“Pharmacologic Management of Acute Disorders in the Adult Lifespan: A Clinical Decision-Making Process for AGACNP Practice”

Purpose
The purpose of this interactive discussion is to allow for a discovery of the clinical decision-making process that guides the appropriate clinical use of pharmacologic agents used in the treatment of acute disorders across the adult lifespan The development of evidence-based prescribing practice supports the professional formation of the AGACNP practice role.
Course Outcomes
This assignment enables the student to meet the following course outcomes:
CO 1: Select appropriate medications according to patient presentation and unique patient factors. (PO 1)
CO 2: Analyze factors pertinent to making the most effective drug selection for a client with a specific diagnosis in the acute care setting. (POs 1, 2)
CO 6: Analyze whether pharmacological therapy is appropriate for individualized patients. (PO 1)
Total Points Possible
This assignment is worth 100 points.
Preparing the Assignment
Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.
Post your initial response to the discussion question by the due date. 
Post substantial replies to a peer and faculty by the due date.  
Paraphrase information rather than rely on direct quotes. Direct quotes must be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. 
Answer the question that corresponds with the 1st letter of your last name only; do not respond to other questions in your initial post (see below). 
A-G:
Explain why an Ace Inhibitor is recommended for a patient who has just experienced an ST-Elevation Myocardial Infarction (STEMI). Which pharmaceutical agent (include dose, route, frequency) would you prescribe for this patient? Explain your rationale.  Determine whether the Ace Inhibitor will protect the patient from having a cardiac arrhythmia post STEMI?  Explain your rationale. 
H-M: 
A 79-year-old male presents to the Emergency Department with acute onset of chest pain, shortness of breath, diaphoresis, and vomiting that started 4 hours prior to arrival.  The EKG obtained demonstrates an acute ST-Elevation Myocardial Infarction (STEMI).  Discuss the medications (dose, route, frequency) you would prescribe for this patient. Explain your rationale for each agent prescribed. 
N-S
An 81-year-old female was admitted to the cardiology unit following an acute ST-Elevation Myocardial Infarction (STEMI) 3 days ago. She was treated successfully with percutaneous coronary intervention and stent to the right coronary artery. She now has symptoms of mild confusion, lightheadedness, and generalized weakness. She vomited her medications this morning. You have a high suspicion of cardiogenic shock. Her blood pressure is 81/30; HR 112. Identify the medications (dose, route, frequency) you would prescribe for this patient. Explain your rationale for each agent prescribed.
T-Z
A 68-year-old male with a history of hypertension presents to the Emergency Department with 3 days of worsening headache. He is currently taking HCTZ 25mg daily. Blood pressure on arrival is 220/112.  HR 100.  No chest pain, no shortness of breath, no abdominal pain. No illness or fever.  His neurological exam is normal. Identify the medications (dose, route, frequency) you would order for this patient. Explain your rationale for each agent prescribed.