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The Comprehensive Role of APRNs in Medication Management and Patient Education Roles and Responsibilities of APRNs in Medication Prescribing

The Comprehensive Role of APRNs in Medication Management and Patient Education Roles and Responsibilities of APRNs in Medication Prescribing


Answer these questions.

  1. Describe the roles and responsibilities of the APRN when prescribing medication.
  2. Describe the method used to determine what drug therapy to prescribe.
  3. Discuss responsibilities for patient education and teaching based on the prescribed therapy.
  4. Discuss Scheduled drugs and prescribing restrictions for each scheduled drug.


Roles and Responsibilities of the APRN in Medication Prescribing

1. Introduction

Advanced Practice Registered Nurse (APRN) is an umbrella term for an advanced nurse who has at least a Master’s degree in Nursing. The APRN profession includes Nurse Practitioners, Clinical Nurse Specialists, Nurse Anesthetists, and Nurse Midwives, each of which provides direct patient care in their respective field of practice. These nurses are licensed by state boards of nursing and they work independently or in collaboration with other healthcare professionals to provide a full range of primary, acute, and specialty healthcare services. According to the American Nurses Association, the scope of practice for APRNs is not defined by the setting they work in, rather it is defined by the state laws and rules in which they practice. It is required that APRNs must follow the standard care that is defined by the Nurse Practice Act of their state because different states have different regulations. Medication prescribing is one of the many responsibilities that APRNs have in patient care. It is also one of the most important and relevant topics to be discussed when examining the roles of APRNs because medication therapy is a critical component in healthcare. Medication can help control, cure, diagnose, prevent diseases, and relieve symptoms, and it is a key tool in improving patient outcomes. With an increasing emphasis on medication safety, growing numbers of medications, and an increasing demand for improved access to healthcare, it is both a challenging and exciting time for APRNs to take on the roles and responsibilities in medication prescribing.

1.1. Definition of APRN

An advanced practice registered nurse (APRN) holds a minimum of a master’s degree in nursing, with additional postgraduate qualifications, and is academically and clinically prepared for an advanced level of nursing practice. An APRN has acquired advanced and specialized clinical knowledge and skills, as well as the legal authority to prescribe medications and medical devices. In accordance with the Centers for Medicare and Medicaid Services, APRNs have the following four roles of prescribing: ordering non-pharmacological and pharmacological interventions, performing medical and surgical procedures, selecting and applying appropriate treatments, and consultation and referral to other health professionals. These roles aim to facilitate the effective management of patients’ healthcare. Orders made by APRNs are to be documented and retained in patients’ medical records, to be consistent with the institution’s policies and state law. Patients’ healthcare can be managed effectively because the orders serve as guides to the nurses, technicians, and other healthcare personnel involved in the patients’ care. By conducting a comprehensive health assessment that includes obtaining a medication history and performing a medication reconciliation review, an APRN is able to select and prescribe the appropriate pharmacological intervention for a patient’s health condition. However, it is essential that the APRN uses their professional judgment in tailoring the selection of the appropriate treatment as well as its duration and dosage to meet the specific medical needs of the patient. An APRN may consult a physician and a range of healthcare professionals, and make referrals to these professionals, to manage the health of patients in a complex and ever-changing healthcare system. This collaboration among professionals will facilitate a team-based approach to meet the patients’ healthcare needs. APRNs therefore are able to provide patients with the flexibility of having access to the best healthcare that is available from these professionals. In addition, with the legal authority in place that recognizes the roles of advanced practice nurses, more and more states and national organizations are adopting and developing legislations and policies that relate to APRNs’ prescriptive authority. This allows APRNs to access the health policy development and seek opportunities to advance and promote changes and improvements in the healthcare system and healthcare quality. As such, APRNs can be more involved in public and individual healthcare management, engage in health promotion and disease prevention education with patients and communities, and be better placed to optimize patients’ health outcomes.

1.2. Importance of Medication Prescribing

Medications have become an integral part of modern healthcare, with the rise in treatment options and increasing complexity of medication therapies. Medication prescribing is a critical component of the role of all APRNs – Nurse Practitioners, Clinical Nurse Specialists, Certified Registered Nurse Anesthetists, and Certified Nurse Midwives. It is a complex and highly regulated area of practice, requiring great depth of knowledge and always putting the patient first. Safe and effective medication prescribing is dependent on all of the components of the prescribing process, such as obtaining and reviewing the patient’s medical and medication history, performing a comprehensive physical evaluation and psychological evaluation, after establishing diagnoses, determining and ordering any necessary tests and procedures, determining and implementing appropriate therapies, and the evaluation of the therapy in terms of the patient’s responses and outcomes. Every state has laws that describe what Nurse Practitioners can do in the prescribing of medications. These laws set forth the requirements for completing advanced pharmacology education and the necessity for being granted prescriptive authority pursuant to the state nurse practice act. These laws address issues such as the different levels of prescriptive authority for different classes of drugs and the requirements for collaboration with physicians when there are limitations on the drugs that may be prescribed. It is important to recognize that no matter how the laws in a particular state are written, the safety and effective use of medications is a shared responsibility among the healthcare providers and patients. It is important and necessary to note that the overriding factors in safe and effective medication prescribing are the appropriate depth of knowledge and clinical skills by the APRN and maintaining the focus on the patients and the trust and confidence that, as a provider on the healthcare team, everything is being done with the patient’s best interests in mind. Every effort must be made to order and prescribe the medications that are best suited for the treatment of the specific patient’s condition and for the goal of achieving the best therapeutic outcomes for that patient. At the most fundamental level, effective medication prescribing is a learned skill that is acquired over time and through continuous hands-on clinical experiences. It is not just learning about the pharmacokinetic and pharmacodynamic properties of a drug or knowing the desired effects and potential side effects. It is developing a depth of knowledge of when to use a medication, or when not to use, in a particular clinical situation and how to monitor the results and outcomes of the therapy. While medication therapies will continue to grow in complexity and the new therapies and treatment regimens are introduced, skilled medication prescribing will always be based upon the fundamentals of patient assessments, evidence-based clinical decision making, and on continually striving for the highest level of safe and effective patient care.

2. Roles of the APRN in Medication Prescribing

2.1. Assessing Patient’s Medical History

2.2. Evaluating Patient’s Current Condition

2.3. Determining Appropriate Medication

3. Responsibilities of the APRN in Medication Prescribing

3.1. Ensuring Patient Safety

3.2. Monitoring Medication Efficacy

3.3. Collaborating with Healthcare Team

4. Methodology for Determining Drug Therapy

4.1. Reviewing Evidence-Based Guidelines

4.2. Considering Patient’s Individual Needs

4.3. Assessing Potential Risks and Benefits

5. Patient Education and Teaching Responsibilities

5.1. Explaining Medication Purpose and Dosage

5.2. Discussing Potential Side Effects

5.3. Providing Instructions for Medication Administration

6. Schedule Drugs and Prescribing Restrictions

6.1. Definition of Schedule Drugs

6.2. Prescribing Restrictions for Schedule I Drugs

6.3. Prescribing Restrictions for Schedule II Drugs

6.4. Prescribing Restrictions for Schedule III Drugs

6.5. Prescribing Restrictions for Schedule IV Drugs

6.6. Prescribing Restrictions for Schedule V Drugs

7. Conclusion


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