course materials

1. Sentinel N521 Advanced Pharmacology Assignment 2
Sentinel N521 Advanced Pharmacology Assignment 2Sentinel N521 Advanced
Pharmacology Assignment 2Assignment 2R. 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 his CNP 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%. Sentinel N521
Advanced Pharmacology Assignment 2In a paper not to exceed six pages, excluding title and
reference pages, please answer the following:What is R. W.’s likely diagnosis?What stage of
disease does RW have?List specific pharmacotherapeutic treatment goals for R. W.What
drug therapy would the CNP likely prescribe? Why?What are the parameters for monitoring
the success of the therapy?Describe specific patient education based on the prescribed
therapy.List one or two adverse reactions for the selected agent that would cause the CNP
to change therapy.What would be the choice for second-line therapy?What health
promotion activities should be recommended for this patient?If RW was currently taking
metoprolol for “headaches” would a change be recommended? Sentinel N521 Advanced
Pharmacology Assignment 2Please use the Case Study Analysis rubric provided to guide you
in completing this assignment. It will be used to evaluate your submitted work.Competency
40 36 33 0 Points EarnedCase Study questions completely and
thoroughly answered with accurate evidence-based ed rationales Accurate and well
defined discussion of all 10 questions for the case study using current evidence-based
resources. Sentinel N521 Advanced Pharmacology Assignment 2 Accurate discussion of
nine case study questions presented with use of current evidence-based resources.
Accurate discussion of 8 questions using current evidence-based resources
Missing response to questions or inappropriate answers to questions. No use of
evidence-based resources. /40Sentinel N521 Advanced Pharmacology Assignment 2
40 36 33 0 Evidence ofcritical thinkingtherapeutic decision-
making in drug selection and evaluation of patient carepathophysiology and current
pharmacological researchassessment of the effectiveness of drug therapyformulation of
clinical care and teaching plans for persons from diverse populationsWell-defined evidence

2. ofcritical thinkingtherapeutic decision-making in drug selection and evaluation of patient
carepathophysiology and current pharmacological researchassessment of the effectiveness
of drug therapyformulation 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.
/40Sentinel N521 Advanced Pharmacology Assignment 2 10 9 8
0 Points EarnedGrammar, spelling, and punctuation There are no errors in
grammar, spelling, and punctuation There are a few minor errors in grammar, spelling,
and punctuation that do not detract from the meaning (1-3 errors) There are major errors
in grammar, spelling, and punctuation .(4-5 errors) No content or more than 5 errors
/10Sentinel N521 Advanced Pharmacology Assignment 2 10 9 8
0 APA Compliance The paper meets APA formatting guidelines There
are a few minor errors (1-3 errors) Sentinel N521 Advanced Pharmacology Assignment 2
There are significant errors in the format of the paper (4-5 errors) No content or
more than 5 errors /10Total Points /100 Case
Study questions completely and thoroughly answered with accurate evidence-based ed
rationalesAccurate and well defined discussion of all 10 questions for the case study using
current evidence-based resources.Accurate discussion of nine case study
questions presented with use of current evidence-based resources.Accurate discussion of 8
questions using current evidence-based resourcesMissing response to questions or
inappropriate answers to questions. No use of evidence-based resources. Sentinel N521
Advanced Pharmacology Assignment 2Evidence of critical thinking 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 populationsWell-defined evidence
of critical thinking 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
populationsEvidence 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.Points EarnedGrammar, spelling,
and punctuationThere are no errors in grammar, spelling, and punctuationThere are a few
minor errors in grammar, spelling, and punctuation that do not detract from the meaning
(1-3 errors)There are major errors in grammar, spelling, and punctuation .(4-5 errors)
Sentinel N521 Advanced Pharmacology Assignment 2No content or more than 5 errorsAPA
ComplianceThe paper meets APA formatting guidelinesThere are a few minor errors (1-3
errors)There are significant errors in the format of the paper (4-5 errors)No content or
more than 5 errorsTotal Points/100Sentinel N521 Advanced Pharmacology Assignment 2

