Discussion: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.

Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare

• Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
• Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
• Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
• Think about a personalized plan of care based on these influencing factors and patient history in your case study.

By Day 3 of Week 1

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

A screening test for prostate cancer has been shown to increase mean survival time by 5 years, and patients diagnosed via screening have demonstrated a better response to treatment than those not detected by screening.

Would you determine this screening program a success?

Why/why not? Provide at least 3 detailed reasons for your answer.

Review the case study and complete the questions to increase your knowledge of Fundamentals content. Copy and paste the questions into a document to type your answers. Copy and paste the questions and answers back into messaging to your coach. You coach will provide you with feedback on your answers.

A 70-year-old female has been admitted to the hospital. The client has had nausea and vomiting for the past three days. Upon admission the client is slightly confused and weak. Her vital signs are: 99 F (37.2 C), respirations 20 breaths/minute, pulse 102 beats/minute, BP 96/66 mm Hg, and her pain level is an “8”on a scale of 0-10. Breath sounds are clear bilaterally upon auscultation. Pulse oximetry is 95% on room air. Bowel sounds are absent in the right and left lower quadrants and in the left upper quadrant. Abdomen is hard and distended. When questioned as to her last bowel movement, the client responds, “I have not moved my bowels in over one week.” Mucous membranes dry; skin turgor poor.

The health care provider (HCP) orders the following:

1. IV of Lactated Ringers (LR). Infuse 1 Liter of LR over 6 hours by infusion pump now. When completed infuse LR at 100 mL/h
2. Insert indwelling urinary catheter to straight drainage
3. Obtain urine analysis (UA) and urine culture and sensitivity (C& S)
4. Insert nasogastric (NG) tube to intermittent suction
5. Diet: NPO
6. Vitals signs every 4 hours
7. Labs: CBC and electrolytes stat
8. Monitor I & O every shift

Questions:

1. The HCP ordered 1 Liter of LR to infuse over 6 hours. Calculate the flow rate you will program the infusion pump.      _____________________mL/h (round to the nearest whole number).

2. The client states she has pain to her left forearm four (4) hours after the start of the infusion. Upon inspection and palpation of her forearm, the nurse notes redness and swelling at the IV site and the forearm is warm to touch. What is the initial action the nurse should take?

3. What are the recommended nursing interventions when an IV becomes infiltrated? What are the recommended nursing interventions when phlebitis is noted?

4. A urine culture C& S is ordered. How would the nurse obtain a urine C& S from a indwelling urinary catheter?

5. To whom can the nurse delegate the task of taking the urine sample to the labatory? How should the specimen be transported?

6. After an X-ray has confirmed placement of the NG tube, how would the nurse check for placement prior to the administration of medication(s) and/or feeding(s) through the NG tube?

7. The nurse is checking placement of the NG tube, what would a gastric pH of 4 or lower indicate? What would a pH of 6 or higher indicate?

8. Name two complications that can occur with an NG tube? List nursing actions to prevent these complications.

9. The client asks the nurse if she could have a glass of water because she is extremely thirsty. What is the best response for the nurse to make?

10. The client’s lab results have returned. What findings (urine and serum) would indicate dehydration?

11. What would be a priority nursing diagnosis for this client? List one short-term goal. List three interventions for your priority nursing diagnosis.

Nursing Operating Theatre Assignment

A 55 year old female client is scheduled for an exploratory laparotomy. The client has been experiencing abdominal symptoms for several months. A baseline assessment of all symptoms was conducted. Answer the following and explain in details to the client following: .

1. The importance of coughing, deep breathing and leg exercises

The client has also signed an informed consent for the surgery. The nurse has completed the client’s physical preparation for the surgery. The client is now being transported to the operating theatre with her records and the completed preoperative checklist.

1. What are the nurse’s responsibilities in regard to obtaining the client’s consent for the surgery?
2. What measures can the nurse take to allay the client’s anxiety concerning the surgery?
3. What are the major items on the preoperative checklist the nurse must ensure have been carried out?

Outline basic safety and sanitation practices critical to preventing food-related illnesses.

in clinical clinic why are doctor ,x-ray tech, receptionist ,nurse, responsibilities are of utmost importance and why the department can’t function without them

1. What multiprofessional team members participate in burn care management?

2. Why is the initial management of the seriously injured burn patient so important?

3. Why is referral to a burn center important for improving patient outcomes?

1. A nurse is planning care for a newborn who is large for gestational age due to maternal gestational diabetes mellitus. The nurse should recognize that the newborn is at risk for which of the following conditions? (Select all that apply.)

What are both strengths and weaknesses of a single payer vs. a multiple payer health care system in general? Name at LEAST two strengths and weaknesses of each system and discuss.

water pollution community nursing care plan

The purpose of this assignment is to examine the importance of informatics and evolving trends in personalized or precision medicine.

As a health informaticist, create a 10-slide presentation to your clinical staff discussing the following:

1. Discuss the role of personalized or precision medicine and the advantages and disadvantages of personalized or precision medicine in the delivery of health care.
2. Discuss how the fields of personalized or precision medicine and informatics have mutually affected one another.
3. Discuss the importance of creating personalized or precision medicine applications that collect accurate data and how those data are communicated to various locations and providers.
4. Describe how personalized or precision medicine supports the aging population and population health.
5. Describe current gaps and challenges in personalized or precision medicine and informatics. How could the future of health informatics evolve over time to respond to those gaps?

Integrate four or five scholarly articles in your paper.

Mrs Smith is 75 years old when she goes for her physical checkup. The doctor notices her height has went from 5’3” to 5’1” over the past few years. She reports she is lactose intolerant, cannot have dairy and does not like green vegetables. She also states that while she has no contraindications to exercise, she does not get much physical activity. The doctor decides to send her for a DXA scan.

What mineral deficiency or toxicity may she have? (4 points)

What led you to that conclusion? (4 points)

Why did her doctor send her for a DXA scan? (4 points)

What diet and lifestyle recommendations would you make for Mrs. Smith? (4 points)

name the respiratory system structure