Sample Answer for NUR-635 Topic 2 DQ 2 Included After Question
Based on the first letter of your last name, complete the case to which you are assigned:
If your last name starts with A through M: Case 1 Adrenergic Antagonist. If your last name starts with N through Z: Case 2 Adrenergic Agonist.
Case 1 Adrenergic Antagonist Deb is a 32-year-old female who struggles to maintain her blood pressure. Deb is currently using lifestyle modifications to decrease her blood pressure. She is not interested in taking antihypertensives. Upon completing her medication reconciliation, you determine she consistently uses pseudoephedrine for nasal congestion. You suspect this pseudoephedrine is contributing to the patient’s hypertension. Use the guidelines and relevant literature in your topic Resources to discuss the following:
Based on the JNC-8 guidelines in the topic Resources, list the various blood pressure goals. Include when pharmacologic intervention is needed. Describe the non-pharmacologic approach (lifestyle modifications) to treat hypertension. Based on the mechanism of action of pseudoephedrine, describe how this can contribute to Deb’s hypertension and congestion relief. Compare and contrast the difference between phenylephrine and pseudoephedrine. Include modes of action, efficacy, and other relevant information in your response. What may be an alternative to adrenergic agonist when treating congestion in hypertension, explain your rationale?
Case 2 Adrenergic Agonist Daniel, a 23-year-old male, is nervous for performing at his concert tonight. His friend offers him propranolol as treatment because it is considered relatively safe. More than 2 days a week but not daily, Daniel suffers from asthma symptoms that require an inhaler. Use the guidelines and relevant literature in your topic Resources to discuss the following:
Based on the asthma guidelines, how would categorize Daniel’s asthma? Summarize the diagnostic criteria associated with social anxiety disorder. Describe the mechanism of action of propranolol and how it differs from metoprolol. Compare and contrast the difference in propranolol and albuterol’s effect on the lungs. Explain your rationale for discouraging the use of propranolol in this patient (e.g., pathophysiology and guideline recommendations).
Participate in follow-up discussion by reviewing the case discussed by classmates that is different than the one assigned to you. American Association of Colleges of Nursing Core Competencies for Professional Nursing Education This assignment aligns to AACN Core Competencies 1.2, 2.2, 2.5. 4.2, 6.4, 9.2 Submitted on: Sep 11, 2023, 6:58 PM VIEW DQ RESPONSE MH Marco Hernandez Sep 11, 2023, 10:08 PM Unread
If your last name starts with A through M: Case 1 Adrenergic Antagonist. If your last name starts with N through Z: Case 2 Adrenergic Agonist.
Case 1 Adrenergic Antagonist Deb is a 32-year-old female who struggles to maintain her blood pressure. Deb is currently using lifestyle modifications to decrease her blood pressure. She is not interested in taking antihypertensives. Upon completing her medication reconciliation, you determine she consistently uses pseudoephedrine for nasal congestion. You suspect this pseudoephedrine is contributing to the patient’s hypertension. Use the guidelines and relevant literature in your topic Resources to discuss the following:
Based on the JNC-8 guidelines in the topic Resources, list the various blood pressure goals. Include when pharmacologic intervention is needed. Describe the non-pharmacologic approach (lifestyle modifications) to treat hypertension. Based on the mechanism of action of pseudoephedrine, describe how this can contribute to Deb’s hypertension and congestion relief. Compare and contrast the difference between phenylephrine and pseudoephedrine. Include modes of action, efficacy, and other relevant information in your response. What may be an alternative to adrenergic agonist when treating congestion in hypertension, explain your rationale?
Case 2 Adrenergic Agonist Daniel, a 23-year-old male, is nervous for performing at his concert tonight. His friend offers him propranolol as treatment because it is considered relatively safe. More than 2 days a week but not daily, Daniel suffers from asthma symptoms that require an inhaler. Use the guidelines and relevant literature in your topic Resources to discuss the following:
Based on the asthma guidelines, how would categorize Daniel’s asthma? Summarize the diagnostic criteria associated with social anxiety disorder. Describe the mechanism of action of propranolol and how it differs from metoprolol. Compare and contrast the difference in propranolol and albuterol’s effect on the lungs. Explain your rationale for discouraging the use of propranolol in this patient (e.g., pathophysiology and guideline recommendations).
Participate in follow-up discussion by reviewing the case discussed by classmates that is different than the one assigned to you. American Association of Colleges of Nursing Core Competencies for Professional Nursing Education This assignment aligns to AACN Core Competencies 1.2, 2.2, 2.5. 4.2, 6.4, 9.2 Submitted on: Sep 11, 2023, 6:58 PM VIEW DQ RESPONSE MH Marco Hernandez Sep 11, 2023, 10:08 PM Unread
A Sample Answer For the Assignment: NUR-635 Topic 2 DQ 2
Title: NUR-635 Topic 2 DQ 2
List the various blood pressure goals based on the JNC-8 guidelines in Resources. Include when pharmacologic intervention is needed.
In the synopsis of the literature, goal 1) is for the general population 60 years of age and older and to treat BP systolic of 150 mmHg / diastolic BP of <90 mmHg. 2) for the general population < 60y/o, the goal is to treat a systolic BP of less than 140 mmHg/ diastolic BP, 90 mmHg; 3) In adults 18 y/o or > w/ CKD with estimated or measured GFR of < ml/mt/1.73 m^2 in clients with < 70 y/o and in clients any age with albuminuria ( >30 mg of albumin per creatinine) tx of BP to < 140 mmHg and Distolic BP < 90 mmHg, 4) Adults 18y/o or older with DM treat to a SBP of < 140 mmHg and DBP of < 90 mmHg. In addition, pharmacologic treatment starts at SBP of 150/90 mmHg or higher in adults 60 y/o and > or 140/90 mmHg or higher in adults younger than 60 years, HTN and DM-BP management starts at 140/90 mmHg or > regardless of age.
