Pathopharmacological Foundations for Advanced Nursing Practice
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Pathopharmacological Foundations for Advanced Nursing Practice
A. Investigated Disease Process: The paper investigates the processes of Alzheimer’s and pharmacological implication.
A1. Pathophysiology: The theory based on monoamine-deficiency determines that the recognizable pathophysiological source of Alzheimer’s Disease is the occurrence of dementia and dementia like symptoms (Unützer, & Park, 2012). Donepezil is applicable in the pathophysiology and is commendable by the therapeutic efficacy of its control. There are various conventional discussions based on the categorization and basis of dementia. The concept made by Emil Kraepelin'sdetermines that is a formulation of a Sigmund and disease. On the other hand, Freud perceives Alzheimer’s disease is an expression of internalized loss and weakness (Unützer, & Park, 2012). Alzheimer’s disease may not be categorized as a homogeneous disease, but it is a sophisticated phenomenon that has various subtypes and at least one etiology. It also has various predispositions in symptomatology that range from mild to severe symptoms.
A2. Standard of Practice: The American Psychiatric Association presents the best practices to be followed while addressing Alzheimer’s disease disorder. The practices aim to assist healthcare providers in making informed decisions by providing systematic strategies. Most Alzheimer’s disease disorders are curable based on evidence- based approaches. Many dementia disorders increase the rate of patient’s morbidity and mortality. The disorder requires the application of randomized clinical trials. There is also the need for intervention and use of right drugs like to manage the disease and reduce adverse medical side effects. Therefore, appropriate treatment reduces symptoms and assists the patient to manage the depressive disorder (Unützer, & Park, 2012).
A2a. Pharmacological Treatments: The major pharmacological treatment includes taking antidepressant medication such as the tricyclic antidepressants (TCAs) and MAO inhibitors (Unützer& Park, 2012). The antidepressant alleviates the depressions symptoms. However, their use are fatal and life –threatening. The medication has severe damage to the cardiovascular system.The society incurs additional cost to manage the side effects especially that are caused by the MAOIs. The interaction with tyramine leads to lethal hypertension. The high cost of the medication and insufficient dosage poses the society to the inability to manage the disorder more so in adults (Unützer, & Park, 2012).
A2b. Clinical Guidelines: The assessment of the disease is based on DMS-IV. The assessment involves the identification of the severity, number of symptoms, the duration of the present episode, and the courses of disorder. The clinician has to identify various symptoms for him to effectively diagnose and treat depression. The physical examinations necessary to reveal the overall health condition. While behavioral aspects determine the severity of the disorder. For a nurse to diagnose and treat depression, they must identify observable and behavioral symptoms such as loss of weight and weakening of urinal system (Unützer, & Park, 2012). The patient education is critical and should be based on how to manage the disorder and best courses of action to handle severe symptoms.
A2c. Standard Practice of Disease Management: There is a gap between how the community and state manage the depression. The communities handle it through counseling and involvement of the victim into community work. On the contrary, the state has established rehabilitations and provides medical assistance.
A3. Managed Disease Process:Access to major resources may be helpful to the patient in the identification and management of the disorder.The person who manages Alzheimer’s disease requires competency and regular access to care. Major useful resources include the MedlinePlus, and the National Institute of Mental Health. The approach enables them to access psychotherapy, medication, and intervention to manage the disease (Unützer& Park, 2012). The resource and access to care enables the patient to manage the disease and to ensure leading a normal life.
A3a. Disparities: The disparity for Alzheimer’s disease management emanates from the quality of care and prognosis process. The national management is guided by the local nursing practices while WHO outlines the guidelines for Alzheimer’s disease treatment (Unützer& Park, 2012). The local management level identifies various stages for the disease management. There is the assessment, prognosis, diagnosis, treatment, and follow-up. On the contrary, the WHO provides useful resources and guiding principles that help patients and clinicians on how to manage depression.
A4. Managed Disease Factors: The factors that help the patient manage the disease include the financial resources, access to care, insured/uninsured factors, and Medicare/Medicaid. Financial resources enable the patient to buy recommended medications. Access to care ensures that patients have access to relevant tools and medication for the disease management. Medicare/Medicaid assist the patient with limited income to access the medical facility/care hence assisting in the illness management at subsidized costs (Unützer& Park, 2012).
A4a. Unmanaged Disease Factors: Lack of the aforementioned factors may lead to an unmanaged disease process. The lack of sufficient finance leads to inaccessibility and inability to acquire advanced medication. The patient is unable to access and take the required medication due to financial constraints. Lack of advanced care units poses the patient to the risk of inadequate resource to the disease management. Lack of Medicaid makes the patient being unable to access quality care due to unsubsidized cost and inadequate medical facilities.
A4ai. Unmanaged Disease characteristics: Therefore, the patient experiences symptoms such as indecisiveness, agitation, and suicidal thoughts (Unützer, & Park, 2012).According to the national institute of mental health, the patient experiences severe side effects that pose them to life-threating symptoms. There is the desire to commit suicide due to withdrawal symptoms. These symptoms become costly to the community and the affected families.
B. Patients, Families, & Populations: The disease poses the community into additional commitments in terms of resources and time to ensure that the patient gets quality care (Unützer& Park, 2012). The community and the family has to raise additional finances and takes a lot of time to seek the appropriate care units that have relevant tools and qualified healthcare providers. The community has to sacrifice the daily economic activities at the expense of ensuring one of their members gets quality care.
B1. Costs: The community is posed to consultation costs, medication costs, and follow-up costs to ensure future management of depression. These costs emanates from the desire to have quality care. The consultation cost relates to assessment and diagnosis. Medication cost relates to pharmacological process, Electroconvulsive therapy, and psychotherapy. The follow-up cost ensures that the patient manage the syndrome and prevents future recurrence of the disease.
C. Best Practices Promotion: I would recommend the management to provide advanced facilities to promote quality care in the organization. The stages to follow to ensure accurate practice involve: * Educating employees and sensitize for self-assessment tests * Providing financial assistance to the affected employees * Providing favorable working condition to prevent depressive environment * The institution should provide internal care facilities to ensure easy access of emergency care
C1. Implementation Plan: The organization needs to train its health care providers on how to assess and diagnose depression. It is also a requirement to sensitize the community on how to avoid depressive activities. These are the keys to ensuring advanced care and subjects employees to quality care and reduce management costs that are costly to the patient and the community at large.
C2. Evaluation Method: The assessment of the aforementioned implementation processes would ensure that the management adheres to the suggested employee needs. The use of evidence-based trials will be appropriate. The reduction of Alzheimer’s diseasecases in the organization may also be used to assess the implementation of the strategies.
D. Sources:
Unützer, J., & Park, M. (2012).Strategies to improve the management of Alzheimer’s disease in primary care.Primary Care: Clinics in Office Practice, 39(2), 415-431.