homework 4 page

Did you provide a specific diagnosis along with the stage of asthma? This was discussed in several seminars. You cannot properly treat a patient until the patient is properly diagnosed. In seminar, we also discussed that this should not be written as a pathophysiology paper. The preponderance should be spent demonstrating your knowledge of the pharmacology of the treatment, not on the pathophysiology over and above providing rational for the diagnosis. Did you add additional, extraneous information by suggesting further testing or adding patient details?

2. Develop a treatment plan specifically for this patient, pharmacologic and non-pharmacologic.

Did you provide a specific treatment for THIS patient, not an overview of the pharmacology of the disease? The prescription writing exercise allowed you to practice prescribing a drug with dose and frequency. In seminar, we discussed treating this patient in front of you right now. Did you discuss non-pharmacologic management such as control of environmental factors like dust, pet dander, etc by using mattress covers, damp moping frequently, removing throw rugs, recognizing food triggers, etc. ? Although stress and anxiety are a component of the problem, did you discuss HOW the patient might manage this stressful time in life, NOT just “manage stress”. This is an area where you could bring the community resources in. Did you mention breathing technique, relaxation methods, exercise, or diet? These things should not be an after- thought, they are integral to synergism with pharmacologics.

In prescribing, did you use national guidelines within citations to support your choice of medications? Within that context, did you take into account the pregnant nature of the patient? The patient is experiencing some distress in your office. What are you going to do to address this immediate concern? A beta 2 antagonist is needed to break her cycle of constriction/inflammation. Although guidelines do discuss ipratropium at times, starting with a simple albuterol nebulizer in-office or via inhaler (since she has used this successfully in the past) is preferred. In pregnancy, one drug is always preferred over two until you see how one works. This also addresses the cost issue. Did you address BOTH inflammation AND constriction for short and long-term management? Did you provide a flu shot today? “Educating” the patient about the flu shot is not sufficient. The immunization should be part of your specific treatment plan.

3. Describe community resources (using your own community) currently available in your state/city to support this patient.

As discussed in seminar, this is not about using GoodRx or prescribing generics. This is about knowing what is available LOCALLY in your community for immediate assistance. In the seminar, I gave examples of religious organizations, shelters, etc. This patient has multiple socioeconomic needs not the least of which are transportation, housing, legal information or protection for domestic safety concerns, employment, meals, etc. While state and federal programs such as Medicaid, WIC, etc are valuable, LOCAL support services need to be included. These are often very valuable means of immediate support for patients.

4. Provide a communication plan that you will use to ensure the patient is an active participant in the treatment plan. Refer to therapeutic communication concepts.

The therapeutic communication discussion board and document posted on the announcement board were meant to prep you for this, more specific, assignment. This patient has psychosocial needs for which you might need to use specific techniques to draw her out. This may be the most important part of prescribing! Did you address how you would assess her communication needs and what specifically, you could do (silence, reflecting, confirming, etc) to draw information out?

5. Utilize national standards, your pharm and/or patho book, and medical or advanced practice professional sources. Do not use patient-facing sources or general nursing texts.

Are the individual aspects of your treatment plan supported by citation from national standards? As we discussed in seminar, you cannot just randomly begin assigning drugs. A clear, algorithmic approach from guidelines is necessary. Patient-facing sources do not provide sufficient depth of information to use as support.

6. Use references to support your concepts. Utilize correct APA formatting (7th edition) and mechanics of professional communication.

Did you actually look up the correct formatting for 7th edition? For each source, you should verify the correct format. APA 7th edition has few, but important, changes from 6th edition. Did you consult the Writing Center?

I am attaching here two examples of well written Unit 4 case studies. There were many to choose from but these two met many of the criteria. Neither is perfect but each illustrates important points. Compare these two case studies to yours in order to understand where you may improve your case.