3. Discussion 4R. S., a 65-year-old African-American man, was referred to the CNP in the
hypertension clinic for evaluation of high BP noted on an initial screening. He reports
having headaches and nocturia. He states that he has gained 8 pounds over the last year.
Past medical history: Appendectomy 30 years ago, Peptic ulcer disease 10 years ago, Type 2
diabetes mellitus for 10 years; Family history: Father had hypertension; died of myocardial
infarction at age 55,Mother had diabetes mellitus and hypertension; died of cerebrovascular
accident at age 60; Physical examination: Height 69 in, weight 108 kg; BP: 140/89 mm Hg
(left arm), 138/82 mm Hg (right arm); Pulse: 84 beats/min, regular; Funduscopic
examination: mild arterial narrowing, sharp discs, no exudates or hemorrhages; Sentinel
N521 Advanced Pharmacology Assignment 2Laboratory findings: Blood urea nitrogen: 24
mg/dL, Serum creatinine: 1.5 mg/dL, Glucose: 95 mg/dL, Potassium: 4.0 mEq/L, Total
cholesterol: 201 mg/dL, High-density lipoprotein cholesterol: 30 mg/dL, Triglycerides: 167
mg/dL, Urinalysis: 1+ proteinuria; Electrocardiogram and chest radiograph: mild left
ventricular hypertrophy; Social history: Tobacco: 35 pack years, Alcohol: pint of
vodka/week, Coffee: 2 cups/dayDiagnosis: Stage 1 HypertensionIn this discussion
forum:Discuss specific goals for pharmacotherapy for treating R. S.’s hypertension and
cholesterolDiscuss what you would consider to be first-line pharmacotherapy for R. S., and
why.Discuss the parameters for monitoring the success of the therapy.Discuss health
promotion recommendations you would consider for R. S.Does the presence of Diabetes
Mellitus impact your treatment selection?Remember to respond to at least two of your
peers. Please see the Course Syllabus for Discussion Participation Requirements and
Grading Criteria.Sentinel N521 Advanced Pharmacology Assignment 2 Example Discussion
4 ApproachSpecific therapy goals on the patient, in this case, R.S, include decreased blood
pressure, decreased cholesterol, and lower cardiovascular disease risk (Arcangelo &
Peterson, 2017). First-line therapy is influenced by age, ethnicity/race, and other medical
conditions (Arcangelo & Peterson, 2017). To treat the diagnosed hypertension, R.S should
be prescribed a diuretic, specifically a thiazide diuretic.Being that R.S is of African American
descent, he should be more responsive to monotherapy with the diuretic (Arcangelo &
Peterson, 2017). The hypertension treatment needs to be considered in the presence of
kidney issues. Arcangelo & Peterson (2017) state that the first line of treatment for
dyslipidemia includes HMG-CoA reductase inhibitors or statins.Monitoring a patient’s
fasting lip levels for one to three months after therapy initiation is vital. If the LDL levels
decrease, this is considered a success. A reduction of fifty percent is what is expected in a
high-dose statin. A reduction of thirty percent should be seen with a moderate dose statin
treatment (Arcangelo & Peterson, Sentinel N521 Advanced Pharmacology Assignment 2
2017).This patient has a diagnosis of diabetes. The goal in treating a patient in the presence
of this condition and hypertension includes a blood pressure reading of less than 140/90
(Arcangelo & Peterson, 2017). Blood pressure needs to be measured at every visit. How a
patient has been modifying their lifestyle should be readdressed. If a patient is not
responding, a hypertension specialist’s referral may be needed (Arcangelo & Peterson,
Sentinel N521 Advanced Pharmacology Assignment 2 2017).According to Arcangelo &
Peterson (2017), African Americans are more prone to hypertension. R.S has a genetic
predisposition to hypertension, diabetes, and hyperlipidemia. The patient should be

4. educated at each visit on healthy lifestyle choices. R.S needs to change his diet and eating
habits, maintain average body weight through exercise of at least one hundred and fifty
minutes a week R.S should be educated on smoking and alcohol cessation, and a low
sodium diet with a therapeutic plan should always be encouraged. Sentinel N521 Advanced
Pharmacology Assignment 2Arcangelo, V. P., Peterson, A. M., Wilbur, V. F., & Reinhold, J. A.
(2017). Pharmacotherapeutics for advanced practice: a practical approach. Wolters Kluwer.
Sentinel N521 Advanced Pharmacology Assignment 2