Module 01 Content

1.

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Many people in the US, particularly the elderly, take more than one prescribed medication. CDC (2014) reported that between 2009 and 2012 nearly 48% of persons asked used at least one prescription drug, 22% used three or more prescription drugs, and nearly 11% used five or more.

In a recent study published by the Mayo Clinic, seven out of 10 Americans take at least one prescription drug. The most commonly prescribed drug is antibiotics — taken by 17 percent of Americans — followed by antidepressants and opioids — each taken by 13 percent of Americans. In addition, findings showed that:

· Even more staggering than the CDC findings, currently more than half of Americans take two prescription medications, and 20 percent of Americans are on at least five prescription medications.

· More women than men receive prescription medications.

· Antidepressant prescriptions are more common among women than men and are most common among women ages 50 to 64.

When people take multiple medications, there is a greater risk of confusion about which medications are taken when they are taken, and what they are being taken for. There is also a higher risk for drug interactions and increased side effects and adverse reactions.

Sometimes because of the sheer number of medications being prescribed, they may be forgotten, become too much of a bother, or a financial burden which can significantly impact client compliance and lead to poor health outcomes.

In this written assignment, you will be interviewing a client who is taking multiple prescribed medications (three or more) and submitting a written paper describing the findings from the interview. You will then develop a Client Teaching Plan. Your instructor will assist you in the selection of the client. You must achieve a “pass” in this assignment to satisfactorily fulfill the requirements for the Pharmacology course.

The three parts of this assignment are:

Interview with a client who is taking multiple medications (polypharmacy). You must prepare the client before the interview by explaining why you are conducting the interview. You can say “My assignment is to find out about the medications you are taking so I can determine if you need more information about what you are taking”. You must always get permission from the client to conduct the interview and you must tell the client how the information will be used. You can say, “I will not be using your name in the information I share and I will be submitting it to my instructor only for this student assignment”. If there is important information that needs to be communicated to you, your doctor, family, or nurse, my instructor will assist me in following up on this”. Tell the client you will take no more than 30-45 minutes for the interview.

There may be a family member or significant other present during the interview. That is fine. Be sure to identify who answered a question and if possible always have the client answer first. Always thank the client (and others) when you complete the interview.

Do not use recording equipment for this interview. Have a notepad and pencil or pen and explain that you will be taking notes. When the interview is over, go to a quiet place and take some time to fill in any information you did not jot down. If you wait, you will not remember.

When setting the environment for the interview, make sure the client (and others) are comfortable and you are comfortably seated facing the client. If possible, interview in a quiet place. Ask questions slowly giving the client time to answer. Pay attention to the client's hearing and ability to respond to the questions. Be sure your non-verbal communication demonstrates you are calm and relaxed.

Use the following interview question guidelines when conducting the interview. Be aware that the client may not be able to answer each of the questions with detailed information. Collect as much information as the client is able and willing to give you. Remember you are the interviewer so you will be collecting information and not making any comments about the information shared by the client except to ask for further clarification if you are not sure what was said or need more detail if it is available.

1. What medications are you taking?

1. Before the interview research each of the medications. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions.

For the following questions, paraphrase the client's answers for your written paper.

1. How long have you taken each of these medications?

1. Do you know why you are taking these medications?

1. Who told you about the medications and why do you need to take them? Were you able to ask any questions about the medications and if so were they answered so you understood what was said?

1. How do you feel about taking these medications?

1. Are you taking other medication purchased “over the counter” such as in a drug store? If so, what is it and why are you taking it?

1. How and when do you take your medications?

1. Do you have any difficulty taking the medications? If so, what happens and how do you deal with any difficulties?

1. Have you ever felt any uncomfortable feelings and body reactions to taking these medications? If so, what were they and how were they handled?

1. If you had the above reaction, did they take you off the medication and replace it with another medication? Were you told why this happened?

1. Do you have any reason not to take the medications?

1. Have you ever not taken the medication? If so, what was the reason?

Ask a final question about whether the client would like to tell you anything further about their medications.

Write a paper describing your research and findings about the medications being taken and the interview results. Report your findings in a 3-5 page written paper. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions.

Use accurate and appropriate spelling and grammar and APA Editorial Format for sources used in your written paper.

Develop a teaching plan for this client based on your findings. Based on the findings from the interview, develop a 2-3 page teaching plan to include the following:

1. List one goal for this teaching plan

1. Describe two to three teaching resources that might be used

1. Identify two teaching strategies that can be used based on the client interviewed

1. List specific client instructions regarding the medications what adverse reactions they should be aware of/and what to do

1. Identify at least one factor that may negatively influence adherence to the medications and how it can be overcome

1. If, appropriate, describe how the family might be involved in ensuring the client is on a proper and safe medication regime

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Review Table 2.2. Create 4 Research questions related to your nursing clinical practice area and/or role.  One of each type: correlational, comparative, experimental, and phenomenology.  

