NR 508 Week 4 Midterm Latest 2022/2023,100% CORRECT
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Course
NR 508
Institution
NR 508
NR 508 Week 4 Midterm Latest 2022/2023
Roles and Responsibilities of APRN
1. All states have title protection for NP
2. All but 5 states stat's board of nursing control practice and licensure.
3. Scope of practice determined by individual NP license of licensing jurisdiction.New prescribers...
NR 508 Week 4 Midterm Latest 2022/2023
Roles and Responsibilities of APRN
1. All states have title protection for NP
2. All but 5 states stat's board of nursing control practice and licensure.
3. Scope of practice determined by individual NP license of licensing jurisdiction.New
prescribers must know the rules
4.in 17 states, NPs have independent scope of practice and prescriptive authority.
5.6 states have full autonomous practice and prescriptive authority.
Clinical Judgement in prescribing
1. Best therapy
2. Least expensive
3. Least likely to cause ADR
4.Clear indication for drug?
5. Are drugs effective in treating disorder?
6. What is goal of therapy?
7. Under what conditions is it determined that drug is not meeting goal and change
should be made?
8.Unnecessary duplications?
9. OTC be just as useful?
10. Cost?
Collaboration with other prescribers
1. Physician: can offer insight
2. Pharmacists: pharm knowledge
3. Other APRNs: clinical experience shared and collaboration
4.PAs
5. RNs.
Autonomy and prescriptive authority
1. More states are broadening and expanding legal, reimbursement, and prescriptive
authority.
2. Gains can be reversed, so address concerns.
,3. Some push for
physician control.
Alpha2Agonists: MOA
1. Activation of central alpha 2 receptors results in inhibition of
cardioacceleration and vasoconstriction centers in brain.
,2. Lead to decrease in peripheral outflow of norepinephrine which leads to decrease
in:
a. peripheral resistance
b.renal vascular resistance
c. heart rate
d.blood pressure
3. Decrease in BP is due to sympathetic function therefore sodium retention and
increased blood volume may occur: give with diuretic.
4.Second or third line HTN drug
Tx of withdrawal d/t ability to lower adrenergic stimulation associated with
withdrawal. Alpha2Agonists: ADRs
Oral and transdermal doses:
bradycardia, AV block, palpitations, tachycardia, hallucinations, sleep disorders, contact
dermatitis, dry mouth, orthostatic hypotension, constipation, nausea, urinary
retention, decreased sexual activity, weight gain, leg gramps, and
thrombocytopenia.
MOST COMMON: dry mouth
Alpha2Agonists: Discontinue
instructions
Do not stop abruptly d/t lack of alpha 2 receptors impair homeostatic balance
that regulates SNS: Gradual taper over 4 days.
Alpha2Agonists: Guanabenz and guanfacine
, 1. Used to treat HTN.
2. EXR guanfacine:
ADHD Alpha2Agonists:
Methyldopa
1. Parallels synthesis of norepinephrine (NE)
2. Stimulation by this metabolite: decrease in sympathetic outflow to the heart,
kidneys, and blood vessels.
3. End result: decreased in BP, peripheral resistance, HR, sl. decrease in CO.
Produces renal vascular resistance.
4.Positive coombs test
5. Rarely hemolytic anemia.
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