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NURS 676 Week 3 Discussion Responses Vicente Gutierrez Seizures are described as any type of epileptic event, seizure disorder is closely related to epilepsy which is described as recurrent seizures that are brought on by excessive excitability or neurons in the brain (Burchum & Rosenthal, 2021). Seizures are treated by antiseizure drugs, the type of medication a person affected by seizures depends on the specific type of seizure they are diagnosed with. For instance, seizure types are separated into two broad categories, partial and generalized seizures, depending on the type of seizure a patient has is the medication that will be prescribed to treat their symptoms (Burchum & Rosenthal, 2021). Medication’s focus is to suppress discharge of neurons within a seizure focus and to suppress propagation of seizure activity in certain areas of the brain (Burchum & Rosenthal, 2021). Antiseizure medications nearly all act through five basic mechanisms: sodium influx, suppression of calcium influx, promotion of potassium efflux, blockade of receptors of glutamine, and potentiation or increase of gamma-aminobutyric acid (GABA) (Burchum & Rosenthal, 2021). When an antiseizure medication is started the provider and the patient will work together to ensure the medication is being effective as well as educating the patient to increase adherence and compliance. A trial period of the medication is important to establish a therapeutic dosage to subside the symptoms of the seizure while not causing undesired side effects (Burchum & Rosenthal, 2021). One of the main potential drug interactions with antiseizure medication is the use of oral contraceptives in women of childbearing age (Burchum & Rosenthal, 2021). It is important to establish a plan with the patient and provider since antiseizure medications decrease the effectiveness of oral contraceptives (Burchum & Rosenthal, 2021). McKenzie Rosendale For asthma exacerbation, there are two phases: early and late. The early phase happens when IgE antibodies are released into the body. These antibiotics can be triggered by many ways with one being the environment. Once the antibodies are released, it will bind to mast cells and basophils (Sinyor & Perez, 2023). When a allergen enters the body, the mast cells will release cytokines, histamine, prostaglandins, and leukotrienes (Sinyor & Perez, 2023). With this reaction happens, it makes the smooth muscles to contract making it hard to breathe. The late phase in asthma exacerbation happens a few hours after the initial reaction and eosinophils, basophils, neutrophils, and T cells will migrate to the lungs, which causes inflammation and constriction (Sinyor & Perez, 2023). An adrenergic agonist decreases the transmission by binding to presynaptic alpha 2 receptors. It also dilates the bronchial passages to help with the constriction from the asthma exacerbation (Sinyor & Perez, 2023). The most appropriate is adrenergic agonists that are selective for beta 2 receptors (albuterol). Beta 2 agonists are typically administered through inhalation, which minimizes systematic effects (Rosenthal & Burchum, 2021, pg. 104). If too much of a beta 2 agonists are inhaled, the effects may be angina pectoris and/or tachycardia because it activates the beta 1 receptors. The typical treatment for a severe asthma attack is a nebulized short acting beta agonist, which can be an inhaled medication. The dosage for this medication is between 1.25-5 mg every four to eight hours as needed (AAAAI, 2023). The dosage for a child is 0.63-2.5mg/kg every four to six hours (AAAAI, 2023). A nurse practitioner can determine the dosage based on the child’s weight and for an adult, the nurse practitioner would be to start at the lowest dose and slowly increase the dosage over time. NURS 530 Week 3 Discussion Responses Maria Sanchez “Mental illnesses are common and found in different cultures and across the socioeconomic spectrum. When left untreated, the consequences can be devastating” (Rogers, 2022, p. 618). Mental illness has been on the rise and although we are more open about talking about it, we still have work that needs to be done. There continues to be a stigma surrounding mental illnesses. The stigma towards mental illness could be due to differences in values, beliefs, religion, culture, age, and much more. Nurse practitioners have a responsibility to their patients to provide a space that is safe, welcoming, and open regarding mental illness. Nurse practitioners can implement various strategies/techniques in their practice to foster open communication, and reduce stigma surrounding schizophrenia, mood disorders, anxiety disorders, PTSD, and OCD. Nurse practitioners can discuss their patients with the lead psychiatrist and interdisciplinary team. The open discussions between nurse practitioners, psychiatrists, and interdisciplinary team can allow for open communication, dialogue of treatment, feedback of treatment, and discussions about alternative treatments. Open communication allows for clear communication between interdisciplinary team and setting of goals. This can reduce stigma because there is clear communication, discussion, and education that occurs between those involved in the treatment team. If a person is knowledgeable, it will allow for them to be more comfortable, confident, and open to talk about mental illness thus normalizing mental illness. Another method that a nurse practitioner can help reduce stigma on mental health is knowing how to effectively communicate with their patients. Nurse practitioners must be aware of the language that they use and must be careful in making sure that they are not using words, phrases, or making comments that could be judgmental, offensive, or blaming patients for their mental illness. Nurse practitioners need to be aware of their own personal beliefs and not let them get in the way of the care for their patients. Khrystene Nguyen I understand the challenges of providing effective pain relief with opioids in neurological patients. Every patient is different, and their pain management therapy may differ from the next. A good place to start is to examine their prior medical records and the medications they are presently prescribed. Conducting a thorough assessment of the patient’s pain, underlying neurological conditions and any coexisting medical issues are also essential. Creating an individualized treatment plan can also aid in targeting the patient’s specific pain needs when considering the severity of pain and treatment goals. An important aspect when prescribing opioid pain medication is to assess for risk factors for opioid misuse, addiction, and overdose. If opioids are necessary, treatment should be initiated with the lowest effective dose and titrated appropriately and cautiously while monitoring the patient’s response (Rogers, 2022). It is also important to regularly assess the patient’s pain and treatment plan to adapt to changing needs and minimize the risk of opioid-related problems. Another option if the patient requires a revision in pain management is to explore alternative therapies such as rehab, psychological support, or complementary therapies to enhance pain management.
