nr508 week 5 discussion 2020 latest

Week 5: Discussion

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Purpose 

Problem-based learning is a methodology designed to help students develop the reasoning process used in clinical practice through problem solving actual patient problems in the same manner as they occur in practice.  The purpose of this activity is to develop students’ clinical reasoning skills using a case-based learning exercise. Through participation in an online discussion forum, students identify learning issues in a self-directed manner which facilitates learning for the entire group. 

Activity Learning Outcomes 

Through this discussion, the student will demonstrate the ability to: 

1. Synthesize clinical knowledge, didactic learning and research findings to provide appropriate pharmacological care to primary care patients. (CO 1, 2, 3, 4 & 5) 

Due Date:  

The student must provide an initial response to the discussion topic by Wednesday, 11:59pm MT. Subsequent posts, including substantive responses to peer(s) and faculty questions must occur by Sunday, 11:59pm MT. A total of 3 substantive posts are required on 3 different days. (Week 8 only- Subsequent posts, including substantive responses to peer(s) and faculty must occur by Saturday, 11:59pm MT).  

 A 10% late penalty will be imposed for initial discussions posted after the deadline on Wednesday11:59pm MT, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT. 

 A 10% penalty will be imposed for not entering the minimum number of interactive dialogue posts (3) ORnot posting on the minimum required number of days (3). NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0) 

Total Points Possible:  100

Case Study & Discussion Questions

Maria is a 46-year-old woman who presents for her yearly physical examination. Her review of systems is significant for fatigue, constipation and hair loss. Her previous medical history is notable only for obesity. She reports her understanding that she should be on a low calorie, low fat diet with moderate aerobic exercise 4-5 times per week but also notes that having a full-time job and four children makes this difficult to achieve.

She has NKDA and takes a multi-vitamin daily. Maria reports a family history of diabetes (mother) and hypertension (brother). She is a nonsmoker. Her diet largely consists of fast food meals. She drinks sweet tea with every meal and an additional 3-4 cups of coffee per day. Previous labs and exam last year are unremarkable.

Vitals today: BP 120/70 mm Hg, pulse 76, temperature 98.7, respirations 18, height 5’9”, weight 225 pounds. Urine dip + glucose, fasting plasma glucose 179 mg/dl, HgbA1C is 7.4%, TSH 8.5mU/L and Free T4 0.1 ng/dl. The physical exam is notable for acanthosis nigricans at the neck but otherwise is normal.

1. What are your treatment goals for Maria?
2. What is your pharmacologic plan and rationale? (cite with appropriate clinical practice guidelines or scholarly, peer-reviewed journals)
3. What is the mechanism of action for each drug?
4. Please give five teaching points for each drug prescribed.
5. How would you change the plan if her initial HbgA1C was 10.2mg/dL and her fasting blood glucose was 305mg/dL? Provide a detailed alternative plan with the rationale.

 

Discussion Guiding Principles

The ideas and beliefs underpinning the discussions guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of discussions provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.

Direct Quotes

Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category.

 

**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.