Pharmacotherapeutics for Advanced Practice Nurse Essay Paper

In the “Do No Harm experience,” there is a lot to learn from Dr. Manning. My perception of the negative consequences of medication misuse changed substantially based on how he interacts with his client. In this case, the client is under the influence of various substances, including alcohol, and it appears that he did not consult with his doctor before changing his dosage.

The exercise taught me that in order to avoid medication misuse, clinicians must guarantee that they devote adequate time to patients to enlighten them about the consequences and hazards that might result from improper use of the medication. Another technique or strategy that the physician utilized on his client that I found to be impressive was the concept of harm minimization. It was through the application of this harm minimization technique that he was able to guarantee that his patient would not suffer the negative consequences of drug misuse, like disability or mortality Pharmacotherapeutics for Advanced Practice Nurse Essay Paper.

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The approaches and instruments used by Dr. Manning in his care of addicted patients would be quite useful in the real world. The harm minimization approach is among the techniques I envision myself adopting in the management of persons who have been affected by drug misuse. Educating patients about the hazards of misusing the medication would be another priority.

Dr. Manning and Dr. Edward’s connection and rapport are both productive and beneficial to each of them in their respective fields. Their relationship allows them to discuss the client with whom they are attending to. This allows them to share their knowledge and approaches for dealing with patients in a way that is mutually beneficial. Physicians, from my personal observation, often do not have the time to connect in this manner; nonetheless, I believe it is beneficial to both clinicians and clients and, therefore, should be fostered.

The depiction of the doctor-nurse connection in this exercise is remarkable and insightful. Based on my own personal observation, this sort of connection and relationship is quite unusual to come across. It makes sense to me that they incorporated this kind of interaction in the exercise to demonstrate just how beneficial it can be when used in a real-world setting Pharmacotherapeutics for Advanced Practice Nurse Essay Paper

Prompt #2 (Choice 3)

Schedules for the categorization of controlled drugs are divided into five categories. It is not permissible to utilize Schedule I medicines for therapeutic reasons. Heroin and marijuana are two examples of such substances. According to Woo (2019), schedule II drugs cannot be refilled, and they ought not to be obtained over the phone except if there is a proven medical urgency. Examples include codeine and morphine. Prescriptions for Schedule III medications must be revised after five refills or six months. Such drugs include Vicodin and methadone. There is one major difference between Schedule IV and III: unlawful acquisition of Schedule IV medicines is punishable by incarceration (Woo, 2019). Klonopin and valium are two examples of these drugs. Lastly, Schedule V drugs, such as Motofen and Lomotil, may be administered without them being prescribed.

The categorization of controlled drugs is done so that any clinician may administer and handle them in an appropriate manner. A rising number of people are concerned about the misuse of controlled drugs, and there are stringent standards for how to administer controlled medicines. Using the drug scheduling technique, a clinician may determine what dosage is appropriate and also how probable it is that addiction will develop. The more dependent one is, the more restrictive the regulations become. There are no schedules for drugs that are believed to be nonaddictive (Preuss et al., 2019). Prescribing of a controlled drug must now be disclosed to the Controlled Substance Utilization Review and Evaluation System in one day following the reception of the drug by the patient, which is a significant reform in California Pharmacotherapeutics for Advanced Practice Nurse Essay Paper

References

Preuss, C. V., Kalava, A., & King, K. C. (2019). Prescription of controlled substances: benefits and risks.

Woo, T. M. (2019). Pharmacotherapeutics for Advanced Practice Nurse Prescribers with 3-yr access to Davis Edge. https://online.vitalsource.com/#/books/9781719641531/

(Please reply to both prompts, for prompt 1, I don’t have the video, I’ll upload two sample paper, please write one page each and just talk about similar topic, and edit). Reply to both prompts. In the subject line of your posts, please identify which prompt you are responding to, for example, prompt #1. Discussion Prompt 1 (Complete the Do No Harm interactive in Week 1 first.) Reflect on your experience as Dr. Manning in the Do No Harm interactive exercise. How did this exercise affect your understanding of how to identify and prevent prescription medication misuse? What tools and techniques did you learn? Can you see yourself realistically using any of them in your practice? Why or why not? Additionally, choose two of the following to address: • Which patient(s) from the video do you feel you worked well with, and which patient situation could you have handled differently? Explain. • Which patient from the video was the most challenging for you to work with? Why? Do you think you would work with them in “real life” the same way that you worked with them in this simulation? • How realistic did you find the portrayal of the relationship between Dr. Manning and Dr. Edwards? In your experience, do doctors interact in this way? Why do you think their interaction was included in this scenario?  • How realistic did you find the portrayal of the relationship between the nurse practitioner and the doctor? In your experience, do doctors and NPs interact in this way? Why do you think their interaction was included in this scenario?  • How realistic do you think these patient situations are? In your experience, have you seen a need for increased vigilance in PMM? Explain. • How does PMM awareness and prevention support the Hippocratic Oath? Use one of the patient scenarios to support your answer. Discussion Prompt 2 Select one of the following case studies to address. In the subject line of your post, please identify which prompt you are responding to, for example, choice #2 using Schedule II substances. 1. Pharmacotherapeutics for Advanced Practice Nurse Essay Paper

