R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years. He reports to the APRN-NP in his family practice clinic. He presents with progressive difficulty getting his breath while doing simple tasks. He is having difficulty doing any manual work, but he has no symptoms when working behind his desk. He also reports a cough, fatigue, and weight loss. He has been treated for three respiratory infections a year for the past 3 years and feels like another one is developing now. On physical examination, you notice clubbing of his fingers, use of accessory muscles for respiration, wheezing in the lungs, and hyperresonance on percussion of the lungs. Pulmonary function studies show an FEV1 of 58%.
In a paper not to exceed six pages, excluding title and reference pages, please answer the following:
Diagnosis & stage of disease
Shows synthesis of patient data utilizing current evidence from the literature to determine diagnosis & stage of disease
Discusses patient data, diagnosis, & stage of disease with use of current evidence from the literature
Lists patient data without the connection shown between the data & diagnosis or stage of the disease. No use of current evidence from the literature.
No discussion of a diagnosis & stage of disease
Pharmacotherapeutic treatment goals & choice of medication therapy
Well-defined evidence of
· critical thinking including treatment goals of medication therapy
· therapeutic decision-making in drug selection and evaluation of patient care
· pathophysiology and current pharmacological research
· assessment of the effectiveness of drug therapy
· formulation of clinical care and teaching plans for persons from diverse populations
Evidence of critical thinking in prescriptive therapy, monitoring and adverse events. May have lacked a teaching plan or pathophysiologic discussion.
Evidence of critical thinking but incompletely described therapeutic decision making and omitted teaching plan and pathophysiology.
Multiple bulleted points are absent or poorly defined in the assignment. There is no demonstration of critical thinking.
Patient monitoring & possible side effects
Synthesizes knowledge of patient & disease to provide well-defined discussion of parameters to determine success of treatment and possible side effects specific to this patient
Discusses parameters to determine success of treatment and possible side effects that are not specific to this patient
Briefly lists parameters to determine success of treatment and side effects that are not specific to this patient
Adverse reactions & second line therapy
Synthesizes knowledge of patient, disease, & medication to provide discussion supported by current research & literature showing two adverse reactions to the original chosen regimen necessitating a change & choice of second line therapy specific to this patient
Discusses two adverse medication reactions necessitating a change & choice of second line therapy that is not patient specific
Briefly lists one adverse medication reaction necessitating a change &/or a choice of second line therapy that is not appropriate for this patient
Health promotion & patient education
Describes 3 health promotion activities & 3 patient education topics specific to the patient and related to the medication therapy. Includes a discussion of potential side effects with differentiation between side effects & adverse effects.
Describes 2 health promotion activities & 2 patient education topics specific to the patient and related to the medication therapy
Lists only one health promotion activity & one patient education topic specific to the patient and related to the medication therapy
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