(Solved) NR565 Week 3: Hypertension and Lipid Protocol – Assignment Solution

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Week 3: Hypertension and Lipid Protocol – Assignment

Purpose

The purpose of this assignment is to develop a standardized procedure or protocol that is applicable to the nurse practitioner role. This assignment will allow for discovery into protocol development as well as establishing a standardized treatment plan for a given diagnosis according to current evidence. This assignment supports the professional formation of the FNP, AGACNP, AGACNP, and PMHNP practice role.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

• CO1: Identify the most commonly prescribed agents in the major drug classes.
• CO2: Make appropriate evidence-based therapeutic treatment decisions for individual patients utilizing drugs from the major drug classes.
• CO3: Apply knowledge of pharmacokinetics, pharmacodynamics and pharmacogenomics in prescribing patient treatment.
• CO4: Distinguish internal and external environment factors affecting drug action, reaction, efficacy, and interaction.
• CO5: Identify client indicators of therapeutic, ineffective, adverse responses and side effects to drug therapy.

Preparing the Assignment

Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

1. Complete the outline templateLinks to an external site.provided for the sections highlighted in yellow and the “click to enter text here” is indicated.
2. Provide references for your protocol at the bottom of the form where indicated. References should come from the following sources: Hypertension and Lipid Protocol
   1. Clinical Practice Guidelines
      • DyslipidemiaLinks to an external site.
      • HTNLinks to an external site.You can click on “Figures/Tables” on the right-hand side of the screen to take you to the algorithm/decision tree to get directly to the information you are looking for to work through the assignment to see how hypertension is treated according to this guideline.
   2. Course Textbook | Hypertension and Lipid Protocol

Rubric

Week 3: Hypertension and Lipid Protocol

Week 3: Hypertension and Lipid Protocol
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomePharmacological Treatment: 6a: HTN Clinical Practice Guideline	40 pts Excellent Includes no fewer than 20 blanks completed correctly. Requirements: • 4 Drug Category/Classifications listed in order according to CPG • 4 Generic named examples for each category (20 Total blanks to complete correctly) 36 pts Very Good 16-19 blanks completed correctly. 33 pts Satisfactory 11-15 blanks completed correctly. 20 pts Needs Improvement 10 blanks completed correctly. 0 pts Unsatisfactory 0-9 blanks completed correctly for this section presented.	40 pts
This criterion is linked to a Learning Outcome Pharmacological Treatment: 6b: 1st line treatment for non-African American	20 pts Excellent Includes no fewer than 8 requirements. Requirements: 1. Drug 2. Dose 3. Route 4. Frequency 5. Instructions 6. Cautions/Precautions 7. Cost 8. Patient Education 18 pts Very Good Includes no fewer than 6 requirements. 16 pts Sati Includes no fewer than 4 requirements. 10 pts Need Includes no fewer than 3 requirements. 0 pts Uns 0-2 requirements for this section presented. Hypertension and Lipid Protocol	20 pts
This criterion is linked to a Learning Outcome Pharmacological Treatment: 6c: 1st line treatment for African American	20 pts Excellent Includes no fewer than 8 requirements. Requirements: 1. Drug 2. Dose 3. Route 4. Frequency 5. Instructions 6. Cautions/Precautions 7. Cost 8. Patient Education 18 pts Very Good Includes no fewer than 6 requirements. 16 pts Sati Includes no fewer than 4 requirements. 10 pts Need Includes no fewer than 3 requirements. 0 pts Uns 0-2 requirements for this section presented.	20 pts
This criterion is linked to a Learning Outcome6d and 8a	10 pts Excellent Includes no fewer than 4 blanks completed correctly. Requirements: Answer the prompts for 6d and 8a which includes 4 blanks to complete. 9 pts Very Good Includes no fewer than 3 blanks completed correctly. 8 pts Satisfactory Includes no fewer than 2 blanks completed correctly. 5 pts Needs Improvement Includes no fewer than 1 blank completed correctly. 0 pts Unsatisfactory No blanks completed correctly. Hypertension and Lipid Protocol	10 pts
This criterion is linked to a Learning OutcomeStatin Therapy 6e	10 pts Excellent Includes no fewer than 14 blanks completed correctly. Requirements: 14 blanks to complete table 9 pts Very Good 10-13 blanks completed correctly. 8 pts Satisfactory 5-9 blanks completed correctly. 5 pts Needs Improvement 2-4 blanks completed correctly. 0 pts Unsatisfactory 0-1 blanks completed correctly for this section presented.	10 pts
This criterion is linked to a Learning OutcomeTreatment Monitoring 7a-c	10 pts Excellent Includes no fewer than 5 blanks completed correctly. Requirements: 1. Follow up timeframe 2. BP Medication Monitoring a. Physical Assessment b. Labs/Diagnostics 3. Statin Medication Monitoring a. Physical Assessment b. Labs/Diagnostics 9 pts Very Good Includes no fewer than 4 blanks completed correctly. 8 pts Satisfactory Includes no fewer than 3 blanks completed correctly. 5 pts Needs Improvement Includes no fewer than 2 blanks completed correctly. 0 pts Unsatisfactory 0-1 blanks completed correctly for this section presented.	10 pts
This criterion is linked to a Learning OutcomeReferences	10 pts Excellent Includes no fewer than 4 requirements. Requirements: 1. Only the 3 sources provided in instructions are used in conjunction with a pharmaceutical cost estimating website such as Good RX. 2. Citations are provided where indicated on the form. 3. Citations and references are in current APA edition format. 4. There is a reference to match every citation provided. 9 pts Very Good Includes no fewer than 3 requirements. 8 pts Satisfactory Includes no fewer than 2 requirements. 5 pts Needs Improvement Includes no fewer than 1 requirement. 0 pts Unsatisfactory No requirements for this section presented.	10 pts
	0 pts

