| Course | NR 293 Pharmacology for Nursing Practice |
|---|---|
| Week | 8 |
| Paper type | Medication care plan |
| Length | About 1,130 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 293 Week 8
Medication Care Plan: Nine Medicines for a 79-Year-Old Man, Grouped by What They Do Together Rather Than One Card at a Time
Student Name
College of Nursing, Chamberlain University
NR 293: Pharmacology for Nursing Practice
Instructor Name
Month Day, Year
Medication Care Plan: Nine Medicines for a 79-Year-Old Man, Grouped by What They Do Together Rather Than One Card at a Time
The List, Then Past It
Mr. O. is 79, admitted with community-acquired pneumonia. He weighs 72 kilograms and his estimated filtration rate is 48. Details are composite. His medicines, each against its reason:
Table 1
Mr. O.'s Medicines on Admission
| Medicine | Dose | Given for |
|---|---|---|
| Lisinopril | 20 mg daily | High blood pressure |
| Amlodipine | 10 mg daily | High blood pressure |
| Furosemide | 20 mg daily | Ankle swelling |
| Tamsulosin | 0.4 mg at bedtime | Enlarged prostate |
| Gabapentin | 300 mg twice daily | Nerve pain in the feet |
| Trazodone | 50 mg at bedtime | Sleep |
| Metformin | 500 mg twice daily | Type 2 diabetes |
| Clarithromycin | 500 mg twice daily, started today | Pneumonia |
| Ceftriaxone | 1 g IV daily, started today | Pneumonia |
Note. Home medicines continued on admission, plus two new antibiotics.
A plan that took these one at a time would produce nine accurate cards and miss what matters most: how they act together. The rest of this plan is grouped by consequence.
Effects That Stack: Blood Pressure
Four of his medicines lower blood pressure: lisinopril, amlodipine and furosemide by design, and tamsulosin as a side effect, since it relaxes smooth muscle in blood vessels as well as in the prostate. At home, his pressure ran around 132/78. Pneumonia adds to the stack, because infection widens blood vessels and he has been eating and drinking little. The result can be a low pressure when he stands, especially at night when tamsulosin has just been given and he gets up to pass urine.
One That Quietly Changes How Another Is Cleared
The newest medicine is the one that changes the others. Clarithromycin inhibits the liver enzyme, cytochrome P450 3A4, that clears amlodipine, so amlodipine levels rise and its blood pressure lowering grows. Wright et al. (2011), studying older adults on calcium-channel blockers in Ontario, found that clarithromycin was associated with a 3.7-fold higher odds of hospital admission for low blood pressure or shock, while azithromycin, which does not inhibit that enzyme, was not associated with a significant increase. The nurse raises this with the provider on the first day: "Mr. O. is on amlodipine 10 and was started on clarithromycin today. Would azithromycin work instead, or should we hold the amlodipine while he's on it?" The choice is the provider's, but the question is the nurse's.
Effects That Stack: Sedation and Falls
Gabapentin and trazodone both sedate, and both are given in the evening. In a 79-year-old with reduced kidney function, gabapentin clears more slowly and accumulates. Add a night-time drop in blood pressure from tamsulosin and the stack above, and the evening is when he is most likely to fall. Because of fall risk, the 2023 Beers panel counts medicines acting on the brain and recommends against a total of three or more at once (2023 American Geriatrics Society Beers Criteria Update Expert Panel, 2023); he takes two, which is below that threshold but still a combination to watch closely.
One Value, Several Pulls: Potassium and the Kidneys
Potassium is pulled in two directions: furosemide lowers it and lisinopril raises it. On most days they balance. In pneumonia, with poor intake and a risk of dehydration, both his potassium and his kidney function can shift. Metformin adds a separate concern: if his kidney function falls sharply, as it can with dehydration and infection, metformin may need to be held, and his provider will decide based on his creatinine.
A Schedule Tied to Doses
0800, before lisinopril, amlodipine and furosemide: blood pressure lying and standing; hold and call if systolic is below 100 or if he is dizzy on standing.
0800 labs: potassium, creatinine and glucose each morning while on antibiotics.
2000, before gabapentin and trazodone: sedation level and orientation; bed alarm on; urinal within reach.
2200, before tamsulosin: blood pressure; remind him to sit on the side of the bed before standing and to call before getting up.
Each meal: intake and whether he drank; metformin with food only if he is eating.
What Would Change the Plan
The plan holds only while the groups behave as expected, and three changes would reshape it. If his standing blood pressure falls below 100 systolic or he becomes dizzy, the first question is which of the four pressure-lowering drugs to hold, and the nurse brings the provider the timing: whether the drop follows the morning doses or the evening tamsulosin. If his creatinine rises by 0.3 mg/dL or more in a day, his kidneys are under strain, and three of his medicines change at once: metformin may be held, gabapentin may need a lower dose because it is cleared by the kidneys, and lisinopril may be held while he is dehydrated. If he becomes confused at night, the sedating medicines and the infection are both suspects, and the nurse reports the confusion with a list of what he was given that evening and when.
Each of these is a reason to call, not to adjust a dose on the unit. The plan's job is to make sure the call happens early and carries the right information.
The Line for the Next Nurse
The handover line summarizes the plan in the form the next nurse can use: "Mr. O. has four drugs lowering his pressure, and clarithromycin started today will raise his amlodipine level. I've asked the provider about switching to azithromycin. Check standing pressure before morning meds and before tamsulosin at 2200. Gabapentin and trazodone at night, so he's a fall risk; bed alarm on. Potassium and creatinine every morning." That sentence carries the three groups, the one pending question and the checks, which is what the next nurse needs, rather than nine separate drug facts.