2. Review Table 2.3. Choose one of your research questions and map out the Independent, dependent variable, population, and testability. 

Mr. Rivera is a 72-year-old patient with end stage COPD who is in the care of Hospice. He has a history of smoking, hypertension, obesity, and type 2 Diabetes. He is on Oxygen 2L per nasal cannula around the clock. His wife and 2 adult children help with his care. Develop a concept map for Mr. Rivera. Consider the patients Ethnic background (he and his family are from Mexico) and family dynamics. Please use the concept map form provided. 

 

Initial Post: Toddlers have behavioral characteristics that often present challenging situations for parents and/or caregivers.

Describe challenges parents and/or caregivers would encounter with these specific characteristics.

• Temperament
• Nutritional Barriers
• Hygiene,
• Activity
• Sleep

Student Instructions for i-Human Virtual Simulation

NR325/NR330 Scott Baldwin

PURPOSE:

The following information is to be used in guiding your preparation and participation in the virtual simulation scenario for this course. This document will provide applicable course outcomes in preparation for your simulation.

SCENARIO OVERVIEW:

19-year-old male presents to the emergency department for a single episode of collapse with jerking and a loss of consciousness.

LEARNER OBJECTIVES:

1. Define the components of a focused nursing assessment. (CO1, 2)

2. Explain the approach for a focused nursing assessment for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2)

3. Demonstrate an appropriate assessment for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2, 3)

4. Distinguish between the treatment/interventions options for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2, 4, 6)

5. Recommend appropriate treatment/interventions for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2, 3, 4, 6)

6. Design an appropriate care plan for an adult brought to the emergency department, via ambulance, for a single episode of collapse with jerking and loss of consciousness. (CO1, 2, 4, 6)

STUDENT ROLES DURING SIMULATION:

You are the staff nurse at the hospital who will be conducting a comprehensive assessment. After completing your assessment, you are expected to document your findings as a nurses note in SBAR format.

KEY FEATURES OF i-HUMAN:

· As the nurse, you are expected to complete the case scenario using the following tabs: EHR, History, Physical, Nursing Notes, Summary

· There are required questions and/or additional information provided related to this case. The questions, information, and videos must be completed/reviewed prior to progressing to the next tab.

· Nursing Notes: At the end of the simulation, you will document your assessment findings using ISBAR.

CONFIDENTIALITY:

To preserve the educational value, integrity, and safety of the learning environment, you agree to maintain strict confidentiality about the proceedings of the simulation session, details of the training scenarios, and the performance of all participants. You acknowledge that this expectation aligns with the guidelines related to the Health Insurance Portability and Accountability Act (HIPAA) as well as laws governing Protected Health Information (PHI) in client care environments.  You will not view, discuss, share, record, or disclose any confidential information pertaining to the session. You understand that lapses in confidentiality are considered academic misconduct and could result in dismissal from the academic program. 

 

FICTION AGREEMENT:

You will suspend judgment of realism for any given simulation in exchange for the promise of learning new knowledge and skills, treating the simulated patients with the same care due an actual patient, act with a genuine desire to learn even when it may be difficult to do so.  

DUE DATE:

The virtual simulation must be completed during

Week 5
.

SIMULATION TIMING:

· Pre-simulation preparation: 30-60 minutes

· Pre-brief: 15 minutes

· Run Time: 2.75 hours

· Debriefing: 60 minutes

ASSESSMENT & EVALUATION

Faculty will utilize your participation measurements in the i-Human case, and debriefing discussions to identify areas of opportunity for enhancement of your clinical growth. Your experiences in i-Human will contribute to your overall completion of clinical requirements for the course as documented on the Clinical Learning Evaluation tool.

i-Human Evaluation – What does my total score mean?

REVIEW AND COMPLETE PRIOR TO THE START OF THE VIRTUAL SIMULATION:

To prepare for the simulation, you are
required to complete the pre-simulation questions below and submit this prework to the faculty via uploading your Word document in Canvas prior to the start of the virtual simulation. If you do not complete the pre-simulation questions and upload them, you will

not
be able to access or participate in the simulation.

1. Create a list of symptoms/cues a nurse would expect to find during each of the phases of a seizure.

a. Pre-Ictal Phase

b. Early Ictal Phase

c. Late Ictal Phase

d. Post-Ictal Phase

2. The healthcare provider ordered Lorazepam PRN for a client at risk for having a seizure. Describe the information that a nurse should know prior to administration including:

a. Purpose of the Medication

b. Therapeutic Use

c. Complications

d. Interventions

e. Medication Administration, Contraindications, Precautions

f. Nursing Interventions

g. Client Education

h. Evaluation of Medication Effectiveness

3. A nurse is caring for a client who suddenly begins to have a seizure. What are the priority nursing actions?

**Immediately following the completion of the virtual simulation, you will complete the evaluation of the simulation using the link provided.

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