Pharmacy response III

Discuss gestational diabetes/respond to this post


In essence, gestational diabetes is diabetes that appears during pregnancy. Although the cause is unknown, some think HLA antigens might be involved (StatPearls, 2023). Additionally, it’s assumed that high proinsulin levels contribute to gestational diabetes, and some research suggests that proinsulin may cause beta-cell stress (StatPearls, 2023). Elevated levels of hormones such as progesterone, cortisol, prolactin, human placental lactogen, and estrogen may impact peripheral insulin sensitivity and beta-cell activity (StatPearls, 2023).

Pharmacy response ii

Respond to the post (Talk about the intolerance piece of metformin such as the GI side effects etc) 

Metformin for Treatment of Type 2 Diabetes

Metformin is part of the first treatment step in the four-step treatment approach. Metformin works in several different ways to manage blood glucose levels. One way is inhibiting glucose from being produced in the liver. Another way is that it slightly reduces glucose from being absorbed in the digestive tract. It also increases glucose uptake in tissues such as fat and skeletal muscle by increasing the sensitivity of insulin receptors. 

One of the positives of treatment with metformin is that there are few side effects, and because it does not actively reduce blood sugar, there is hardly any risk of hypoglycemia. The most common side effect is gastrointestinal issues. Although it is not common, the severe side effect is metabolic acidosis and is mainly a concern in patients with impaired renal function. 

Metformin is prepared as an oral medication; either an immediate-release or extended-release tablet or an oral solution is available. Metformin should be taken with food to avoid gastrointestinal upset side effects (Corcoran & Jacobs, 2022). 


Amy, a 3 year old girl is brought to your office by her mother because she has a fever and complains that her ear hurts. She has no significant medical history. The child is not pleased to be in the provider’s office and has been crying. Her mother explains that she developed a “cold” about 3 days ago with sniffles. As she cries she continues to cough and has yellowish nasal discharge. 


In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.


  • Review this week’s Learning Resources and consider the insights they provide.
  • Consider what history would be necessary to collect from the patient.  
  • Consider what physical exams (Focused respiratory assessment at minimum******* and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? (diagnostic testing: Flu swab, COVID swab, RSV swab, strep throat swab)*****
  • Identify at least five possible conditions that may be considered in a differential diagnosis for the patient*** (1. RSV 2. Ear infection 3. strep throat 4. sinusitis 5. rhinovirus)




Write a 1-page paper that addresses the following:

  • Explain your diagnosis for the patient, including your rationale for the diagnosis.
  • Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
  • Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.


Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. 

The patient has a history of drug abuse and possible Hepatitis C.

HL is currently taking the following prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

This is a case study you do in a Grand Rounds (advanced clinician level brainstorming) style with the ‘Pharmacological Plan’ as the major part of your discussion.

Instructor/Facilitator help/suggestions:

1. Include three differential diagnoses. Do not just say “Symptoms are vague, no diagnoses possible, I will just do further assessment.” Subjective & Objective information are intentionally provided vague (as a clinical case) so that you can develop a couple of pharmacological cases & discuss.

2. Briefly address how you will pharmacologically treat the three diagnoses you listed (Pharmacological Plan).

3. Include why patient is on Synthroid, Nifedipine, a peripheral calcium channel blocker & prednisone an anti-inflammatory immunosuppressive agent (pharmacological information needed) and why patient was on these drugs, discussion based on your objective & assessment. Briefly state the mechanism of action of these agents.

4. Long discussions/stories of no relevance to advanced practice pharmacology will carry no value with this project.

5. Include NEWER AGENTS of cure for hepatitis C infection. Spell out the drug names. Discuss how these NEWER hepatitis C drugs of CURE work.

6. Include peer reviewed, scholarly articles of past 4 years as reference. 

7. Make it a Point you have Clinician Level Pharmacology in focus

Pharm discussion due June26

To Prepare:

  • Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
  • Select one type of diabetes to focus on for this Discussion.
  • Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
  • Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.

Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.


  • American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetesLinks to an external site.—2018. Diabetes Care, 41(Supplement 1), S73–S85. Retrieved from article provides guidance on pharmacologic approaches to glycemic treatment as it pertains to treating patients with diabetes. Reflect on the content of this article as you continue to examine potential drug treatments for patients with diabetes.

Health Asmnt Due 6/17

Case 2: 1 year old overweight toddler who lives in a shelter with his underweight mother.


