Special Considerations for Patient Populations Paper
To complete this assignment, you will utilize the case study assigned to you by faculty for a patient population for special consideration during prescribing practices. You will consider the specific patient and determine the appropriate medication to prescribe, based on the patient specifics and medication attributes in various case studies. You will construct a 4- to 5-page paper in which you determine the medication, the dosing, necessary patient education, and potential side effects. You will also indicate why the other medications would not be appropriate, as well as any necessary labs or diagnostics that might be needed. You will develop a plan to enhance medication adherence for the nonadherent patient.
Special Considerations for Patient Population Cases:
Week 10 Assignment 2 – Choose the case of your choice
Choose the case of your choice
• Patient 1: 82-year-old male presenting with cognitive decline. He had always been a very active individual. Over the past year, he has become less active in the community. Previously, he played cribbage weekly with friends at the local senior center but has been struggling with the math involved with the game and no longer attends the weekly card game. He had also volunteered as a crossing guard for the local public school. He quit doing that after he took the wrong turn to get home and drove around the town feeling lost. He acknowledges he is “sensitive” to this and can be irritable towards his children when they bring up these concerns. He was diagnosed with mild neurocognitive disorder after completing neuropsychological testing. Of the following medications, which would be the most appropriate to prescribe? Explain why you chose this medication. What would be the dosing schedule for this patient? Provide education to the patient and review risks, benefits, and potential side effects of the medication. In addition, explain why the other medications listed are not appropriate for this patient. Med List: lorazepam, olanzapine, memantine
• Patient 2: 76-year-old female who recently moved from her home to an assisted living. After 1 week of moving in, she has become extremely confused. Staff have attempted to re-orient her, and she struggles to focus on what they are saying. She is only oriented to self. She has become very agitated and has even thrown breakable objects in her room. Her family is concerned stating she is “out of it.” The PCP ordered labs and UA. Labs are unremarkable outside of mild leukocytosis and positive dipstick analysis for nitrite and red blood cells. Med List: valproate, alprazolam, trimethoprim
• Patient 3: A 33-year-old female that is 6 weeks postpartum. She presents with depressed mood, sadness, easily emotional, difficulties with sleep even when the infant is sleeping. She has lost weight and has a poor appetite. You note psychomotor retardation. She has limited interests in hobbies or bonding with the infant. Her partner is concerned and reports she is typically active and “bubbly” and enjoys the outdoors. She is diagnosed with major depressive disorder, with postpartum onset. She denies suicidal ideation, homicidal ideation, or infanticidal ideation. No psychotic symptoms are present. She is nursing the infant and wants to continue this hoping it will assist with bonding with the infant. Med List: lithium, paroxetine, sertraline
• Patient 4: 10-year-old male who comes in with his father. He has been diagnosed with generalized anxiety disorder. He has constant worries that he cannot control. He feels nervous and tense. He is easily irritable. He struggles to settle down or relax. He is also quite fidgety and restless. He and his father are interested in medications to manage these symptoms. Med List: quetiapine, duloxetine, fluoxetine
• Patient 5: 27-year-old male with a diagnosis of schizophrenia. He has been hospitalized three (3) times in the past 1 year due to symptoms. When symptomatic, he becomes disorganized and paranoid. He will respond to auditory hallucinations. He will scream out at night after seeing a shadow in his room. He has delusions that the CIA is poisoning food and will not eat for multiple days. He has unintentionally hurt his mother after “slapping” food out of her hand, as he did not want her to ingest the “poisoned food.” Symptoms are treated very well with paliperidone, but he struggles to remember to take it. Med List: paliperidone palmitate, clozapine, lamotrigine
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
• Review the Learning Resources.
• Carefully review your assigned vulnerable population patient.
• Carefully review the medication list to determine the best medication to prescribe.
• Consider the implications, impact, advantages, and disadvantages of the listed medications.
The Assignment (4–5 pages)
Construct a paper concerning your assigned vulnerable population patient case. In your paper include the following:
• Determine which medication would be most appropriate to prescribe from the assigned vulnerable population patient case medication choices.
• Explain your rationale for choosing this medication. Explain why the other medications listed are not appropriate for this patient.
• Explain the dosing schedule for the specific patient including the therapeutic endpoint.
