29 Apr Advanced Practice Clinical Reasoning and Medication Optimization in the Older Adult
The purpose of this fishbowl discussion is to strengthen advanced practice nurses’ ability to analyze complex medication regimens, apply evidence-based deprescribing principles, and communicate clinical reasoning collaboratively. Students will work in small groups to examine different aspects of medication management for an older adult and engage in professional dialogue across perspectives.
Post: Case Scenario
Mrs. P. is an 80-year-old woman recently discharged from a 24-hour observation stay after being diagnosed with acute bronchitis…
Vital Signs:
Chief Complaint:
Fishbowl Discussion Structure
You will be assigned to one discussion Group C.
Each group will be responsible for leading one section of the discussion and responding to the other two sections.
Posting Rules
· Each group submits ONE collective discussion post
· Group members should collaborate before posting
· Do not submit individual posts for this discussion
Group Assignments
Group C: Chronic Disease Optimization and Patient-Centered Care
(Lead Section)
Address the following:
1. Given the absence of heart failure exacerbation and adherence to a reduced sodium diet, identify any additional medication adjustments that could be considered.
2. Explain your rationale for maintaining, adjusting, or continuing current therapy.
3. Discuss how patient preferences and quality of life influence medication optimization in older adults.
Required Cross-Section Engagement
In addition to leading your assigned section, your group must also:
· Respond thoughtfully to the other two sections by:
· Agreeing or offering an alternative clinical perspective
· Expanding on another group’s rationale using evidence
· Raising a clinical consideration not previously addressed
These responses may be included within the same group post or as clearly labeled subsections.
Scholarly Expectations
· Support your discussion with current evidence or clinical guidelines appropriate for older adult care
· Use a professional, scholarly tone
· Cite sources using current American Psychological Association format
Grading Note
This discussion is graded at the group level using the discussion rubric. Evaluation will focus on:
· Depth of clinical reasoning
· Use of evidence to support recommendations
· Quality of cross-section engagement
· Professional tone and clarity
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