Cardiovascular System

Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options.

This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs.

Review the case study assigned by your Instructor for this Assignment.

• Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
• Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
• Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
• Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

ASSIGNMENT

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

1. Explain how the factor you selected (AGE) might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
2. Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
3. Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Case Study 1

LM is an 86-year-old female admitted to the emergency department with delirium. Her spouse is with her and verifies that LM adheres to the medications she is currently prescribed. She does not self-monitor her BP or heart rate at home.

PMH:

A Fib diagnosed 1 month ago

HTN x 10 years

CKD x 5 years

Osteoarthritis x 7 years

GERD x 20 years

Medications:

Digoxin 0.25 mg QD

Metoprolol XL 25mg QD

Warfarin 3 mg QD

APAP 650 mg TID

Omeprazole 20mg QD

Multivitamin QD

Allergies: NKDA

Social History:

Married to husband for 57 years

No smoking, alcohol, limited daily exercise (short walks each morning)

Family History:

None reported

Vitals:                                     Labs:

Wt 113 lbs Ht 5’4”                   Na+ 138          K+ 4.0

BP 101/58, HR 52                   Cl- 99              CO2 27

BUN 33           Cr 1.2

Gluc 109         INR 3.8

Dig 2.4

PE:

Elderly female with altered level of consciousness, no signs of bruising, bleeding, or other injury.