DD2

help.docx

L. P., age 23, is a Hispanic woman who graduated from college last year. She reports to the CNP in her local community mental health center. She began working as an accountant 1 month after graduating. Approximately 2 months ago, she moved into a two-bedroom apartment with another woman who works at the same accounting firm. She states that her roommate recommended that she see a doctor to find out if she has anemia or “some sort of fatigue syndrome.” She states that she has felt “restless” and “on edge” for most of the past 9 months. She becomes easily fatigued and irritable and has difficulty concentrating and falling asleep. She states that sometimes her mind “just goes blank,” and she is worried that her work performance is no longer excellent. She reports that all her life she had good grades in school and was very successful in everything she attempted. Although she has been “a worrier from the day I was born,” now she worries more than she ever has and feels nervous “all the time.” L. P. reports that she has a good relationship with her boyfriend but they do not get to see each other very often because he is attending graduate school 100 miles away. She reports having a satisfying sexual relationship with him. She denies having any problems with relationships with her parents, roommate, or peers. She denies having any financial worries unless she is fired from her job for poor work performance. She reports that she has always been healthy and has taken good care of herself. The only medication she takes is birth control pills, which she has taken for the past 4 years without any adverse effects.

In a paper not to exceed six pages, excluding title and reference pages, submit your answers to the following in an MS Word document:

1. What is L. P.’s likely diagnosis?

2. List specific pharmacotherapeutic treatment goals for L. P.

3. Should the CNP order any labs for L. P. at this time? Why?

4. What drug therapy would the CNP likely prescribe? Why?

5. What are the parameters for monitoring the success of the therapy?

6. Describe specific patient monitoring based on the prescribed therapy. What are the common side effects of the chosen drug therapy?

7. List two adverse reactions for the selected agent that would cause the CNP to change therapy. If a change is required, what would be the second line therapy of choice?

8. L. P. returns to see the CNP after six weeks, complaining of still feeling anxious and had heard of a medication called Klonopin that she would like to try; how should the CNP respond to her request?

9. What health promotion activities should be recommended for this patient?

What is L. P.’s long-term prognosis?

Competency	16	15	14	0	Points Earned
Diagnosis determination & treatment goals	Shows synthesis of patient data utilizing current evidence from the literature to determine diagnosis & treatment goals that are specific to the patient	Discusses patient data, diagnosis, & treatment goals with use of current evidence from the literature	Lists patient data without the connection shown between the data & diagnosis or treatment goals. No use of current evidence from the literature.	No discussion of a diagnosis & stage of disease	/16
Choice of medication therapy & lab tests	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.	/16
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		0/16
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		0/16
Health promotion, patient education, & long term prognosis	Describes 3 health promotion activities & 3 patient education topics specific to the patient and related to the medication therapy. Integrates a clear discussion of this patient’s long term prognosis based upon the medication therapy & individualized to this patient’s situation	Describes 2 health promotion activities & 2 patient education topics specific to the patient and related to the medication therapy including a brief discussion of the patient’s long term prognosis.	Lists only one health promotion activity & one patient education topic specific to the patient and related to the medication therapy &/or no discussion of the patient’s long term prognosis	No discussion of health promotion and patient education or discussion is not specific to the patient & the medication therapy	0/16
Competency	10	8	7	0
Use of Klonopin	Integrates knowledge of the patient & medication therapy to answer the patient’s question about Klonopin	Analyzes knowledge of the medication therapy to answer the patient’s question about Klonopin	Briefly discusses the use of Klonopin in general	No discussion of Klonopin	0/10
Competency	5	4	3	0
Grammar, 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	/5
APA Compliance	The paper meets APA formatting guidelines	There 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 errors	/5