Part A: The goal is to provide professional focused information on a medication Consider the patient situation Mr. Jimmy Barrett is a 70-year-old Aboriginal male, diagnosed six months ago with COPD

NURSING STUDENTS
NUR231 Task Three (3) Assessment Information 1500 words+/- 10%
Refer to the marking rubric in canvas for this task.

This assessment comprises two parts:

Part A- The goal is to provide professional focused information on a medication.

Part B – The goal is to provide person-centred information on a medication.

As a nurse, you will be required to interpret and use pharmacotherapeutic information and reliable clinical evidence to support your colleagues and patients in the quality use of medicines.
You will interpret and use evidence to inform safe and comprehensive practice when designing professional focused and person-centred medication

Assessment Information:

Please enter your responses in the sections of the template
You will need to download the word document and save a copy of the template into your own drive and rename as:

Surname_First name_STUDENT ID_ Task 3_NUR231 Drug Therapy_2025

This is not an essay format and does not require an introduction or
Use the third person in your
Do not use bullet points in your Use academic writing.
Use Arial 11 font with 5 line spacing.
Approximate word counts have been provided to guide you in each
Use APA 7th edition
References are to be placed in the section at the end as
The reference list is not included in your overall word

Clinical Reasoning template

Use the following ‘Clinical Reasoning’ template (below) to help you structure your
Do not remove the
Use valid sources of evidence in support of your work and provide in-text citations and a reference list to achieve maximum points.

Use of Al is permitted in this task
In light of the recent publication by the University on the responsible and ethical use of generative 811wanted to clarify a few concepts.

GenAI can be used in your work in NURXXX provided you address the points below {it is in the rubric)
It MUST be acknowledged as per the statement at the bottom of this announcement
It MUST be used as a tool, not as a replacement of your academic writing – for example, use ChatGTP to re-construct a sentence or paragraph, not to analyse the case study for you
It MUST be paraphrased – so it is not a copy and paste from software, but rather, you use it to guide your writing and content
As an example, Grammarly is a GenAI software, and you still must acknowledge its use {this saves you and I time in reviewing your submission for academic integrity) as the GenAI screening software will detect this

Use of GenAI is fast evolving and we have a responsibility to use it ethically as we would any other evidence or tool

It is something you must LEARN to use rather than to replace your own thoughts and analysis (there are lots of great resources available online that demonstrate ways of using it well)

Please use the statement below:

Copy and paste this text after your reference list

Acknowledgement of the use of Artificial intelligence in this assignment:
I acknowledge the use of in the preparation of this assessment.

List the complete prompt questions that you used in a bulleted list here:

X X

Explain how you used the output from the Al system here:

Add a personal reflection on your experience of using Al in the preparation of your assignment

Failure to acknowledge the use of Al may constitute academic misconduct and would be against the use of intellectual property and results in a fail grade as per the rubric for this task and referral to UniSC Integrity and Compliance Unit for Academic Misconduct. UniSC takes Student Misconduct seriously and this could result in an investigation with serious consequences

Part A: The goal is to provide professional focused information on a medication
Consider the patient situation

Mr. Jimmy Barrett is a 70-year-old Aboriginal male, diagnosed six months ago with COPD and had a recent admission to the acute medical ward with exacerbation of COPD due to a community acquired pneumonia. Mr. Barrett now weighs 70 kg (non-obese) and had been actively working for the 20 years in the mines. He lives at home with his son and daughter-in law, who are his primary carers, retired from work 5 years ago. Mr. Barrett is on continuous home oxygen (02) for 15 hours per day; has a history of type 2 diabetes mellitus (T2DM), currently controlled with metformin XR 500mg BO; prednisolone 5mg daily; hyperlipidemia (atorvastatin 40mg daily) and hypertension (perindopril 5mg daily).

Mr. Barrett has re-presented, 2 weeks after discharge, to the local Emergency Department overnight, complaining of irregular heart palpitations; dizziness; an increase in urinary frequency and thirst; lethargy; blurred vision and further weight loss (10 kilos over 6 months). Mr. Barrett has now been admitted to the medical telemetry with unstable T2DM (hyperglycemia) and rapid atrial fibrillation (RAF), awaiting review by the Endocrinologist and Cardiologist. He has been placed on continuous cardiac monitoring and a 4th hourly BGL monitoring plan.