• Provide necessary education to the patient to review risks, benefits, and potential side effects of the medication.
• Describe any necessary labs or additional diagnostics needed prior to prescribing this medication.
• Explain how you might monitor efficacy or side effects of the medication.
• Include any additional collaboration or education to others that would be necessary for this patient. Consider family members, home health care, primary care providers, etc.
• What would you need to include in your assessment for a patient who may become nonadherent with your prescribing plan for your scenario? What are alternative treatment solutions based upon how you assessed? Describe your new treatment plan.
This Assignment requires a minimum of five (5) peer-reviewed, evidence-based scholarly references outside of course resources.
Note: You will need to include the APA style formatting.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Walden Writing Center Sample PaperLinks to an external site. provides an example of those required elements. All papers submitted must use this formatting.
By Day 7 of Week 10
Submit by Day 7 of Week 10.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
1. To submit your completed assignment, save your Assignment as WK10Assgn2_LastName_Firstinitial
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.
LEARNING RESOURCES
Readings
• Mayo Clinic. (2022, March 19). Antidepressants for children and teensLinks to an external site.. https://www.mayoclinic.org/diseases-conditions/teen-depression/in-depth/antidepressants/art-20047502
• Walkup, J. (2009, September). Practice parameter on the use of psychotropic medication in children and adolescentsLinks to an external site.. Journal of the American Academy of Child & Adolescent Psychiatry, 48(9), 962—973. https://doi.org/10.1097/CHI.0b013e3181ae0a08
• Vickery, P. B. (2023, December 1). Concepts for selection and utilization of psychiatric medications in pregnancyLinks to an external site.. Mental Health Clinician, 12(6), 255—267. https://doi.org/10.9740/mhc.2023.12.255
• Zhuk, R. (2022, March 16). Caring for pregnant women: A psychiatrist’s guideLinks to an external site.. American Psychiatric Association Blogs. https://www.psychiatry.org/news-room/apa-blogs/caring-for-pregnant-women-a-psychiatrists-guide
• Grover, S. & Avasthi, A. (2023, February). Clinical practice guidelines for the assessment and management of elderly presenting with psychiatric emergenciesLinks to an external site.. Indian Journal of Psychiatry, 65(2), 140—158. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10096200/
• Turner, L. (2022, July 21). How to write a prescription: 7 steps for safetyLinks to an external site.. https://www.studentdoctor.net/2018/08/15/how-to-write-a-prescription/
• Drugs.comLinks to an external site.. (2023). https://www.drugs.com/
Note: Please use the following resource to check the most up-to-date box warnings, FDA approvals and indications, recommendations for follow-up evaluations, changes, etc.
Media Resources
• Pharmacy by asim. (2021, April 26). Prescription writing! How to write a prescription | Prescription formatLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=B9h53gy2838
• Psychopharmacology Institute. (2021, June 12). Nonadherence and side effectsLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=VF09in9_wsE
Optional Media
• Psychopharmacology Institute. (2021, June 18). Improving psychotropic drug adherenceLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=bmgGmda5Ki8
• Psychopharmacology Institute. (2021, June 24). Technology-facilitated adherence enhancement and family involvementLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=US9ZA5VxDS0
Rubric
NURS_6630_Week10_Assignment2_Rubric
NURS_6630_Week10_Assignment2_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDescribes the selected medication and explains the selection, dosing, and necessary patient education. 20 to >18.0 pts
Excellent
The response comprehensively and clearly describes the selected medication, dosing, and patient education information. The response includes relevant, specific, and appropriate examples that fully support the selection, dosing, and patient education information. 18 to >15.0 pts
Good
The response clearly describes the selected medication, dosing, and patient education information. The response includes relevant, specific, and accurate examples that support the selection, dosing, and patient education information. 15 to >10.0 pts
Fair
The response inaccurately and vaguely describes the selected medication, dosing, and patient education information. The response includes inaccurate and irrelevant examples that may support the selection, dosing, and patient education information. 10 to >0 pts
Poor
The response includes inaccurate and vague examples that does not describe the selected medication, dosing, and patient education information, or some or all are missing. The response includes inaccurate and vague examples that do not support the selection, dosing, and patient education information, or it is missing.
