At least one peer-reviewed resource is presented as a reference and it’s associated in-text citation is appropriately placed; and an associated and approved course resource is present as a reference and it’s associated in-text citation is appropriately placed; and all references and in-text citations are APA formatted.

above is part of the rubric.

You must use my text-book and a peer-reviewed source. you must use in-text citations for all sources.

Please do the discussion below:

Discussion: Clotting

BE SURE TO READ THE DISCUSSION EXPECTATIONS AND RUBRIC BEFORE POSTING FOR THIS DISCUSSION. NOTE, YOUR ORIGINAL RESPONSE IS DUE AT THE END OF WEEK 5, YOUR RESPONSE TO AT LEAST TWO OTHER LEARNERS IS DUE AT THE END OF WEEK 6.

Mrs. Jay, a 73 year old female, has been admitted to the hospital for treatment of a deep vein thrombosis in her right calf. Her PMH includes hypertension. She has been taking Capoten 12.5 mg BID with good control of her pressure.  She is ordered on bedrest with the following orders:

Heparin 5000units IV bolus, followed by a heparin drip of 25,000units in 250ml to infuse at 1000 units per hour. Follow heparin protocol that includes obtaining a stat aPTT 6 hours after initiation and 6 hours after any dose change.

How many mL per hour will you administer the heparin drip to deliver 1000 units per hour?

What is an aPTT? What is a therapeutic range?

How does heparin work? What precautions need to be taken?

What is the treatment for a heparin overdose?

After three days, the physician orders Warfarin (Coumadin) 2mg po daily.  Mrs. Jay asks why she needs to take Coumadin and the heparin.

How will you respond to her?

How does Coumadin work? What is the difference between Heparin and Coumadin?

What lab value will be monitored while on Coumadin? What is a therapeutic range?

What is the antidote for Coumadin overdose?

What are some nursing considerations for a patient taking anticoagulants?

Develop a detailed teaching plan for Mrs. Jay regarding taking Coumadin when she goes home.

Discussion Post and Response – Not an essay

2/3 of Page for Post (Pick any medication just not the same as this classmate that response is required for)

The prompt for this week is to gIve an example of a medication that affects the nervous system and explain how it does that using concepts from Chapter 12.

This can be a medication you use in practice or an example from your book or other reference. Try your best to find one your classmates have not already talked about and explain the process in your own words.

Please give both the generic name and common trade name of the drug, what it is most commonly used for and potential side effects.

1/3 of Page for Response to classmates post

Classmates post: Please write a response
One of the drugs we use commonly in the Critical Care area is Norepinephrine also known as Levophed. Norepinephrine (Levophed) is a catecholamine agent with potent alpha-1 and mild beta-1 properties. Norepinephrine has no beta-2 activity, so the vasoconstrictive effects are unopposed (Hallengren, strand, Eksborg, Barle, & Frostell, 2017).  Consequently, norepinephrine is a  potent vasopressor and weak positive inotrope. Norepinephrine is indicated for hypotension due to distributive shock states including septic and neurogenic shock. As a result, Norepinephrine is recommended as the initial vasopressor per the Surviving Sepsis Campaign recommendations.

Due to its massive effect of alpha-1, blood pressure, MAP, SVR, and CO are increased with Norepinephrine (Girbes & Hoogenberg, 1998). Adverse reactions include tachycardia, hypertension, ventricular dysrhythmias, and myocardial ischemia. Because of strong vasoconstrictive effects, high doses of norepinephrine can impede tissue perfusion, particularly of the skin, viscera, and kidneys (Yamamura et al., 2018).

References

Girbes, A. R. J., & Hoogenberg, K. (1998). The use of dopamine and norepinephrine in the ICU. In Yearbook of Intensive Care and Emergency Medicine 1998 (pp. 178-187). Springer, Berlin, Heidelberg.

Hallengren, M., strand, P., Eksborg, S., Barle, H., & Frostell, C. (2017). Septic shock and the use of norepinephrine in an intermediate care unit: Mortality and adverse events. PLoS One, 12(8), e0183073.

Yamamura, H., Kawazoe, Y., Miyamoto, K., Yamamoto, T., Ohta, Y., & Morimoto, T. (2018). Effect of norepinephrine dosage on mortality in patients with septic shock. Journal of intensive care, 6(1), 1-7.

The prompt for this week is to gIve an example of a medication that affects the nervous system and explain how it does that using concepts from Chapter 12. (Attaching Ebook)

This can be a medication you use in practice or an example from your book or other reference. Try your best to find one your classmates have not already talked about and explain the process in your own words.

Please give both the generic name and common trade name of the drug, what it is most commonly used for and potential side effects. Described an experience with the medication in your practice as a registered nurse in the state of Massachusetts.