After review by the Endocrinologist and Cardiologist, Mr Barrett is to commence the following medications (in conjunction with his current medication regime) this morning to control current BGL >20mmols and irregular fast hear rate (HR) >120 beats per minute (BPM):

1. A basal-bolus regime with a supplemental insulin order

2. metoprolol 50mg, 1 tablet mane

3. rivaroxaban (Xarelto) 20mg daily

Students are NOT required to discuss his regular cardiovascular medications unless they are related to a safety considerations (atorvastatin and perindopril).

Criterion 1 (A): Synthesis and application of pathophysiological concepts to justify

clinical decision-making

Collect cues/information

As a nursing student, your clinical facilitator has allocated you to care for Mr Barrett during the morning shift.

Q1. You are asked to explain the pathophysiology of type 2 diabetes mellitus (T2DM) to your clinical facilitator. What is your response? Discuss two symptoms of T2DM that Mr. Barrett is experiencing.

Q2. You are asked to explain the pathophysiology of atrial fibrillation (AF) to your clinical facilitator. What is your response? Discuss two symptoms of AF that Mr. Barrett is experiencing.

Examples of responses:

Q1

Think about the difference between the types of diabetes.

What is happening in type 2 compared to type 1 in regards to insulin

From the case study, discuss two symptoms and give rationale ie thirst why?

Q2

What is happening in the heart, thinking about heart structures and impulses and what’s causing the irregular heart rate

How does it develop and what can be used to treat disease ie beta-blockers

Symptoms and why? le dizziness

Criterion 1 (B): Evidenced based argument and justification of decisions

Identify problems/issues

You are on a night shift and Mr. Barrett rings his call-bell at 0200hrs and states he feels unwell. You take his blood glucose level (BGL) and find it to be 3.0mmol/L. This is the second consecutive night this has happened.

Q1. Identify two possible causes of his hypoglycaemia.

Take action

Q2. What are the appropriate nursing actions after taking Mr. Barrett’s BGL? Give a rationale for the nursing actions for Mr Barrett, who currently has a Glascow Coma Scale (GCS) 15/15, alert and orientated.

Q3. If Mr. Barrett has a low BGL and altered level of consciousness, explain the nursing actions you would take and provide a rationale.

Q4. Provide two (2) person-centered strategies during this hypoglycaemic event

Responses: (approx. 300 words)

Criterion 1B

Q2 and 3 are the during the hypogylcaemic events.

The case study refers to you as the nursing student, therefore what would you do in this situation ie think about escalation/reporting pathways.

Then you need to think about what treatment may be required in this situation – refer to hypogylcemic guidelines.

Q4 is related to the person-centered strategies as you have outlined, such patient education and empowerment, individual treatment plans etc.

Q1

Refer to you Knights and Craft for response. You can list these and provide a short rationale for the answer ie

Think about food intake and how might this cause low BGL

Q2

You need to be thinking as a student nurse, what would I do immediately after finding the patient with a low BGL but they are awake, conscious and alert (stable)

Do you need to contact anyone, and if so who and how?

Think about what the RN might need to consider and what treatment for the patient at this time whilst patient has a GCS 15 alert and orientated.

You should find good information in Diabetes Australia(2024) and QLD Health guidelines.

Q3

You need to be thinking as a student nurse, what would I do immediately after finding the patient with a low BGL but they are now unconscious (unstable)

You should find good information in Diabetes Australia (2024) and QLD Health guidelines.

Prioritising care – Is this an emergency? What do I do in this situation? Who do I need to notify and how? Why is this important?

Q4.

Related to the person-centered strategies, such patient education and empowerment, individual treatment plans, regular follow up etc.

Refer to Person-centred care Australian Commission on Safety and Quality in Health Care

Refer to WHO Medication without harm

Criterion 2: Application of pharmacotherapeutic concepts to explain safe medication

practice

Process information

Q1. Explain to your clinical facilitator how Mr. Barrett’s’ prescribed basal-bolus regime works to achieve glycemic control (Knights et al., 2023, p.639). Discuss why he might need supplemental insulin during his acute phase of his condition.

Q2. Explain the mechanism of the action of NovoRapid and Optisulin in attaining glycaemic control (See also MimsOnline 2022 Full Prescribing Information NovoRapid and Optisulin)

Q3. Explain the mechanism of action and administration (dose and method) of metoprolol for rate control and/or resolve atrial fibrillation (AF) with rapid ventricular response (RVR). * Hint – there may be more than one route of administration*

Q4. Explain the mechanism of action and administration (dose and method) of rivaroxaban for treatment of AF.