For this Assignment, you will consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

Assignment: Child Health Case: Include the following:

  • An explanation of the health issues and risks that are relevant to the child you were assigned.
  • Describe additional information you would need in order to further assess his or her weight-related health.
  • Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
  • Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
  • Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

Response II week II Hlth asmnt

Respond to peers post 


Respond on or before Day 6 on 2 different days to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.




Case 1: Paloma Hernandez, 26 year-old, Spanish speaking patient who presents to the clinic for the last 2 days in a row complaining of abdominal pain that is getting worse. The first visit the staff relied on her younger bilingual daughter to translate. She was treated with Omeprazole and encouraged to take OTC medication. Today she presents with the same problem. Her daughter states it is the same problem but worse today.


The first thing to address is that a professional translator should have been utilized and encouraged for the first visit. Communication is key to understanding the patient’s concerns and addressing the reason for the visit. Relying on the patient’s daughter to translate is not going to be an accurate way to gather information. The patient is 26 years old so more than likely her daughter is twelve years old or younger and may not be able to accurately describe the abdominal pain and translate effectively. Utilizing professional interpreter ensures that communication is optimized, improves outcomes, and increases patient satisfaction. A barrier to utilizing a professional interpreter would be that it can be difficult to establish trust between the triad when involving an interpreter into the relationship that acts like a mediator for the message to be translated (Jungner et al., 2019). Hispanic population have additional barriers to receiving timely health care that can include a lower income and decreased likelihood to have obtained higher education. These barriers can make it difficult for this population to pay out of pocket medical care and many do not have adequate insurance. Once the communication barrier is taken care of the line of communication should be able to ask targeted questions to figure out the cause of the patient’s abdominal pain. The following would be targeted questions to obtain more information regarding the current symptoms as well as obtain more health history information (Escarce, 2006).

  1. How would you describe the pain?
    1. Knowing if the pain is dull, sharp, radiating, etc. is critical to ensuring the patient feels heard and gives a better hint of what the etiology of the pain may be from (Mayo Clinic, 2021).
  2. What does your typical diet consist of?
    1. Important to ask if there have been any recent dietary changes that could be causing abdominal pain.
  3. How much water do you drink daily?
    1. The body needs adequate water to function properly.
  4. Have you had any current difficulty with using the restroom? Burning or pain while using the bathroom or experienced any constipation?
    1. These questions are important because stool can tell a lot about a person’s health and UTIs and other infections related can cause abdominal pain. Also, it is important to ask if there has been any blood in the stool or urine.
  5. Do you have a history of GI complications?
    1. Knowing if a patient has chronic GI symptoms can improve treatment goals and help address if the underlying issue that is causing the pain could be related to chronic issues.
  6. Are you currently trying to become pregnant?
    1. Stomach pain and cramps are common with pregnancy, knowing if the patient is actively trying to conceive is important not only for being a possible cause for the pain, but to also know while prescribing any treatments (NHS, 2021).
  7. Traveled recently outside of the United States?
    1. Traveling outside of the United States can increase risk for developing GI complications due to drinking or eating contaminated water or food (Mayo Clinic, 2021).

Health Asm Response 1




Respond on or before Day 6 on 2 different days to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.


Respond to the following: 


A comprehensive understanding of a patient’s inherent characteristics is indispensable in improving the quality of care. A nurse should consider a specific set of questions that they should ask to facilitate comprehension of a patient’s history. The questions should be framed in such a way that they are not insensitive to the patient’s background, lifestyle, or culture. A review of the patient in the assigned case study affirms that she is 26 years old and Spanish speaking. Her chief complaint is abdominal pain, which has been getting worse. During her first visit to the clinic, Paloma relied on her younger bilingual daughter as a translator. Paloma was advised to take over-the-counter medication. She had been put on Omeprazole. However, her situation has not improved. In her present visit, she presents with the same problem. The limitations in the information presented about her case make it difficult to discern the exact cause of the patient’s worsening abdominal pain.

It is essential to consider a patient’s socioeconomic factors in the development of a treatment plan. Arpey et al. (2017) attest there is evidence that socioeconomic status affects an individual’s health outcome and health care received; people within the lower socioeconomic bracket are more likely to have worse self-reported health, lower life expectancy, and suffer from more chronic conditions compared with those of higher socioeconomic status. Some of the socioeconomic variables to consider when interacting with Paloma include her financial status, employment status, and availability of social support. A close examination of the above factors will facilitate the development of a patient-centered approach to managing her abdominal pain.