What He Takes Home
At discharge, the teaching follows the same groups rather than a list of nine drugs. He is told which of his pills lower blood pressure and taught to stand slowly, especially at night. He is told that gabapentin and trazodone can make him drowsy and unsteady, and that a night light and a urinal by the bed are worth having for the first week home. He is told that the antibiotic is finished on a certain date and that, if it was clarithromycin, his amlodipine dose may have been changed while he took it, so he should confirm with his provider which dose to take afterward. And he is given a written list, grouped the same way, for his daughter to keep with his pillbox.
References
2023 American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372
Wright, A. J., Gomes, T., Mamdani, M. M., Horn, J. R., & Juurlink, D. N. (2011). The risk of hypotension following co-prescription of macrolide antibiotics and calcium-channel blockers. Canadian Medical Association Journal, 183(3), 303-307. https://doi.org/10.1503/cmaj.100702
What the NR 293 Week 8 assignment asks for
The final assignment asks for a medication care plan for a patient with multiple medications, often from a case. Expect the instructions to ask for the medication list with indications, important interactions, nursing assessments and monitoring, safety concerns, teaching and evaluation, in APA, supported by interaction studies and older adult prescribing guidance. The strongest plans group medicines by combined effects rather than writing separate cards. Monitoring should be tied to when doses are given, with numbers for holding and calling. Recommending that drugs be stopped belongs to the prescriber; the nurse raises concerns. Teaching should follow the same groups so the patient hears one conversation, not nine.
How the NR 293 Week 8 example is put together
The plan opens with Mr. O.'s nine medicines in a table, each against its reason, then announces that the rest is grouped by consequence. Blood pressure comes first: lisinopril, amlodipine, furosemide and tamsulosin, plus pneumonia. Clarithromycin's effect on amlodipine clearance is named, citing Wright et al. (2011), with a question for the prescriber about azithromycin. Gabapentin and trazodone are grouped for evening sedation and falls, with the Beers Criteria cited. Potassium and kidney function follow, including metformin. A schedule ties checks to 0800, 2000 and 2200 doses. A section lists three changes that would reshape the plan. The handover line and discharge teaching close it. Each section ends with the action the nurse takes.
Where the points sit in the NR 293 Week 8 rubric
Medication care plan rubrics commonly grade the medication review, identification of interactions and cumulative effects, monitoring with parameters, safety interventions, teaching, evaluation and APA. Combined effects decide most of the grade here, so the plan is organized by group instead of by drug. Monitoring scores when it is timed to doses and carries numbers, such as holding below 100 systolic. Interactions earn more when backed by evidence and turned into a question for the prescriber. Safety interventions are graded on fit, such as a bed alarm in the evening. Teaching by group meets the education criterion. A handover line shows the plan can be used tomorrow. A plan the next shift can pick up meets the continuity criterion.
NR 293 Week 8 help from the desk
The commonest failure is eight drug cards stapled together and called a plan. A monitoring schedule unrelated to dose times reads as routine, not monitoring. Arguing that the list should be shorter gives away the work being graded, since deprescribing is the prescriber's call. Parameters with no figures, breaches with no response, teaching repeated drug by drug and no handover line all lose points. Raise a concern with the prescriber rather than recommending a stop. Use the care plan format your section names. Most plans cover six to ten medicines. Bring your patient's medication list, and an NR 293 plan grouped by effect can be drafted.
Get a NR 293 Week 8 example written to your instructions
Send the case, the medication list your section supplied and the plan template if there is one, and a worked example returns inside 24-48h with the first one free. Tell us how many medicines the prompt carries and whether a nursing diagnosis format is required, since both change how the grouping section is laid out on the page.
More NR 293 papers and pre-licensure samples
- NR 293 Week 1: Nurse's Medication Responsibility Post
- NR 293 Week 2: Spironolactone Drug Card
- NR 293 Week 3: Dosage Calculation Practice Set
- NR 293 Week 4: Medication Error Safety Analysis
- NR 293 Week 5: Beta-Blocker Drug Class Write-Up
- NR 293 Week 6: Older Adult Opioid Case Response
- NR 293 Week 7: Levothyroxine Teaching Script
- NR 302 Week 8: Head to Toe Write-up
- NR 283 Week 8: Sepsis Final Case Paper
- NR 304 Week 8: Comprehensive Assessment Paper
- NR 228 Week 8: Older Adult Nutrition Care Plan
NR 293 Week 8 questions, answered
Should I recommend stopping one of the medicines?
No, and the pull to do it is strong by this point in the term. Reviewing a list and removing from it is a prescriber's decision and the coursework that teaches it sits later. Here the strongest equivalent move is inside your remit anyway: name the overlap you can see, write the observation that would detect it early, and report the finding with the value attached.
Does this have to be in a nursing care plan format?
Sections differ, and the published template settles it. Where a formal layout with diagnoses, goals and interventions is required, the medication reasoning still carries the points; the grouping, the parameters and the schedule simply get distributed into the columns. Where free prose is allowed, the same content reads more easily as headed sections. Neither choice changes what is being marked.
How many medicines does a plan usually cover?
Whatever the case supplies, and the number is rarely the interesting part. Even a list of four produces overlaps worth writing about, while a list of ten mostly adds transcription. If your prompt lets you choose, pick a list with at least two genuine interactions in it, because a plan built on a set of unrelated medicines has very little to group.
Where can I find a free NR 293 Week 8 sample paper?
The full Week 8 medication care plan for Mr. O., with nine medicines grouped by combined effect, the dose-timed schedule and the handover line, is shown on this page.
Which interaction does the NR 293 Week 8 plan flag?
Clarithromycin inhibits the liver enzyme that clears amlodipine, raising its level and its blood pressure lowering, so the nurse asks the provider about azithromycin instead.