Describe the non-pharmacologic approach (lifestyle modifications) to treat hypertension.
In managing HTN patients, the primary underlying condition needs to be addressed to inform the client of the potential to make positive outcomes to reduce HTN. Therefore, smoking, ETOH consumption, dietary implementation to reduce lipids, reducing sodium intake not with the preparation of foods but by adding salt to prepared food, increasing potassium-rich foods, physical exercise even though they walk in work or stand in position and explain to the client that activity is by continue practice without intermittent stops like waking at a certain pace for 30mts 3x/ week, relaxation techniques and biofeedback that focus on breathing and meditation techniques.
Based on the mechanism of action of pseudoephedrine, describe how this can contribute to Deb’s hypertension and congestion relief.
Pseudoephedrine is a prototype drug with the same chemical components as the known non catecholamine, sympathomimetic; it has a phenylethylamine but no HOs, which can be absorbed by the GIT and act on CNS and cross BBB; they work on the receptors where NE, EPI, and are sympathomimetic causing the CNS stimulation and if the dosage increases the result is an increase in heart rate, BP, stimulate the fight or flight system by increasing vasoconstriction and therefore reducing the nasal congestion at the expense of adrenergic system to activate.
Compare and contrast the difference between phenylephrine and pseudoephedrine. Include modes of action, efficacy, and other relevant information in your response.
Phenylephrine is a medication that belongs to the sympathomimetic drugs. It mimics the epinephrine or NE, adrenalin, etc., but it is selective to the alpha one receptors in venous and arterial systems and causes vasoconstriction. In comparison, pseudoephedrine and eine also have vasoconstriction properties. Still, it acts on both alpha and beta receptors, and it lasts longer than 2 with no HO on and, therefore, prolongs more extended action to break down.
What may be an alternative to adrenergic agonists when treating congestion in hypertension? Explain your rationale.
The medication of choice is fluticasone, an intranasal corticosteroid, and montelukast can help block the leukotriene receptors and relieve nasal congestion, and both can be used in treatment. Reference. McCance, K. L., & Huether, S. E. (2018). Pathophysiology – e-book (8th ed.). Elsevier Health Sciences. Rosenthal, L. D., & Burchum, J. R. (2020). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants – e-book (2nd ed.). Elsevier Health Sciences.
List the various blood pressure goals based on the JNC-8 guidelines in Resources. Include when pharmacologic intervention is needed.
In the synopsis of the literature, goal 1) is for the general population 60 years of age and older and to treat BP systolic of 150 mmHg / diastolic BP of <90 mmHg. 2) for the general population < 60y/o, the goal is to treat a systolic BP of less than 140 mmHg/ diastolic BP, 90 mmHg; 3) In adults 18 y/o or > w/ CKD with estimated or measured GFR of < ml/mt/1.73 m^2 in clients with < 70 y/o and in clients any age with albuminuria ( >30 mg of albumin per creatinine) tx of BP to < 140 mmHg and Distolic BP < 90 mmHg, 4) Adults 18y/o or older with DM treat to a SBP of < 140 mmHg and DBP of < 90 mmHg. In addition, pharmacologic treatment starts at SBP of 150/90 mmHg or higher in adults 60 y/o and > or 140/90 mmHg or higher in adults younger than 60 years, HTN and DM-BP management starts at 140/90 mmHg or > regardless of age.
Describe the non-pharmacologic approach (lifestyle modifications) to treat hypertension.
In managing HTN patients, the primary underlying condition needs to be addressed to inform the client of the potential to make positive outcomes to reduce HTN. Therefore, smoking, ETOH consumption, dietary implementation to reduce lipids, reducing sodium intake not with the preparation of foods but by adding salt to prepared food, increasing potassium-rich foods, physical exercise even though they walk in work or stand in position and explain to the client that activity is by continue practice without intermittent stops like waking at a certain pace for 30mts 3x/ week, relaxation techniques and biofeedback that focus on breathing and meditation techniques.
Based on the mechanism of action of pseudoephedrine, describe how this can contribute to Deb’s hypertension and congestion relief.
Pseudoephedrine is a prototype drug with the same chemical components as the known non catecholamine, sympathomimetic; it has a phenylethylamine but no HOs, which can be absorbed by the GIT and act on CNS and cross BBB; they work on the receptors where NE, EPI, and are sympathomimetic causing the CNS stimulation and if the dosage increases the result is an increase in heart rate, BP, stimulate the fight or flight system by increasing vasoconstriction and therefore reducing the nasal congestion at the expense of adrenergic system to activate.
Compare and contrast the difference between phenylephrine and pseudoephedrine. Include modes of action, efficacy, and other relevant information in your response.
Phenylephrine is a medication that belongs to the sympathomimetic drugs. It mimics the epinephrine or NE, adrenalin, etc., but it is selective to the alpha one receptors in venous and arterial systems and causes vasoconstriction. In comparison, pseudoephedrine and eine also have vasoconstriction properties. Still, it acts on both alpha and beta receptors, and it lasts longer than 2 with no HO on and, therefore, prolongs more extended action to break down.
What may be an alternative to adrenergic agonists when treating congestion in hypertension? Explain your rationale.
The medication of choice is fluticasone, an intranasal corticosteroid, and montelukast can help block the leukotriene receptors and relieve nasal congestion, and both can be used in treatment. Reference. McCance, K. L., & Huether, S. E. (2018). Pathophysiology – e-book (8th ed.). Elsevier Health Sciences. Rosenthal, L. D., & Burchum, J. R. (2020). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants – e-book (2nd ed.). Elsevier Health Sciences.
