PA 524 Week 8 Renal Dosing Adjustment Table Example

Course	PA 524 Comprehensive Clinical Module Nephrology & Genitourinary
Week	8
Paper type	Renal dosing adjustment table
Length	About 710 words, 5 pages
Format	APA 7 student paper
School	Chamberlain University
Program	Master of Physician Assistant Studies (MPAS)
Updated	October 2026

Free sample paper for PA 524 Week 8

Renal Dosing Adjustment Table for G.H. at a Cockcroft-Gault Clearance of 27 mL/min: Eight Medicines, Each Row With Its Route of Removal, Source, Action and What Is Watched Next

Student Name

Chamberlain University

PA 524: Comprehensive Clinical Module Nephrology & Genitourinary

Instructor Name

Month Day, Year

What this page is doingThe title puts the kidney function figure first and promises a reason, source and follow-up in every row, which is what makes the grid usable.

Renal Dosing Adjustment Table for G.H. at a Cockcroft-Gault Clearance of 27 mL/min: Eight Medicines, Each Row With Its Route of Removal, Source, Action and What Is Watched Next

The Figure at the Top

Kidney function used for dosing: Cockcroft-Gault creatinine clearance about 27 mL/min, from a creatinine of 1.9 mg/dL on day 2 after the norovirus admission, age 74 and a weight of 55.4 kg. The indexed eGFR by the 2021 CKD-EPI equation is about 36 mL/min/1.73 m2. The clearance figure is used because most drug labels state their dose changes in clearance, and the lower figure is the safer one while creatinine is still changing. The table will be redone when creatinine is stable for 48 hours.

What this page is doingStating the kidney function figure, its source and why it was chosen, at the top, is what lets every row below be checked.

The Grid

Table 1

Medicine-by-Medicine Kidney Dosing Review

Drug and indication	How it is removed	Source consulted	Action	Watched next
Metformin 500 mg twice daily, diabetes	Kidney, unchanged	KDIGO 2024 CKD guideline	Stop: eGFR below 30 is a contraindication, and the acute injury raises lactic acidosis risk	Glucose before meals; restart only if eGFR stays at 30 or above
Gabapentin 300 mg three times daily, nerve pain in the stump	Kidney, unchanged	2023 Beers criteria, kidney table	Reduce to 100 mg three times daily	Drowsiness, falls, every shift; pain score daily
Lisinopril 20 mg daily, blood pressure	Kidney	KDIGO 2024 CKD guideline	Hold during acute injury and low pressure	Restart at 5 mg once creatinine is stable and blood pressure allows; potassium and creatinine one week after
Hydrochlorothiazide 25 mg daily, blood pressure	Kidney	Expert panel on hyponatremia	Stop permanently: caused hyponatremia	Sodium at each draw
Enoxaparin 40 mg daily, clot prevention in hospital	Kidney	2023 Beers criteria, kidney table	Reduce to 30 mg daily	Bleeding, platelet count every 3 days
Nitrofurantoin, proposed for a urine culture result	Kidney	2023 Beers criteria, kidney table	Do not start: avoid at clearance below 30; choose another agent	Culture sensitivities
Amlodipine 5 mg daily, blood pressure	Liver	Product labeling	No change	Blood pressure each shift
Tamsulosin 0.4 mg daily, enlarged prostate	Liver	Product labeling	No change; hold one dose if standing pressure is low	Standing blood pressure daily

Note. Note. Sources: KDIGO 2024 (Stevens et al., 2024); 2023 Beers criteria (2023 American Geriatrics Society Beers Criteria Update Expert Panel, 2023); hyponatremia panel (Verbalis et al., 2013).

A Reason in Every Row

Each row carries a reason, including the two rows that do not change. Amlodipine and tamsulosin are cleared by the liver, so the kidney injury does not alter their levels; tamsulosin is still watched because the illness has lowered G.H.'s standing pressure, and it can lower it further.

What this page is doingGiving the unchanged rows a reason shows they were reviewed and not skipped, which is the point the week makes about no-change entries.

Rows That Stay the Same Are Still Rows

A blank or missing row would leave a reader unsure whether the drug was checked. Writing "no change, cleared by the liver" for amlodipine closes that question.

A missing row is also a safety problem at discharge, because a drug left off the review is the one most likely to be restarted at its old dose by someone else.

The Source, per Row

The kidney table in the 2023 Beers criteria gives specific clearance thresholds for gabapentin, enoxaparin and nitrofurantoin in older adults (2023 American Geriatrics Society Beers Criteria Update Expert Panel, 2023). The KDIGO 2024 guideline addresses metformin by eGFR and the handling of ACE inhibitors during acute illness (Stevens et al., 2024). Where a row rests on product labeling, it says so.

What Happens Next

The table is a snapshot. When creatinine is stable, clearance will be recalculated, and gabapentin and enoxaparin doses reviewed again. Metformin will be considered only if eGFR settles at 30 or above, and then at a reduced dose. Lisinopril is the one drug the team expects to restart, at a lower dose, because it protects the kidneys over the long term in chronic kidney disease once the acute illness has passed. The pharmacist reviewed the table, and G.H. received an updated medication list at discharge with the stopped drugs crossed out.