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There are a variety of requirements or restrictions states may impose on advanced practice registered nurses (APRNs) who prescribe controlled substances. In your state, discuss the role of the APRN in administering and dispensing drugs under the federal drug classification and schedules. Discuss your state requirements and restrictions and identify practice barriers to the nurse practitioner role including the administration of controlled substances. 2. You have determined after a thorough history and examination that your patient’s injury requires treatment using a Schedule II substance. What are the policies for writing a prescription for a Schedule II CS? Can you offer the patient refills? What is the DEA policy on post-dated prescriptions for Schedule II drugs? How can you avoid tampering with prescriptions for controlled substances? This may vary by state. Make sure to research both the federal and state requirements where you practice. 3. Controlled substances are categorized using a classification system. Define the five different schedules for controlled drugs and provide examples of drugs in each schedule. Explain the reason why controlled substances need to be categorized. What are the associated controls required in your state for prescribing in each schedule? Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas. In your peer replies, please reply to at least one peer who chose a different topic. TEXTBOOK: Pharmacotherapeutics For Advanced Practice Nurse Prescribers • Author: Woo, T. & Robinson, M. • Publisher: F. A. Davis • Edition: 5th Chapter 1,2,3,4,5,8,10 Sample: Discussion Prompt 1: In the Do Not Harm Scenario, I learned the fundamental protocols of prescription misuse. I learned mistakes of health care providers, how to evaluate patient therapy to pain medications. I also learned a comprehensive assessment on how to treat patients taking pain medications. The most important guidelines for practice is when treating a patient who takes opioids is to consider all the causes for use. Assess for medication misuse. Establish an agreement for misuse. Establish goals and therapy, and regularly reassess the patient’s condition and level of functioning Pharmacotherapeutics for Advanced Practice Nurse Essay Paper

Lastly the Four A’s includes assess response to analgesia, activity, aberrant behavior and adverse side effects. I can see myself utilizing these tools and techniques as an advanced practitioner. I believe I worked well with Peterson. Patient stated he was pain free, I chose to assess further and deeper into the patient’s medication misuse and educating the patient, urine drug test is a means of documenting good clinical care. Dr. Cumming prescribed Peterson a different medication regimen to ensure that he was not misusing drugs and that the pain would likely return since it is an expected finding. Honesty will ensure that there is clear communication between the prescriber and patient. By stating the truth to Peterson, I followed the Hippocratic oath. “I will practice my profession with conscience and dignity” (Bruckenthal, 2007). It is important to state the goals of therapy and conditions, to establish trust and honesty with patients. I learned from this scenario that, when prescribing opioids, it is important to assesses for PMM, establish goals of therapy, prohibit misuse or diversion and assesses the patient’s status to pain regimen I felt the most challenging situation was working with Franklin. He stated he had heavy pain and that his medication regimen was not working. My choice was to assess his pain regimen further. I prescribed him other medications that would mitigate his pain. It is important to be honest to patients and tell them what to expect. Reference Bruckenthal, P. (2007). Controlled substances: Principles of safe prescribing. The Nurse Practitioner, 32(5), 7-11. Sample : Discussion Prompt#1 Dr. Manning’s experience in the “Do No Harm” interactive exercise was complex and nuanced throughout the care he provided. Opiate (and benzodiazepine) misuse is a difficult thing to manage. We are taught from the very beginning in nursing school that “pain is whatever the patient says it is” Pharmacotherapeutics for Advanced Practice Nurse Essay Paper

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Understanding this principle makes these waters very difficult to navigate. I am very familiar with addiction in nursing practice, as I have worked in chemical dependency nursing for several years. When the patient walks through the doors of a chemical dependency unit, our only concern is helping them to safely and comfortably detox off of the given substance. In addition, models of coping strategies and recovery are utilized for further outpatient treatment, but it is definitely a secondary concern that is more heavily focused on once they leave the facility. Ultimately, the interactive exercise was an excellent depiction of the roadblocks to providing adequate pain management while still being acutely aware of the potential for misuse of medications. One of the major takeaways from the situation was the need for being clear and assertive with patients about boundaries required as well as measures needed to be taken to continue treatment involving opiate prescriptions. This can be equally frustrating for both patients and clinicians. To provide adequate care, particularly under Peplau’s interpersonal nursing theory, there needs to be mutuality and empathy for each other’s needs. Under these circumstances, it is difficult to expand on the clinician-patient relationship when an impasse is reached with the patient’s desire for adequate pain management and the clinician’s desire for patient safety and ethicality. This is where the major disconnect for me existed in this exercise. While Dr. Manning did everything he was required to do, I felt that a degree of empathy was missing. I was very judgmental of his body language and tone of voice. However, I did appreciate that I could use a little bit more of the assertiveness that he illustrated when dealing with his patients. His ability to set boundaries was something that I could definitely learn from. I believe that I would be able to connect better with my patients than he did, but I appreciate how stringent he was in the situations presented in the exercises Pharmacotherapeutics for Advanced Practice Nurse Essay Paper