20 pts
This criterion is linked to a Learning OutcomeDescribes any necessary labs or diagnostics needed prior to prescribing, as well as how side effects and efficacy will be monitored. 20 to >18.0 pts
Excellent
The response comprehensively and clearly describes needed labs and other diagnostics. The response comprehensively and clearly describes monitoring of efficacy and side effects. The response includes relevant, specific, and appropriate examples that fully support the descriptions. 18 to >15.0 pts
Good
The response clearly describes needed labs and other diagnostics. The response clearly describes monitoring of efficacy and side effects. The response includes relevant, specific, and accurate examples that support the descriptions. 15 to >10.0 pts
Fair
The response inaccurately or vaguely describes needed labs and other diagnostics. The response inaccurately or vaguely describes monitoring of efficacy and side effects. The response includes inaccurate and irrelevant examples that may support the descriptions. 10 to >0 pts
Poor
The response inaccurately and vaguely describes needed labs and other diagnostics, or it is missing. The response inaccurately and vaguely describes monitoring of efficacy and side effects, or it is missing. The response includes inaccurate and vague examples that do not support the descriptions, or it is missing.
20 pts
This criterion is linked to a Learning Outcome20
Explains why the other medications are not appropriate 20 to >18.0 pts
Excellent
The response comprehensively and fully details why other medications are not appropriate. The response includes relevant, specific, and appropriate examples that fully support the explanation. 18 to >15.0 pts
Good
The response clearly details why other medications are not appropriate. The response includes relevant, specific, and accurate examples that support the explanation. 15 to >10.0 pts
Fair
The response inaccurately or vaguely details why other medications are not appropriate. The response includes inaccurate and irrelevant examples that may support the explanation. 10 to >0 pts
Poor
The response includes inaccurate and vague examples that do not support why other medications are not appropriate, or it is missing. The response includes inaccurate and vague examples that do not support the explanation, or it is missing.
20 pts
This criterion is linked to a Learning OutcomeProvides any additional collaboration or education necessary for the patient. Discussion includes: what would be needed to include in the assessment for a patient who may become nonadherent with the prescribing plan. Discussion includes what are alternative treatment solutions based upon assessment. Describes a new treatment plan based upon these factors. 20 to >18.0 pts
Excellent
The response accurately and clearly provides all additional necessary information. The response includes relevant, specific, and appropriate examples the information. 18 to >15.0 pts
Good
The response accurately provides all additional necessary information. The response includes relevant, specific, and accurate examples that support the information. 15 to >10.0 pts
Fair
The response inaccurately or vaguely provides all additional necessary information. The response includes inaccurate and irrelevant examples that may support the information. 10 to >0 pts
Poor
The response inaccurately and vaguely provides all additional necessary information, or it is missing. The response includes inaccurate and vague examples that do not support the information, or it is missing.
20 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. Writes succinctly 4–5 page paper. 10 to >7.0 pts
Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided, which delineates all required criteria. Writes succinctly 4–5 page paper. 7 to >4.0 pts
Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the Assignment is stated yet is brief and not descriptive. Writes succinctly 4–7 page paper. 4 to >1.0 pts
Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the Assignment is vague or off topic. Writes succinctly 8–9 page paper. 1 to >0 pts
Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. No purpose statement, introduction, or conclusion was provided. Does not write succinctly 10+ page paper.
10 pts
This criterion is linked to a Learning Outcome5
Written Expression and Formatting—English writing standards:
Correct grammar, mechanics, and proper punctuation 5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors. 4 to >3.0 pts
Good
Contains a one or two grammar, spelling, and punctuation errors. 3 to >1.0 pts
Fair
Contains three or four grammar, spelling, and punctuation errors. 1 to >0 pts
Poor
Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning Outcome5
Written Expression and Formatting: The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5 to >4.0 pts
Excellent
format with no errors. Contains a minimum of 5 peer-reviewed, evidence-based scholarly references outside of course resources. 4 to >3.0 pts
Good
Contains a one or two APA format errors. Contains a minimum of 3-4 peer-reviewed, evidence-based scholarly references outside of course resources. 3 to >1.0 pts
Fair
Contains three or four APA format errors. Contains a minimum of 1-2 peer-reviewed, evidence-based scholarly references outside of course resources. 1 to >0 pts
Poor
Contains five or more APA format errors. Contains no peer-reviewed, evidence-based scholarly references outsi
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