Lena D – DM

Preparing the Assignment

Follow these guidelines when completing each component of the discussion. Contact your course faculty if you have questions.

General Instructions

Step 1: Identify your assigned client from the Week 5 Explore lesson. Your assignment is based on the first letter of your last name in the chart below. Review your assigned clinical application activity from the lesson. The client case link will take you to the page in the lesson where the respective case is located.  Scroll to the bottom of the page to locate the client case.

Last Name	Client from Week 5 Lesson
A – E	Lena Dziedzic

Step 2: Assess the client’s case, the applicable clinical practice guideline (CPG), and the prescription writing activity for that client within the lesson. 

Step 3: Answer the discussion prompts below with explanation and detail, providing complete references for all citations. Refer to the lesson for client information. 

Step 4: Reply to peers with a different assigned client. 

Include the following sections:  

1. Application of Course Knowledge: Answer all questions/criteria with explanations and detail.  

a. Describe your assigned client’s situation. Why are they presenting to the clinic? What medications are they currently taking? 

b. Assess the applicable clinical practice guideline (CPG) for your assigned client linked on the same page in the lesson where the client case is located. What treatment is recommended by the CPG for your client’s situation?

c. Discuss your personal professional assessment of the client’s situation provided in the scenario. What pharmacological treatment is necessary and why?

d. Reflect on additional questions you have about your assigned client that may influence treatment. What else do you need to know? What follow-up assessments, labs, or conversations are required to ensure optimal health outcomes?

2. Integration of Evidence: Integrate relevant scholarly sources as defined by  program expectationsLinks to an external site. :

a. Cite a scholarly source in the initial post.

b. Cite a scholarly source in one faculty response post.

c. Cite a scholarly source in one peer post.

d. Accurately analyze, synthesize, and/or apply principles from evidence with no more than one short quote (15 words or less) for the week.

e. Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations.

3. NR565_W5 Discussion Rubric

NR565_W5 Discussion Rubric
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeApplication of Knowledge 4 Required Criteria  Answer all questions/criteria with explanations and detail:  1. Describe your assigned client’s situation. Why are they presenting to the clinic? What medications are they currently taking?  2. Assess the applicable clinical practice guideline (CPG) for your assigned client. What treatment is recommended by the CPG for your client’s situation?  3. Discuss your personal professional assessment of the client’s situation provided in the scenario. What pharmacological treatment is necessary and why? 4. Reflect on additional questions you have about your assigned client that may influence treatment. What else do you need to know? What follow-up assessments, labs, or conversations are required to ensure optimal health outcomes	20 pts Excellent All requirements met. 18 pts Very Good 3 requirement met. 17 pts Satisfactory 2 requirements met. 10 pts Needs Improvement 1 requirement met. 0 pts Unsatisfactory No requirements met.	20 pts
This criterion is linked to a Learning OutcomeIntegration of Evidence 5 Required Criteria  Integrate relevant scholarly sources as defined by program expectations:  1. Cite a scholarly source in the initial post.  2. Cite a scholarly source in one faculty response post.  3. Cite a scholarly source in one peer post.  4. Accurately analyze, synthesize, and/or apply principles from evidence with no more than one short quote (15 words or less) for the week.  5. Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations	12 pts Excellent All requirements met. 11 pts Very Good 4 requirements met. 10 pts Satisfactory 3 requirements met. 6 pts Needs Improvement 1-2 requirements met.

,

An appropriate prescription for Lena is:

Name: Lena Dziedzic 

Date Of Birth: 1/31/1977

Date Prescribed: Current Date

Rx: metformin (Glucophage) 500mg 

Disp: 60

Sig: Take one tablet by mouth twice daily with meals (once in the morning and once in the evening) 

Refills (O-4): 2

Dispense as Written: 

Generic Substitution Permitted: 

· Either  Dispense as Written or  Generic Substitution Permitted should be checked on every written prescription depending on what is best for each client.  Refer to the week 1 lesson for criteria.

Rationale: Biguanides like metformin are the first-line medications used to treat clients newly diagnosed with type 2 diabetes. Since this client is newly diagnosed with type 2 diabetes and does not have any contraindications, it is the appropriate medication therapy choice to add to lifestyle modifications (Samson et al., 2023). Four refills are prescribed as follow-up lab work should be done in approximately three months to recheck hemoglobin A1c. This will help the provider determine if current therapy is effective. The client should be taught to call the provider if they are experiencing any adverse effects in the interim period. Since this client is obese, if the client’s hemoglobin A1c is still elevated at a follow-up appointment, the provider should consider adding a GLP-1 agonist or an SGLT-2 inhibitor, according to the CPG (Samson et al., 2023).

Clinical Practice Guidelines for Type 2 Diabetes Management 

Prescribing considerations outlined in clinical practice guidelines (CPGs) for type 2 diabetes focus on a client-centered approach, with the choice of therapy tailored based on individual characteristics such as cardiovascular risk, kidney function, risk of hypoglycemia, and need for weight management. Initially, lifestyle modifications alongside metformin are recommended as foundational treatments. For clients with established atherosclerotic cardiovascular disease (ASCVD), heart failure, stroke/TIA, or chronic kidney disease, specific glucose-lowering medications with proven cardiovascular benefit, such as SGLT-2 inhibitors or GLP-1 receptor agonists, are preferred as first-line treatments over others due to their benefits beyond glycemic control. DPP-4 inhibitors, thiazolidinediones, and sulfonylureas are considered for clients without certain comorbidities in scenarios where first-line agents are contraindicated, not tolerated, or insufficient to achieve glycemic targets. Insulin therapy is reserved for clients with type 2 diabetes with significant hyperglycemia at diagnosis or those who do not achieve glycemic targets despite optimal use of oral agents. It is critical for providers to partner with clients for ongoing monitoring and medication regimen adjustments to achieve and maintain glycemic targets (Samson et al., 2023).