Outline Template

HYPERTENSION PROTOCOL: INITIAL VISIT

• RATIONALE
  1. This protocol will assist in the differentiation between essential hypertension and renal artery stenosis to aid in the identification of patients in need of referral to nephrology to prevent further renal damage from an unidentified renal artery stenosis. The design of the protocol for UTI encompasses these principles.

• SYMPTOMS
  1. HYPERTENSION
     1. Blood pressure >140/90 mmHg
     2. Other possible subjective symptoms
        • Headache
        • Visual changes
        • Dyspnea
        • Chest pain
        • Sensory or motor deficit
     3. RENAL ARTERY STENOSIS
        1. Onset of hypertension age >55 years or <30 years
        2. History of accelerated, malignant, or resistant hypertension

• History of unexplained kidney dysfunction

1. History of multivessel coronary artery disease
2. History of other peripheral vascular disease
3. Abdominal bruit

• Sudden or unexplained recurrent pulmonary edema
• Other possible factors
  • Absence of family history of hypertension
  • Other bruits
  • History of acute kidney injury after administration of ACE inhibitor or angiotensin II receptor antagonist (ARB)

• HISTORY
  1. Continue with treatment of hypertension but consult supervising physician if patient has:
     1. History of accelerated, malignant, or resistant hypertension
     2. History of unexplained kidney dysfunction

• History of multivessel coronary artery disease

1. History of other peripheral vascular disease
2. Abdominal bruit | Hypertension and Lipid Protocol
3. Sudden or unexplained recurrent pulmonary edema

• PHYSICAL EXAM
  1. Perform the following examinations:
     1. Vital Signs (blood pressure, pulse)
     2. Auscultation for bruits (carotid, abdominal, and femoral)

• Palpation of thyroid

1. Cardiac
2. Respiratory
3. Lower extremities for edema and pulses

• Neurological

1. Consult supervising physician if findings of:
   1. Abdominal bruit
   2. Another bruit

• LAB TESTS
  1. Metabolic panel
     1. Cholesterol
     2. Blood sugar

• Uric acid level

1. Glomerular filtration rate
2. Consult supervising physician if:
   1. GFR indicates chronic kidney disease (CKD) or renal failure

• PHARMACOLOGICAL TREATMENT
  1. List the hypertension drug classifications and examples you would prescribe in order of treatment according to clinical practice guidelines without consideration of race or ethnicity: Hypertension and Lipid Protocol(Provide generic names for examples. Doses are not needed or required.)

Drug Category/ Classification	Example 1	Example 2	Example 3	Example 4
Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.
Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text. Hypertension and Lipid Protocol	Click or tap here to enter text.	Click or tap here to enter text.
Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.
Click or tap here to enter text. Hypertension and Lipid Protocol	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.

Citation (Provide (Author, year) and not full reference): Click or tap here to enter text.

1. 1^st line pharmacological treatment if warranted in a non-African American patient after a thiazide diuretic has been given and no compelling contraindications/comorbidities are identified: (Choose a generic drug from the drug class you would like to prescribe to either add to existing treatment or replace a thiazide.)
   1. Drug: Click or tap here to enter text | Hypertension and Lipid Protocol
   2. Dose: Click or tap here to enter text.

