| Course | NR 293 Pharmacology for Nursing Practice |
|---|---|
| Week | 1 |
| Paper type | Discussion post with one reply |
| Length | About 540 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 293 Week 1
Week 1 Discussion: Where the Nurse's Responsibility Begins
Digoxin 0.125 mg at 0900: The Apical Pulse and the Potassium That Belong to the Nurse Before the Tablet Leaves the Cup
Initial Post
My post is not about whether digoxin should have been prescribed. That decision belongs to the provider. It is about what becomes mine the moment the order appears on the medication administration record for my patient, who is 78 and has both atrial fibrillation and a weak left ventricle: digoxin 0.125 mg by mouth daily at 0900.
One medicine, one detail. The detail is the apical pulse, counted for a full minute with a stethoscope over the heart before I give the dose, not taken from the monitor or the pulse oximeter, which can miss beats in atrial fibrillation. Digoxin slows conduction through the heart, which is part of why it is given, but too slow is dangerous. The number under the word hold on my unit's protocol is an apical rate below 60 beats a minute: at that rate, I hold the dose and call the provider before 1000, rather than giving it and reporting afterward.
The second number I check is her potassium from this morning's labs. A low potassium makes the heart more sensitive to digoxin's effects, so a dose that is usually safe can cause rhythm problems when potassium is low. She is also on furosemide, which lowers potassium. Ziff and Kotecha (2016), reviewing the evidence on digoxin, stress that its use should take account of the dose, the blood level, drug interactions and side effects. For me, at 0900, that becomes two concrete checks: the pulse and the potassium, both before the tablet leaves the cup.
I would also ask her two questions, because some early signs of digoxin toxicity are things only she can report: whether she has been nauseated or lost her appetite, and whether her vision has changed, such as seeing colors or halos around lights. A "yes" to either would also mean holding and calling. Older adults with reduced kidney function, which she has, clear digoxin more slowly, so a dose that was right last month can build up this month without any change in the order. That is why the checks are repeated before every dose, not only when the drug is started. If her pulse had been 56 this morning, I would chart the apical rate, hold the tablet, and say to the provider: "Her apical pulse is 56 before her 0900 digoxin and her potassium is 3.3. I've held the dose. Do you want a level drawn?"
What your section settles: on our unit, the hold parameter is written into the order. I would be interested to hear whether other units expect the nurse to know it without it being written.
Reply to a Classmate
Rachel, you wrote about checking blood pressure before giving lisinopril. I would add one number your post left out: the potassium, because lisinopril can raise it, the opposite of what furosemide does to my patient's. If your patient were on both, like mine, the two drugs would pull potassium in opposite directions. Would you hold lisinopril for a high potassium even if the blood pressure was fine?
References
Ziff, O. J., & Kotecha, D. (2016). Digoxin: The good and the bad. Trends in Cardiovascular Medicine, 26(7), 585-595. https://doi.org/10.1016/j.tcm.2016.03.011
What the NR 293 Week 1 assignment asks for
The first NR 293 discussion asks you to describe the nurse's responsibilities when giving a medication, usually by choosing one drug and one patient. Expect the prompt to focus on assessment before the dose, monitoring after it and teaching, with a scholarly or drug reference source. One initial post and replies to classmates follow the course calendar. The prompt is about the nurse's part, not whether the prescriber chose well, so arguing for or against the drug answers the wrong question. Give each assessment a moment and a number. A hold decision needs the value that triggers it. Replies are graded on adding something a nurse would actually do differently.
Inside the NR 293 Week 1 example
The post opens by stating what it will not discuss: the choice of drug. It then names one detail, the apical pulse counted for a full minute rather than taken from a monitor that can miss beats in atrial fibrillation. A second check, this morning's potassium, follows with the reason: low potassium makes the heart more sensitive to digoxin, and furosemide lowers it. Two questions for the patient cover nausea and vision changes, early toxicity signs only she can report. Ziff and Kotecha (2016) support the points. The post ends on whether units write hold parameters into orders. The reply to Rachel adds potassium to a lisinopril post and asks about her hold value.
Reading the NR 293 Week 1 grading rubric
Points in this first pharmacology discussion usually follow accuracy of drug information, focus on nursing responsibilities, specific assessments and parameters, the peer reply and APA. Focus on the nurse's role carries a large share, which is why the post sets the prescribing decision aside in its first line. Specific assessments earn more when each has a timing and a number, such as a full-minute apical pulse and a morning potassium. Patient questions about nausea and vision show monitoring that only the nurse can do. The reply scores by supplying a missing value. Citing a current drug review rather than a general website supports the source row. Post timing and reply counts follow the classroom prompt.
NR 293 Week 1 help from the desk
Most lost points come from posts that answer a different question, arguing that the drug suits the condition. An assessment named without a moment attached guards nothing. The word hold with no value under it reads as vocabulary, not a plan. Monitor the patient, with no effect named and no timing, earns little. Teaching written in chart language instead of plain words loses marks. Replies that praise and add nothing a nurse would do differently cost the reply row. A real drug is easier to write about than a hypothetical one. Send the medication you are considering and your section's prompt, and an NR 293 post can be shaped around it.
Get a NR 293 Week 1 example written to your instructions
Send us the prompt for your week, the rubric if your section publishes one, and the medicine or class you have been given. A custom example is written to those instructions and comes back inside 24-48h, and the first one costs nothing. If your classmates have already posted, say so and we will keep the example clear of the ground they took.
More NR 293 papers and pre-licensure samples
- NR 293 Week 2: Drug Card
- NR 293 Week 3: Dosage Calculation Set
- NR 293 Week 4: Medication Safety Analysis
- NR 293 Week 5: Drug Class Write-up
- NR 293 Week 6: Patient Case Response
- NR 293 Week 7: Patient Teaching Script
- NR 293 Week 8: Medication Care Plan
- NR 302 Week 1: Discussion Post
- NR 283 Week 1: Cellular Injury Discussion Post
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NR 293 Week 1 questions, answered
Does the post have to name a real drug?
Most sections expect one, because a check only becomes specific once a medicine is attached to it. An ordinary drug works better than an unusual one, since your reader should recognize it immediately. Where the prompt supplies the agent or the class, use it exactly as published, and keep that same one running through your replies so the thread reads as one continuous line of thought.
Is this the week where I argue the drug was appropriate?
No, and posts that reach for it lose points to their own ambition. Whether this agent suits this condition is settled before the order ever reaches you, and the coursework that argues it comes much later in a career. The question here is narrower and harder to fake: given that the order exists, what has to be true before the dose goes in, and what tells you afterward that it worked.
How do the replies get marked?
By what they add, not by their warmth. A reply that names an assessment the original skipped, questions when a value was taken, or reports the same check behaving differently in a patient with kidney disease has done work. Length is not the variable being measured. Two specific sentences with a source behind them usually beat a paragraph of enthusiastic agreement.
Where can I find a free NR 293 Week 1 sample paper?
The complete Week 1 post on giving digoxin 0.125 mg at 0900, with the apical pulse, the potassium check and the reply to Rachel, is printed on this page.
Why does the NR 293 Week 1 post count the apical pulse by hand?
In atrial fibrillation a monitor or pulse oximeter can miss beats, so a full-minute apical count with a stethoscope gives the true rate before digoxin, which slows conduction, is given.