Limitations and Challenges

Week 2 discussion

Discussion Part I: Limitations and Challenges

From providing ongoing assessments to monitoring for complications and facilitating recovery, advanced practice nurses who care for patients in perioperative environments experience a unique set of limitations and challenges. Reflecting on your experiences in this complex and critical environment will help you develop your professional competency and prepare you for your future role as an advanced practice nurse. In this week’s Discussion, you consider limitations and challenges of clinical practice in perioperative care settings.

To prepare:

Reflect on this week’s clinical experiences.

Consider one limitation or challenge you encountered.

Think about how you overcame this limitation or challenge and how this might affect your future practice in pre- and post-operative care settings.

Post on or before Day 3 a description of at least one limitation or challenge you encountered during your clinical experience this week. Explain how you overcame this limitation or challenge and how this might affect your future practice.

Note: If you refer to a patient in your Discussions or Assignments, be sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

Read a selection of your colleagues’ responses.

Respond on or before Day 6 to two colleagues by sharing additional insights or alternative perspectives.

Discussion Part II: Pharmacology

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

To prepare:

Read the following articles to enhance your knowledge of commonly prescribed medications:

Ando, S., Yasugi, D., Matsumoto, T., Kanata, S., & Kasai, K. (2014). Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia. Psychiatry Clinical Neuroscience, 68(9), 721.

Dassanayake, T. L., Jones, A. L., Michie, P. T., Carter, G. L., McElduff, P., Stokes, B. J., & Whyte, I. M. (2012). Risk of road traffic accidents in patients discharged following treatment for psychotropic drug overdose: A self-controlled case series study in Australia. CNS Drugs 26(3), 269–276.

Retrieved from the Walden Library databases.

Kulick, D., & Deen, D. (2011). Specialized nutrition support. American Family Physician, 83(2), 173–183. Retrieved from http://www.aafp.org/afp/2011/0115/p173.html

Martini, D. I., Nacca, N., Haswell, D., Cobb, T., & Hodgman, M. (2015). Serotonin syndrome following metaxalone overdose and therapeutic use of a selective serotonin reuptake inhibitor. Clinical Toxicology 53(3), 185–187.

Robinson, A., & Wermeling, D. P. (2014). Intranasal naloxone administration for treatment of opioid overdose. American Journal of Health-System Pharmacy, 71(24), 2129–2135.

Retrieved from the Walden Library databases.

Thomas, D. R. (2013). Total parenteral nutrition (TPN). In The Merck Manual Professional Edition. Retrieved from http://www.merckmanuals.com/professional/nutritional_disorders/nutritional_support/total_parenteral_nutrition_tpn.html

All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage.

KPhos, bicarb, calcium, magnesium

Iron, folic acid, B12

Diamox

Macrolides

Muinolones/mluoroquinolone

Cephalosporins, 4th and 5th generation

Aminoglycosides

Carbapenems

Lipopeptide

Tigecycline

Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group.

For this Discussion, address 1 of the following options. Post by Day 3:

Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose.

Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication?

Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Discuss a patient to whom you would prescribe this medication.

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