Pathopharmacological Foundations for Advanced Nursing Practice

The INTRODUCTION: As an advanced practice nurse, it is important to diagnose, treat, and evaluate patients who have a chronic disease. A nurse must understand how pathology, treatment, regimens, and psycho-social issues affect patients and the care they receive. Disease management is more than just monitoring a medication or treatment; it is evaluating the disease process from the micro to macro level. As a nurse with an advanced degree, you will be expected to assess patients and individual and population responses to chronic illness.

For this assessment, you will investigate pathopharmacological issues related to a specific disease process. You may choose to investigate traumatic brain injury, depression, obesity, asthma, or heart failure. As part of this assessment, you will analyze the various impacts the disease process has on the patients, their families, and populations at a local, national, and international level.

*I would like the topic of the paper to be on OBESITY.

REQUIREMENTS: Must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

A. Investigate one of the following disease processes: traumatic brain injury, depression, obesity, asthma, or heart failure.

1. Analyze the pathophysiology of the disease process you selected in part A.

2. Discuss the standard of practice for the selected disease process.

a. Discuss the evidence-based pharmacological treatments in your state and how they affect management of the selected disease in your community.

b. Discuss clinical guidelines for assessment, diagnosis, and patient education for the selected disease process.

c. Compare the standard practice for managing the disease within your community with state or national practices.

3. Discuss characteristics of and resources for a patient who manages the selected disease well, including access to care, treatment options, life expectancy, and outcomes.

a. Analyze disparities between the management of the selected disease on a national and international level.

4. Discuss three or four factors (e.g., financial resources, access to care, insured/uninsured, Medicare/Medicaid) that contribute to a patient being able to manage the selected disease.

a. Explain how a lack of the factors discussed in part A4 leads to an unmanaged disease process.

i. Describe the characteristics of a patient with the selected disease that is unmanaged.

B. Analyze how the selected disease process affects patients, families, and populations in your community.

1. Discuss the financial costs associated with the selected disease process for patients, families, and populations from diagnosis to treatment.

C. Discuss how you will promote best practices for managing the selected disease in your current healthcare organization.

1. Discuss three strategies you could use to implement best practices for managing the selected disease in your current healthcare organization.

2. Discuss an appropriate method to evaluate the implementation of each of the strategies from part C1.

D. When you use sources, include all in-text citations and references in APA format.

Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.

*Use the following sources: VitalSource E-Texts

McCance, K.L., Huether, S.E. (2018). Pathophysiology: The biological basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby Elsevier. ISBN: 9780323583473
Frandsen, G. & Pennington, S.S. (2013). Abrams’ clinical drug therapy: Rationales for nursing practice. (10th ed). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins Print ISBN: 9781609137113, 1609137116
American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC: American Psychological Association. ISBN-13: 9781433805615urces:

*RUBRIC Explained:
Section What Rubric States What this means for you
Articulation The candidate provides substantial articulation of response. You are expected to write logically with clarity. Organization, and proper writing mechanics.
A. Investigated Disease Process The candidate investigates 1 of the given disease processes. 1. You are expected to provide a brief introduction of the disease process you have selected to investigate.
2. Consider including a discussion of why you selected this topic and the scope of the impact of the disease in general.
A1. Pathophysiology The candidate provides a plausible analysis, with substantial detail, of the pathophysiology of the disease process selected in part A. 1. You are expected to discuss the pathophysiology of the selected disease from the macro to micro level.
2. This is an opportunity to begin with a general approach to the sequence of factors that result in alterations in normal function at the systems level and drill down to the hormonal, electrolyte and cellular changes that promote the appearance or progression of the disease.

Things to consider: Have you identified and discussed the factors that contribute to the disease from a system level all the way down to the cellular level? What changes occur as a result of the disease and how does the body respond (compensate)?
A2. Standard of Practice The candidate provides a logical discussion, with substantial detail, of the standard of practice for the selected disease process. 1. You are to discuss the aspects of the standards of practice for the disease in detail.
2. The standard of practice is essentially a consensus of what providers follow assessing, diagnosing, and managing the disease on a daily basis. They may align completely with the Clinical Practice Guidelines or differ in some ways based on prevalence, resources and local outcomes.
3. Consider looking at your facility protocols or the practice recommendations in your state.
A2a. Pharmacological Treatments The candidate provides a logical discussion, with substantial detail, of the evidence-based pharmacological treatments in the candidate’s state and how they affect management of the selected disease in the candidate’s community. 1. Identify and discuss the pharmacological treatments generally used in your state (based on Standards of Practice or Clinical Practice Guidelines). You may use 1st person or ‘in the author’s state’…
2. Next, discuss the ways in which those medications impact the individuals in your community who have the disease. Consider these and other issues: Are outcomes changed? Is progression of the disease limited? Are hospitalizations decreased? Are patients more compliant?
A2b. Clinical Guidelines The candidate provides a logical discussion, with substantial detail, of clinical guidelines for assessment, diagnosis, and patient education for the selected disease process. What are the elements of the Clinical Practice Guidelines that focus on assessment, diagnosis, and patient education? Identify and discus them in detail.
A2c. Standard Practice of Disease Management The candidate provides an appropriate comparison, with substantial detail, of standard practice for managing the disease within the candidate’s community with state or national practices. In what ways do the local practice guidelines in your community (or facility) align with the state or national practice guidelines? Compare them in detail by discussing elements that are similar and those that differ.