• Route: Click or tap here to enter text.

1. Frequency: Click or tap here to enter text.
2. Instructions to provide patient: Click or tap here to enter text.
3. Caution/Precautions: Click or tap here to enter text.

• Using a source such as GoodRX, what is an estimated cost of this drug for a 30-day supply? Click or tap here to enter text.
• What patient education is needed for this drug?Click or tap here to enter text.

Citation (Provide (Author, year) and not full reference): Click or tap here to enter text.

 

1. 1^st line pharmacological treatment if warranted in an African American patient after a thiazide diuretic has been given and no compelling contraindications/comorbidities are identified: Hypertension and Lipid Protocol (Choose a generic drug from the drug class you would like to prescribe to either add to existing treatment or replace a thiazide.)
   1. Drug: Click or tap here to enter text.
   2. Dose: Click or tap here to enter text.

• Route: Click or tap here to enter text.

1. Frequency: Click or tap here to enter text.
2. Instructions to provide patient: Click or tap here to enter text.
3. Caution/Precautions: Click or tap here to enter text.

• Using a source such as GoodRX, what is an estimated cost of this drug for a 30-day supply? Click or tap here to enter text. Hypertension and Lipid Protocol
• What patient education is needed for this drug?Click or tap here to enter text.

Citation (Provide (Author, year) and not full reference): Click or tap here to enter text.

1. When should ACEIs be used in African Americans according to the course textbook? Include a citation with matching reference in the reference section. Hypertension and Lipid Protocol
   1. Click or tap here to enter text.
   2. Click or tap here to enter text.

• Click or tap here to enter text.

Citation (Provide (Author, year) and not full reference): Click or tap here to enter text.

1. Prescribe statin therapy according to the prescription table which follows: Hypertension and Lipid Protocol

Complete the following table to indicate which drug at which dose would be used for different intensity statin therapies to treat high low-density lipoprotein (LDL) as noted in the course textbook. Each drug listed in each column should be a different drug with a specific dose or dose rans as indicated in your course textbook.

High-Intensity Therapy	Moderate-Intensity Therapy	Low-Intensity Therapy
Daily dose lowers LDL-C on average by Click or tap here to enter text.	Daily dose lowers LDL-C on average by  Hypertension and Lipid Protocol Click or tap here to enter text.	Daily dose lowers LDL-C on average by Click or tap here to enter text.
Drug/Dose 1: Click or tap here to enter text. Drug/Dose 2: Click or tap here to enter text.	Drug/Dose 1: Click or tap here to enter text. Drug/Dose 2:Click or tap here to enter text. Drug/Dose 3:Click or tap here to enter text. Drug/Dose 4:Click or tap here to enter text. Drug/Dose 5:Click or tap here to enter text.	Drug/Dose 1: Click or tap here to enter text. Drug/Dose 2:Click or tap here to enter text. Drug/Dose 3:Click or tap here to enter text.
What patient education is needed when prescribing statins? Consider any patient counseling points and adverse effects they may need to be aware of or report if experienced.	Click or tap here to enter text. Hypertension and Lipid Protocol

Citation (Provide (Author, year) and not full reference): Click or tap here to enter text.

• TREATMENT MONITORING
  1. How long until a follow up appointment should be done with patient?

Click or tap here to enter text.

1. Monitoring needs for blood pressure medication prescribed: (Include physical assessments as well as lab/diagnostics as applicable. If not applicable, enter N/A to show you find it not applicable.)
   1. Physical Assessments: Hypertension and Lipid Protocol

Click or tap here to enter text.

1. Labs/Diagnostics:

Click or tap here to enter text.

Citation (Provide (Author, year) and not full reference): Click or tap here to enter text.

1. Monitoring needs for statin medication prescribed: (Include physical assessments as well as lab/diagnostics as applicable. If not applicable, enter N/A to show you find it not applicable.)
   1. Physical Assessments: Hypertension and Lipid Protocol

Click or tap here to enter text.

1. Labs/Diagnostics:

Click or tap here to enter text.

Citation (Provide (Author, year) and not full reference): Click or tap here to enter text.

• TREATMENT FAILURE
  1. How will you know if the treatment is not working or needs to progress? Include a citation with matching reference in the reference section. Hypertension and Lipid Protocol

Click or tap here to enter text.

Citation (Provide (Author, year) and not full reference): Click or tap here to enter text.

References (Full APA References)