Question 1: Explain the difference between ACE (Angiotensin converting enzyme)...

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Question 1: Explain the difference between ACE (Angiotensin converting enzyme) inhibitors and ARBs (Angiotensin receptor blockers). You must include the mechanism of action for each in your...

Question 1:	Explain the difference between ACE (Angiotensin converting enzyme) inhibitors and ARBs (Angiotensin receptor blockers). You must include the mechanism of action for each in your explanation (100 words max)		Satisfactory response
			Yes☐	No☐
Answer: ACE (angiotensin converting enzyme ARBs (Angiotensin receptors blockers is anti-hypertensive medication they block the body from being able to respond			Mark/4
Question 2:		Explain how beta blockers can lower blood pressure and heart rate. You must include the mechanism of action in your answer (100 words max)	Satisfactory response
			Yes☐		No☐
Answer: Beta blockers works mainly by slowing down the heart byreducing blood pressure. It works by blocking the effect of the hormone epinephrine, also known as adrenaline. Beta blocker cause your heart to beat more slowly and less force, which lowers blood pressure.			Mark/4
Question 3:		Why are people with Parkinson’s disease a dopamine agonist?You much include the mechanism of action in your answer (70 words max)	Satisfactory response
			Yes☐		No☐
Answer:			Mark/3
Question 4:		Why are people who have delirium given antipsychotic medications? Explain how the medication works on delirium (70 words max)	Satisfactory response
			Yes☐		No☐
			Mark/3
Question 5:		Explain how oral hypoglycaemic medications work on the 4 different areas of the body (150 words max)	Satisfactory response
			Yes☐		No☐
Answer:			Mark/9
Question 6:		Name three (3) considerations important to a nurse when administering insulin (70 words max)	Satisfactory response
			Yes☐		No☐
Answer:			Mark/3
Question 7.	Name all considerations the are important to a nurse when administering: Warfarin (70 words max)		Satisfactory response
			Yes☐		No☐
Answer:			Mark/5
Question 8.	Name 3 conditions/situations in which an anticoagulant is indicated (20 words max)		Satisfactory response
			Yes☐		No☐
Answer:			Marks/3
Question 9.	Why would a patient be prescribed a corticosteroid if they have asthma? (70 words max)		Satisfactory response
			Yes☐		No☐
Answer:			Marks/3
Question 10.	Describe how you would give an intramuscular injection. Include needle gage, and amount injected (70 words max)		Satisfactory response
			Yes☐		No☐
Answer:			Mark/3
Question 11.	Name all the areas you can inject for a subcutaneous injection (S/C) (max 20 words)		Satisfactory response
			Yes☐		No☐
Answer:			Mark/3
End of General knowledge questions / 43 marks Case study questions – 3 questions Case study 1: Mr Jones has been admitted to the hospital for an angiogram. The nurse admits him and makes a note of the medications he is on: ·Metoprolol ·Amlodipine ·Clexane ·Gliclazide The nurse gives him all his medications and leaves the room. Mr Jones calls for the nurse because he doesn’t feel well, the nurse does a set of vital observations, check his blood glucose level and check his bloods and finds the following BP: 123/64 HR: 53 SpO₂: 96% on room air RR: 10 BGL 5.3 K: 4.1 Na: 136 The nurse decides to withhold one of Mr Jones medications and report it to the nurse in charge and the doctor.
Question 1:		Which medication is within a nurse’s scope of practice to withhold? Explain why you picked the medication, why it was withheld and the consequences of not withholding it (100 words max)	Satisfactory response
			Yes☐		No☐
Answer:			Marks/5
Case study 2: Mrs Smith has come into hospital pre operatively for surgery to place a Deep Brain Stimulator in her brain. The nurse admits her and makes a list of her medications. She is on the following ·Phenytoin ·Madopar ·Peridopril The nurse was in a rush and had to prioritise Mrs Smith’s medications. So the nurse did a set of vital observations, checked her blood glucose levels and her blood results. The nurse only gave Mrs Smith one of her medications and plans to come back in 20 minutes and give her the rest. BP: 123/64 HR: 73 SpO₂: 97% on room air RR: 12 BGL: 6.3 Na: 137 K: 3.9
Question 1:		Which medication did the nurse decide to give immediately and why? Please explain the importance of giving this medication on time, and the consequences of not giving it on time (100 words max)	Satisfactory response
			Yes☐		No☐
Answer:			Marks/4
Case study 3: Mr Singh presents to the hospital feeling very unwell and is short of breath. The nurse takes a set of vital observations, checks Mr Singh’s blood glucose level and other blood test results and finds the following: BP: 180/80 HR: 95 RR: 35 SpO₂: 90% on room air BGL: 4.6 Na:142 K: 3.8 The nurse also takes a patient history and finds that Mr Singh has a few medical conditions, which includes: ·Type 2 diabetes mellitus ·Congestive cardiac failure ·Atrial fibrillation The nurse makes a list of medications that Mr Singh is on: ·Metformin 500mg daily ·Warfarin 2mg daily ·Frusemide 20mg daily ·Metoprolol 25mg daily The nurse gives all this information to the doctor and the doctor decides to increase one of Mr Singh’s medications.
Question 1:		Taking into consideration all the information above, which medication did the doctor increase? In your explanation you must include: ·The mechanism of the medication to help explain your medication choice ·The symptoms the were treated by increasing this medication ·The observations were treated by increasing this medication (150 words max)	Satisfactory response
			Yes☐		No☐
Answer:			Marks/10
End of Case study questions /19 marks Critical thinking questions – 12 questions Scenario 1: Mr Kaur present to the emergency department. He tells the doctor he is experiencing crushing chest pain. The doctor prescribes glyceryl nitrate (GTN) sub lingual (S/L) 300mcg every 10 minutes until the chest pain resolves. The nurse administers the GTN and checks Mr Kaur’s blood pressure (BP) regularly
Question 1:		Explain how glyceryl nitrate (GTN) is used to treat chest pain and why the nurse was checking Mr Kaur’s blood pressure regularly specifically to this situation? (100 words max)	Satisfactory response
			Yes☐		No☐
Answer: GTN is used for heart failure, high blood pressure. It works in relaxing the blood vessels and this reduce the strain on your heart, making it easier for your heart to pump blood around your body.it used and prevent chest pain caused by decreased blood flow to the heart.			Marks/5