Note: You may use 1st person in your discussions about your state, community or facility.
A3. Managed Disease Process The candidate provides a logical discussion, with substantial detail, of characteristics of and resources for a patient who manages the selected disease well, including access to care, treatment options, life expectancy, and outcomes. Discuss ‘what it takes’ for an individual to manage their disease. Consider including a description of the patient and linking those characteristics to the presentation of the disease and the connection with access to care, available options for treatments, life expectancy and outcomes.
A3a. Disparities The candidate provides a plausible analysis, with substantial support, of disparities between management of the selected disease on a national and international level. 1. Focus on the differences in management of the disease in two socioeconomic areas, regions, states, ethnicities in the US. Consider including access to care, ability to pay for care, treatment received, and alignment with guidelines.
2. Focus on the differences in management of the disease in two nations outside the US. Consider including access to care, ability to pay for care, treatment received, and alignment with guidelines and ways in which it is similar or different from the care received in the US.
A4. Managed Disease Factors The candidate provides a logical discussion, with sufficient detail, of 3 or 4 factors that contribute to a patient being able to manage the selected disease. Identify and discuss at least 3 factors that are critical to assuring the patient can manage the disease. Consider access to care, insurance status, government assistance, socioeconomic status, education, health literacy, support system, cultural beliefs and other factors.
A4a. Unmanaged Disease Factors The candidate provides a logical explanation, with substantial detail, of how a lack of the factors discussed in part A4 leads to an unmanaged disease process. Identify and discuss the ways the absence of factors critical to being able to manage the disease lead to unmanaged disease. Consider using the same factors discussed in A4.
A4ai. Unmanaged Disease Characteristics The candidate provides an appropriate description, with sufficient detail, of the characteristics of a patient with the selected disease that is unmanaged. Picture the patient with unmanaged disease and describe him or her in relation to physical appearance and emotional status.
B. Patients, Families, & Populations The candidate provides a plausible analysis, with substantial detail, of how the selected disease process affects patients, families, and populations in the candidate’s community. 1. Discuss the ways in which the disease directly affects the patient – work, limitations, activity, social relationships, support system…
2. Discuss the ways in which the disease indirectly impacts the family – work, roles, family dynamics, lifestyles, more than one person in family with disease…
3. Discuss the ways in which the disease indirectly impacts the community – high or low prevalence, available resources, reallocation of resources, increased outreach…
B1. Costs The candidate provides a logical discussion, with substantial detail, of the financial costs associated with the selected disease process for patients, families, and populations from diagnosis to treatment. 1. What are the financial costs to the patient? Consider out-of-pocket expenses, insurance premiums, medications, treatments and diagnostic tests, procedures, assistive devices, hospitalizations, out-patient visits…
2. What are the financial costs to the family? These are generally indirect. Consider discussing increased premiums, life insurance, care-giver responsibilities, limited disposable income, home revisions/accommodations, the impact on household income…
3. What are the financial costs to the community? Outreach and education programs, adaptive equipment, increased allocation of resources and funding, increased providers and facility capabilities…
C. Best Practices Promotion The candidate provides a logical discussion, with substantial detail, of how the candidate will promote best practices for managing the selected disease in the candidate’s current healthcare organization. Discuss the specific initiatives/interventions you as an Advanced Practice nurse would use (given the opportunity) to promote best practices in your current organization. Think about ways you can make a substantial difference in the outcomes of the disease in your facility and/or the community utilizing evidence based practices? Are there aspects of your organization’s standards of practice that you can identify and what would you do to address them?
C1. Implementation Plan The candidate provides a logical discussion, with substantial detail, of 3 strategies the candidate could use to implement best practices for managing the selected disease in the candidate’s current healthcare organization. Identify and discuss 3 specific strategies/interventions you might use to implement best practices for the selected disease.
You might consider using approaches that align with your current specialty track.
C2. Evaluation Method The candidate provides a logical discussion, with substantial detail, of an appropriate method to evaluate the implementation of each of the strategies from part C1. Identify and discuss an objective measurement tool to determine whether each of your interventions is successful. Be sure your tool/mode of evaluation is evidence-based and aligns with your interventions in C1.
D. Sources When the candidate uses sources, the candidate provides appropriate in-text citations and references with no readily detectable deviations from APA style, OR the candidate does not use sources. Correctly use in-text citations and references to support your discussions. Strictly adhere to APA guidelines.

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