What this page is doingEnding with the conditions for revisiting each change keeps the table from being read as permanent when the kidney function behind it is still moving.

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

Stevens, P. E., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., Herrington, W. G., Hill, G., Inker, L. A., Kazancıoğlu, R., Lamb, E., Lin, P., Madero, M., McIntyre, N., Morrow, K., Roberts, G., Sabanayagam, D., Schaeffner, E., Shlipak, M., . . . Levin, A. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International, 105(4, Suppl.), S117-S314. https://doi.org/10.1016/j.kint.2023.10.018

Verbalis, J. G., Goldsmith, S. R., Greenberg, A., Korzelius, C., Schrier, R. W., Sterns, R. H., & Thompson, C. J. (2013). Diagnosis, evaluation, and treatment of hyponatremia: Expert panel recommendations. The American Journal of Medicine, 126(10 Suppl. 1), S1-S42. https://doi.org/10.1016/j.amjmed.2013.07.006

Reading the PA 524 Week 8 instructions

The final week asks for a table adjusting a patient's medicines for reduced kidney function. Above the table, state the kidney function figure you used, how it was calculated and why that estimate was chosen, and note whether function is still changing. In the table, give each drug its indication, how the body removes it, the source consulted with its edition or date, the action taken and what is monitored afterward and how often. Fill rows with no change as fully as the others, with a reason. Cite a source per row rather than one general reference. Below the table, explain any rows that need comment and state the conditions under which the table should be revisited. Make sure the actions are consistent with the patient's current state, such as acute injury or low blood pressure.

How this PA 524 Week 8 example is built

The paper opens with a clearance of about 27 mL/min from a day-2 creatinine of 1.9, an indexed eGFR near 36, and the reason the lower figure is used while creatinine is still changing. Table 1 lists eight medicines: metformin stopped, gabapentin reduced to 100 mg three times daily, lisinopril held with a 5 mg restart plan, hydrochlorothiazide stopped after hyponatremia, enoxaparin reduced to 30 mg, nitrofurantoin avoided, and amlodipine and tamsulosin unchanged as liver-cleared drugs. Each row names its source and monitoring. A section explains the unchanged rows and why tamsulosin is still watched. Another explains why missing rows are a discharge safety risk. A sources section ties the Beers kidney table and KDIGO 2024 to specific rows, and the close sets conditions for redoing the table.

PA 524 Week 8 rubric: what full points look like

Grading here centers on the columns. A table that lists drugs and new doses without how each is removed, a source or a monitoring plan loses the largest share. Faculty check that the kidney function figure is stated at the top with its method, since every row depends on it. Rows with no change must still carry a reason; blank or missing rows are deducted. Credit goes to actions consistent with the patient's current state, such as holding an ACE inhibitor during acute injury. Sources must be specific per row and current. The follow-up column is graded for realistic monitoring and timing. Deductions apply for dose changes that contradict the cited source. A closing statement of when to revisit the table completes the expected structure.

PA 524 Week 8 help from the desk

Dosing tables often lose marks for empty columns and unexplained no-change rows. Send your patient's kidney function, weight and medicine list, and the table prepared for you would state the function figure and method at the top, then give each drug its route of removal, source, action and monitoring. Unchanged drugs get full rows with reasons. Sources are cited per row from the references your course uses. If kidney function is still changing in your case, the table says when it will be redone. Actions are checked against the patient's current state, such as low blood pressure or acute injury. Verify every dose against a current drug reference and your program's guidance before using the table.

Get a PA-524 Week 8 example written to your instructions

Send the medication list your assignment supplies together with the reference your section requires, and a completed table built to that reference comes back inside 24 to 48 hours, the first one free. If the classroom posted a blank grid, attach it and the columns in the example match yours exactly.

More PA 524 papers and MPAS samples

PA 524 Week 8 questions, answered

How many drugs should the table cover?

Whatever list your case supplies, complete, including the ones needing nothing. Where the assignment lets you build the list, a workable size carries a spread rather than a count: something the kidney removes almost entirely, something it barely touches, something needing a longer interval instead of a smaller amount, and something whose place on the list is worth questioning at all.

Which reference should the rows cite?

The one your section assigns, named in the table with its edition, because references disagree on thresholds and a row built on a different source looks like an error to whoever marks it. Send the reference along with the assignment and every row is built on it. Where none is named, the example says which it used and holds to that source throughout.

Does the table have to say what should be prescribed?

No, and the strongest versions are careful about this. A row records what a reference says happens to that drug at a reduced clearance and what the table therefore does with the entry, which is a documentation task. Choosing therapy for a person is a different subject taught elsewhere in your program, and these examples stay on the side of the line the assignment is actually asking about.

Where can I find a free PA 524 Week 8 sample paper?

The full PA 524 Week 8 dosing table is on this page, eight medicines reviewed at a clearance of about 27 mL/min, each row with a source and a monitoring plan.

Why does the PA 524 Week 8 sample fill in rows with no change?

A missing row leaves the reader unsure whether the drug was reviewed and makes it more likely to be restarted at its old dose after discharge.