Scenario 2:

Mrs Tran has had a craniotomy and

Answered Same DayJul 24, 2021

Pratyusha · Accepted Answer

Assignment Question
	Question 1: 
	Explain the difference between ACE (Angiotensin converting enzyme) inhibitors and ARBs (Angiotensin receptor blockers). 
You must include the mechanism of action for each in your 
explanation 
(100 words max) 
	Satisfactory response 
	
	
	Yes☐ 
	No☐ 
	Answer: 
Angiotensin is a hormone (peptide hormone) associated with the functioning of kidneys by stimulating the discharge of aldosterone and as a result causing increase in blood pressure through vasoconstriction. ACE (Angiotensin converting enzyme) inhibitors and ARBs (Angiotensin receptor blockers) although playing a common role in inhibiting the functions of angiotensin, their mechanisms of action are different.
As supported by Messerli, Bangalore, Bavishi and Rimoldi (2018), ACE inhibitors restrain the formation of Angiotensin II by inhibiting the breakdown of bradykinin and subsequently affecting the angiotensin II type 1 (AT1) receptor and the angiotensin II type 2 (AT2) receptor. ARBs on the other hand, specifically dislodge angiotensin II from the AT1 receptor by stimulating the receptor more, leading to vasodilation and an anti-hypertensive effect in the body. 
	Mark/4 
	Question 2: 
	Explain how beta-blockers can lower blood pressure and heart rate. You must include the mechanism of action in your 
answer 
(100 words max) 
	Satisfactory response 
	
