurrences occurred at intervals of 3 weeks to 3 months following completion of antibiotic therapy. For the past two days, the woman has once again been experiencing dysuria, increased frequency, and urgency, so she goes to see her nurse practitioner provider. Her vital signs are T = 37.6°C, P = 100, R = 18, and BP = 110/75 mm Hg. Physical examination reveals a mild tenderness to palpation in the suprapubic area, but no other abnormalities. A bimanual pelvic examination reveals a normal-sized uterus and adnexae with no apparent adnexal tenderness. No vaginal discharge is noted. The cervix appears normal.

Questions:

1. What is the differential diagnosis for this set of symptoms? What is your preliminary diagnosis?

2. What tests should you order to confirm your preliminary diagnosis?

3. What are the possible causes of recurrent lower UTIs? Which of these is most likely in this case?

4. When would you collaborate with other professionals and refer your patient to a specialist and why?

5. Please support with up-to-date evidence-based standard of care guidelines.

The Assignment

Examine Case Study: An African American Child Suffering From Depression. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

• At each decision point stop to complete the following:
  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with strong scientific evidence and references.  Why did you NOT select the other treatment options available?  Again, provide STRONG scientific evidence.  Clinical studies or treatment guidelines are a good place to start!
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • What ethical considerations impacted your treatment plan and communication plan with the patient?
  • Decision #2
    • Why did you select this decision? Support your response with strong scientific evidence and references.  Why did you NOT select the other treatment options available?  Again, provide STRONG scientific evidence.  Clinical studies or treatment guidelines are a good place to start!
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • What ethical considerations impacted your treatment plan and communication plan with the patient?
  • Decision #3
    • Why did you select this decision? Support your response with strong scientific evidence and references.  Why did you NOT select the other treatment options available?  Again, provide STRONG scientific evidence.  Clinical studies or treatment guidelines are a good place to start!
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • What ethical considerations impacted your treatment plan and communication plan with the patient?

Conclusion (1 page)

Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

After writing up your rationale at each decision point, I would ask yourself the following questions:

• Have I provided clinical data from a meta-analysis, case report or clinical trial to support the drug I picked being safe, efficacious and the best choice for this patient?
• Have I provided clinical data, etc. to support a clear rationale as to why the other treatment options are NOT optimal?
• Is the focus of my discussion on mechanism of action and receptors/neurotransmitters that the drug acts on? If the answer is YES, you should consider doing additional research to address the above two questions
• Also include how ethical considerations might impact your treatment plan and communication with clients.

**RUN THROUGH THE DECISION TREE ONCE ONLY**

The rubric, as I interpret it, suggests 5 references cited with every assignment for full credit on this portion (20 points).  References used for your introductory paragraph, ethical considerations or conclusion do not count towards the 5 references required.  As a general rule of thumb, I would encourage you to reference AT LEAST two sources (not including the textbook) for each decision point – this will result in 6 references total for your clinical decision making. Good luck!!

By Day 7 of Week 3 (by Sunday, 11:59 pm MT)

Create a 5- to 6+ slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. It is ok if you go over 6 slides; please be sure you include all required information:

• Describe long-term control and quick relief treatment options for asthma patients, as well as patient education. Please include specific drug examples.
• Explain the stepwise approach to asthma treatment and management. Please include the number of steps and drugs in each step.
• Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

Do NOT submit notes. Include ALL information in your powerpoint slides.