Exam (elaborations)
NR 566 CLASS DISCUSSION WEEK 1.
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NR 566 CLASS DISCUSSION WEEK 1.
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This is a graded discussion: 100 points possibledue Jan 10
Week 1: Clinical Case Study (Original response due by Wednesday, responses due by Sunday)
No unread replies.9999 replies.
Purpose
Problem-based learning is a methodology designed to help students develop the reasoning process used
in clinical practice through problem solving actual patient problems in the same manner as they occur in
practice. The purpose of this activity is to develop students’ clinical reasoning skills using a case-based
learning exercise. Through participation in an online discussion forum, students identify learning issues
in a self-directed manner which facilitates learning for the entire group.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
Synthesize clinical knowledge, didactic learning and research findings to provide appropriate
pharmacological care to primary care patients. (CO 1, 2, 3, 4, & 6)
Due Date:
The student must provide an initial response to the discussion topic by Wednesday, 11:59pm MT.
Subsequent posts, including substantive responses to peer(s) and faculty questions must occur by
Sunday, 11:59pm MT. A total of 3 substantive posts are required on 3 different days.
A 10% late penalty will be imposed for initial discussions posted after the deadline on Wednesday
11:59pm MT, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on
Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
A 10% penalty will be imposed for not entering the minimum number of interactive dialogue posts (3)
OR not posting on the minimum required number of days (3). NOTHING will be accepted after 11:59pm
MT on Sunday (i.e. student will receive an automatic 0)
Total Points Possible: 100
Case Study & Discussion Questions
,John is a 46-year-old male who presents for his yearly physical examination. He has no complaints.
Previous medical history is notable for obesity and hyperlipidemia. He reports a very sedentary lifestyle.
He sits at a desk for 8 to 10 hours per day and when he comes home he “just wants to relax in front of
the television.” He doesn’t feel motivated enough to exercise on a regular basis, although he knows he
should.
John is allergic to penicillin (hives). Medications include atorvastatin 10mg daily and a multivitamin. He
occasionally takes acetaminophen for a headache.
Family history is significant for diabetes (mother, maternal grandmother, paternal grandfather) and
hypertension (father and brother). He is a nonsmoker and reports drinking “a few beers on the weekend
during football season”. His diet largely consists of fast food meals. He drinks sweet tea with every meal
and an additional 3-4 cups of coffee per day. Previous labs and exam last year are unremarkable.
Vitals today: BP 130/70 mm Hg, pulse 82 and regular, temperature 98.7, respirations 18, height 6’1”,
weight 235 pounds (up 3 lbs. since his visit 1 year ago). He completed fasting labs prior to this
appointment as he was instructed which reveal the following:
Fasting plasma glucose=209 mg/dl, HgbA1C=9.1%, TSH=4.0mU/L and Free T4=1.1 ng/dl. Fasting lipid
panel includes the following: total cholesterol=190 mg/dL, HDL=35 mg/dL, LDL=120 mg/dL and
triglycerides=260 mg/dL.
Physical exam is remarkable for obesity but is otherwise normal.
What are your treatment goals for John?
What is your pharmacologic plan and rationale? (cite with appropriate clinical practice guidelines or
scholarly, peer-reviewed journals)
What is the mechanism of action for each drug?
Please give five medication teaching points for each drug prescribed.
How would you change the plan if his initial HbgA1C was 14.0 mg/dL and his fasting blood glucose was
350mg/dL along with a urine dipstick that revealed 3+ glucose and + ketones? Provide a detailed
alternative plan with the rationale.
Discussion Guiding Principles
,The ideas and beliefs underpinning the discussions guide students through engaging dialogues as they
achieve the desired learning outcomes/competencies associated with their course in a manner that
empowers them to organize, integrate, apply and critically appraise their knowledge to their selected
field of practice. The use of discussions provides students with opportunities to contribute level-
appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models
professional and social interaction. The ebb and flow of a discussion is based upon the composition of
student and faculty interaction in the quest for relevant scholarship. Participation in the discussion
generates opportunities for students to actively engage in the written ideas of others by carefully
reading, researching, reflecting, and responding to the contributions of their peers and course faculty.
Discussions foster the development of members into a community of learners as they share ideas and
inquiries, consider perspectives that may be different from their own, and integrate knowledge from
other disciplines.
Direct Quotes
Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to
one short quotation (not to exceed 15 words). The quote must add substantively to the discussion.
Points will be deducted under the grammar, syntax, APA category.
**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray
bar above the discussion board title and then Show Rubric.
DISCUSSION CONTENT
Category
Points
%
Description
Application of Course Knowledge
35
, 35%
Decisions are well supported with evidence based medicine (EBM) arguments that are in-line with the
scenario; AND
Proper rationale and reasoning skills are demonstrated; AND
Information is taken from source(s) with appropriate interpretation/evaluation to develop a
comprehensive analysis or synthesis of the topic at hand; AND
Applies concepts to personal experience in the professional setting and/or information has relevant
application to real life; AND
All of the post makes direct reference to concepts discussed in the lesson; AND
Posts are on topic and answer all presented questions which demonstrates a solid understanding of the
topic.
(6 critical elements)
Support from Evidence-Based Practice (EBP)
35
35%
Discussion post is supported with appropriate, scholarly sources; uses valid, relevant, and reliable
outside sources to contribute to the threaded discussion; AND
Sources are published within the last 5 years (unless it is the most current CPG); AND
Reference list is provided and in-text citations match; AND
Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed
professional or academic decisions
(4 critical elements)
Interactive Dialogue
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