The roles and responsibilities of the APRN when prescribing medication.

Full Answer Section

• Collaboration: Consulting with other healthcare professionals, such as physicians and pharmacists, when necessary.
• Maintaining Competency: Staying up-to-date with current evidence-based practices, drug information, and prescribing guidelines.
• Adherence to Legal and Ethical Standards: Prescribing within the scope of their practice and in compliance with all applicable laws and regulations.
• Patient Safety: Prioritizing patient safety by minimizing the risk of medication errors and adverse drug reactions.

2. Method Used to Determine What Drug Therapy to Prescribe:

APRNs use a systematic approach to determine appropriate drug therapy:

• Evidence-Based Practice: Relying on current research and clinical guidelines to inform decision-making.
• Patient-Centered Approach: Considering the patient's individual needs, preferences, and values.
• Pharmacokinetics and Pharmacodynamics: Understanding how the body absorbs, distributes, metabolizes, and eliminates drugs, as well as how drugs interact with the body's receptors.
• Clinical Guidelines and Protocols: Following established guidelines for specific disease states.
• Drug Information Resources: Utilizing reliable drug information resources, such as drug formularies, databases, and clinical pharmacists.
• Consideration of Co-morbidities and Drug Interactions: Evaluating potential drug interactions and the impact of co-existing medical conditions.
• Cost-Effectiveness: Considering the cost of medications and exploring alternative treatment options when appropriate.
• Shared Decision-Making: Engaging the patient in the decision-making process and ensuring informed consent.

3. Responsibilities for Patient Education and Teaching Based on the Prescribed Therapy:

Patient education is a crucial aspect of medication management:

• Medication Information: Providing clear and concise information about the medication, including its purpose, dosage, route, frequency, and potential side effects.
• Administration Instructions: Demonstrating proper medication administration techniques, such as using inhalers or insulin injections.
• Adherence Strategies: Discussing strategies to promote medication adherence, such as using pill organizers or setting reminders.
• Side Effect Management: Educating patients about potential side effects and how to manage them.
• Drug Interactions: Informing patients about potential drug interactions, including interactions with other medications, food, or alcohol.
• Monitoring and Follow-Up: Explaining the importance of monitoring for therapeutic effects and adverse reactions, and scheduling follow-up appointments.
• Lifestyle Modifications: Discussing lifestyle modifications that can complement medication therapy, such as diet and exercise.
• Documentation: Documenting all patient education and teaching provided.
• Tailoring Education: Adjusting the education to the patient's literacy level, and cultural background.

4. Scheduled Drugs and Prescribing Restrictions for Each Scheduled Drug:

Scheduled drugs are classified based on their potential for abuse and dependence. Prescribing restrictions vary for each schedule:

• Schedule I:
  • High potential for abuse; no currently accepted medical use in the U.S.
  • Examples: Heroin, LSD, marijuana (federally).
  • Prescribing Restrictions: No legal prescriptions.
• Schedule II:
  • High potential for abuse, which may lead to severe psychological or physical dependence.
  • Examples: Opioid pain medications (e.g., oxycodone, hydrocodone), stimulants (e.g., amphetamine, methylphenidate).
  • Prescribing Restrictions: Requires a written prescription or electronic prescription. No refills without a new prescription.
• Schedule III:
  • Potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence.  
  • Examples: Combination products containing less than 90 milligrams of codeine per dosage unit (e.g., Tylenol with codeine), ketamine, anabolic steroids.  
  • Prescribing Restrictions: Written, faxed, electronic, or verbal prescriptions allowed. Refills allowed up to five times within six months.
• Schedule IV:
  • Low potential for abuse relative to substances in Schedule III.
  • Examples: Benzodiazepines (e.g., alprazolam, diazepam), sleep aids (e.g., zolpidem).
  • Prescribing Restrictions: Written, faxed, electronic, or verbal prescriptions allowed. Refills allowed up to five times within six months.
• Schedule V:
  • Low potential for abuse relative to substances in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics.  
  • Examples: Cough preparations containing limited amounts of codeine, pregabalin.  
  • Prescribing Restrictions: Written, faxed, electronic, or verbal prescriptions allowed. Some may be dispensed without a prescription under certain conditions.

It's vital for APRNs to remain updated on their state's particular rules, as these can vary slightly.

Sample Answer

1. Roles and Responsibilities of the APRN When Prescribing Medication:

APRNs (Advanced Practice Registered Nurses) with prescriptive authority have a wide range of responsibilities:

• Assessment and Diagnosis: Conducting thorough patient assessments, including history taking, physical examinations, and ordering diagnostic tests, to establish accurate diagnoses.
• Drug Selection and Dosing: Choosing the appropriate medication, dosage, route, and frequency based on the patient's condition, age, weight, and other relevant factors.
• Prescribing: Legally authorizing medication orders, either electronically or in writing, according to state and federal regulations.
• Monitoring and Evaluation: Assessing the patient's response to medication, monitoring for adverse effects, and adjusting the treatment plan as needed.
• Documentation: Maintaining accurate and complete records of medication orders, patient responses, and any adverse events.