	
	Yes☐ 
	No☐ 
	Answer: 
Beta-blockers work mainly by slowing down the heart by reducing blood pressure. It works by blocking the effect of the hormone epinephrine, also known as adrenaline. Beta-blocker causes your heart to beat more slowly and less force, which lowers blood pressure. They help to increase the blood flow to all organs by opening up the veins and arteries. They may bring an effect to the heart or to both the heart and blood vessels, as supported by Bain (2018). They act by blocking the beta-1 adrenergic receptors not allowing epinephrine to bind. Examples of beta-blockers are Bisoprolol, Metoprolol and Nebivolol, which can be taken orally.
	Mark/4 
	Question 3: 
	Why are people with Parkinson’s disease a dopamine agonist? You much include the mechanism of action in your answer 
(70 words max) 
	Satisfactory response 
	
	
	Yes☐ 
	No☐ 
	Answer: 
In Parkinson’s disease, there is a lack of release of dopamine, as the patients do not have the nerve endings producing dopamine, which is gradually lost with age, hence the movements of the body and actions, generated is impaired. Dopamine agonists mimic the actions of Dopamine by binding to Dopaminergic receptors such as D1 and D2 and they bring the regulation of the motor neurons. Hence, the body’s natural activity is resumed. 
	Mark/3 
	Question 4: 
	Why are people who have delirium given antipsychotic medications? Explain how the medication works on delirium 
(70 words max) 
	Satisfactory response 
	
	
	Yes☐ 
	No☐ 
	Delirium leads to acute disturbances of consciousness in patients and they can develop a mixture of symptoms such as dementia or depression. In hyperactive delirium, patients tend to hallucinate or get agitated quite often in even turning violent. Hence, they require the antipsychotic medications. The antipsychotic medications play important role in regulating the amount of acetylcholine, dopamine serotonin and gamma-aminobutyric acid (GABA) by mostly binding to their receptors after understanding the pathogenesis, as supported by Markowitz and Narasimhan (2008).
	Mark/3 
	Question 5: 
	Explain how oral hypoglycaemic medications work on the 4 different areas of the body 
(150 words max) 
	Satisfactory response 
	
	
	Yes☐ 
	No☐ 
	Answer: 
The oral hypoglycaemic medications act by bringing down the levels of the blood glucose. They are medicines such as α-Glucosidase inhibitors, Biguanides, Sulfonylurea and Metformin, which are used in the treatment of type-2 diabetes. Biguanides acts on the liver and bringing the lessening effects of the output by liver along with increasing the sensitivity of insulin in hepatic and the peripheral tissues. Metformin acts on many organs associated with regulating the blood glucose level.
It acts on the muscle tissues to increase the insulin action and the activity of the insulin receptors even have antilipolytic effects to lower the concentration of fatty acids in the serum. It also has an action on the liver and adjoining tissues, stimulate glucose uptake, and lessen their breakdown. Metformin also inhibits the levels of HbA1c by nearly 2 percent. They also have an effect on the stomach and small intestine causing discomfort and metallic taste in mouth, as supported by Lorenzati, Zucco, Miglietta, Lamberti and Bruno (2010).
	Mark/9 
	Question 6: 
	Name three (3) considerations important to a nurse when administering insulin 
(70 words max) 
	Satisfactory response 
	
	
	Yes☐ 
	No☐ 
	Answer: 
i. The bottle containing insulin should not bear any changes such as aggregation, change of colour, precipitation or clumping when it is going to be administered.
ii. The vial containing the insulin should not be shaken vigorously while administering in the patients (Rizos et al., 2016). 
iii. The injection sites should be first rotated for a while before administering, there should be minimum damage to the muscles or careful to avoid any further damage to the subcutaneous layers.
	Mark/3 
 
	Question 7: 
	Name all considerations the are important to a nurse when administering:

Question 1: Explain the difference between ACE (Angiotensin converting enzyme) inhibitors and ARBs (Angiotensin receptor blockers). You must include the mechanism of action for each in your...

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