            The second set of factors to consider during the interactions with Paloma are spiritual factors. The existing evidence suggests that spirituality affects multiple facets associated with access to healthcare services. For instance, Rego et al. (2020) document that greater spiritual well-being is often associated with less decisional conflict, decreased uncertainty, a feeling of being more informed and supported, and greater satisfaction with one’s decisions. In Paloma’s case, assessing Paloma’s spiritual or religious beliefs would be critical to understanding the impact of these aspects on her coping mechanism and decision-making related to her health. Besides, the knowledge may help them comprehend some of her cultural or religious practices that might influence her preferences regarding treatment and the involvement of spiritual leaders in healthcare decisions. Overall, consideration of Paloma’s spirituality would improve the prospects of positive patient outcomes.

            Similarly, lifestyle factors have a considerable impact on the health and well-being of an individual. A keen review of the factors may facilitate the adjustment of a treatment plan to suit the needs of an individual patient. Contemporary evidence on the subject asserts that lifestyle factors have a momentous influence on the health and well-being of an individual. For instance, Li et al. (2018) postulate that factors such as diet, activity, alcohol consumption, and BMI have a considerable impact on the life expectancy of an individual. In Paloma’s case, it would be useful to consider her diet and nutrition. The outcome of such an assessment would offer insight into potential dietary causes or aggravating factors for her abdominal pain. Besides, it would be useful to explore her level of engagement in physical activity, exercise routines, and sedentary behaviors to assess her overall fitness and potential lifestyle-related risk factors. A close review of the above variables would facilitate the development of a tailor-made treatment plan for Paloma.

            It would be useful to explore Paloma’s culture as she seeks healthcare services. The prevailing evidence suggests a patient’s cultural background can have a profound impact on their treatment and diagnosis options. Shepherd (2019) suggests that healthcare professionals should strive to improve their intercultural awareness for them to progress the quality of healthcare services. In Paloma’s case, it would be useful to consider her cultural norms, values, and expectations to enhance the provision of culturally sensitive care and tailor the treatment plan to align with her cultural preferences and beliefs.

            An interaction with Paloma would require a consideration of a few sensitive factors. Such includes language and communication; it would be useful to avail a translator/interpreter to facilitate quality interactions. Suarez et al. (2021) assert that patients stand to benefit greatly from the presence of medical interpreters that double up as cultural brokers or literacy guardians. Besides, it would be useful to consider her level of health literacy. The move will make it feasible to discern whether she understands the information presented to her. Overall, a consideration of the above variables would improve the quality of her experience with the healthcare services.

            The following set of questions would help build Paloma’s health history and risks:

  • Are there any factors that appear to trigger or worsen the pain?
  • Have you experienced similar episodes of abdominal pain in the past?
  • Does the pain radiate or spread to any other parts of your body?
  • Do you have any other symptoms, such as fever, jaundice, or urinary problems?
  • Are there any occupational or environmental exposures that might be relevant?



What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.


To Prepare:

  • Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
  • Review the scenario assigned by your Instructor for this Assignment.
  • Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
  • Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
  • Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

Write a 2- to 3-page paper that addresses the following:

  • Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
  • Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
  • Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
  • Explain the process of writing prescriptions, including strategies to minimize medication errors.


JJ is a 7-year-old male that has been dealing with asthma his entire life.  Multiple treatments have been tried, which have helped symptoms, but nothing that works completely.  You are treating him and know of a study regarding a new asthma medication being developed.  This new medication contains a bronchodilator/steroid/antihistamine as an inhalation.  None of the drugs being studied have previously been approved for children under the age of 12.  The study would last for 16 weeks

Week 8 discussion (PHARM) due Jul 19

Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.

Generalized Anxiety Disorder is a psychological condition that affects 6.1 million Americans, or 3.1% of the US Population. Despite several treatment options, only 43.2% of those suffering from GAD receive treatment. This week you will review several different classes of medication used in the treatment of Generalized Anxiety Disorder. You will examine potential impacts of pharmacotherapeutics used in the treatment of GAD. Please focus your assignment on FDA approved indications when referring to different medication classes used in the treatment of GAD.



To Prepare:

  • Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
  • Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
  • Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
  • Think about a personalized plan of care based on these influencing factors and patient history with GAD.

Post a discussion of pharmacokinetics and pharmacodynamics related to anxiolytic medications used to treat GAD. In your discussion, utilizing the discussion highlights, compare and contrast different treatment options that can be used.