Responses

Q1

Refer to Knights (2023) p,639. Explain how basal-bolus regime works, what does it do in the body- hint, more than one.

Think about why the patient may need supplemental insulin plus his regular insulin doses. What is happening to your patient? Stress responses?

Q2

Refer to eMIMS and outline the how these insulins are working in the body, duration of action, half life, type and site of injection

Q3

Refer to eMIMS/e Therapeutic Guidelines and metoprolol works, thinking about receptors we learnt about and relate this back to his cardiac presentation -AF

You might need to look at different routes and how these might work in this case study.

Q4

Refer to eMIMS/e Therapeutic Guidelines for rivaroxaban -what sort of drug class, dose, methods of administration

Think about reversal treatments in case of emergency

Onset and half life

Part B: The goal is to provide person-centred information on a medication
*Integrate the ACQHS Quality Use of Medicines principles into any of your responses below

Mr Barrett and his family require information and education about diabetes and anticoagulant medication management before discharge. Standard 3.2 of the NMBA Registered Nurse Standards for Practice requires nurses to ‘provide the information and

education required to enhance people’s control over health’ (2016, p. 4).

Criterion 3: Application of social justice principles and the Quality Use of Medicines when describing mechanisms of action, adverse effects, benefits, risks, and management of pharmacotherapy using person-centred approaches

Remember:

Discuss how ONE aspect of social justice can be applied to patient.

You need to use at least three QUM principles in the following questions.

You may choose to use two principles in one question and the third principle in another question.

Take time to educate

Q1. Planning for discharge, Mr. Barrett is struggling to understand the rationale of adding an extra oral antihyperglycemic agent (OHA), empagliflozin 10mg once a day added to his existing metformin 500mg XR, BD. What information would you give him and the family about the long-term benefits of having both empagliflozin and metformin and why the importance of closely monitoring his BGL?

Q2. What information would you provide to Mr. Barrett and his family about taking these new medications (rivaroxaban, empagliflozin, and metoprolol) following discharge?

Q3. Identify and discuss one aspect of social justice principles (access, participation, equity and human rights) and apply this to Mr. Barrett’s current situation. How could this impact Mr. Barrett’s ongoing health needs? Provide one potential evidenced based solution you can offer to address this?

Mr. Barrett’s diabetes educator has suggested he commence in home exercise under

the guidance of an Exercise Physiologist, considering he is on home 02

Q4. Identify one issue in relation to increasing his exercise tolerance that you need to

discuss related to gylcaemic control. Provide one strategy to address this identified issue

Q5. Mr Barrett’s HbA1cis10% prior to discharge. What does this indicate? What would be the targeted goal for Mr. Barrett’s’ HbA1c?

Examples responses:

Refer to at least 3 of QUM principles throughout Criterion 3 and link with your patient. For example: Guiding Principles to Achieve Continuity in Medication Management

Guiding principle 7 Administration of medicines in the community How might this be relevant to our pt? Does he need pharmacy input and education?

Guiding Principles for Medication Management in the Community Guiding principle 8 – up to date medications list

Q1

What are we trying to prevent and why? Think about lifestyle and cultural safety?

Q2

Refer to eMIMS and the look at all 3 medications listed, contraindications and adverse effects? Use academic writing, do not list these.

Q3

Cultural background, age, location, access to healthcare services?

You will need to give a definition of one of a Social Justice principle and apply this to Mr Barretts’ current condition.

Refer to Alm Ata – WHO (1978)

Close the Gap

Chronic disease and lifestyle changes, disease burden.

Q4

Education and compliance. What is important for patient and family to be aware of. Think of what happens when you increase energy – carbohydrates

Need to use scholarly literature to support your ideas

Q5

You will find a lot of Australian up to date literature on HbA1c for patients with type 2 diabetes monitoring

Criterion 4. Apply principles and practices of academic communication, writing, and referencing

Please write in academic format

Do not just use dot points and list answers. There needs to be sentence structure to your responses.

Third person, this is not a reflection

You are the student nurse, but some of your responses will use critical thinking and discussing the treatment pathways that need to followed

Please remember to link your responses back to the case study

References:

Refer to task 3 assignment tab for literature and links to up to date resource