| Course | NSG 124 Pharmacology |
|---|---|
| Unit | Unit 5 |
| Paper type | Monitoring and counseling brief |
| Length | About 840 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 124 Unit 5
Starting a Weekly Bisphosphonate: What Is Followed and What Is Taught, and Which Teaching Point Supports Which Check, for a 66-Year-Old With Osteoporosis
Student Name
Department of Nursing, Herzing University
NSG 124: Pharmacology
Instructor Name
February 12, 2026
Starting a Weekly Bisphosphonate: What Is Followed and What Is Taught, and Which Teaching Point Supports Which Check, for a 66-Year-Old With Osteoporosis
The Patient and the Medication
A composite 66-year-old woman, a retired postal clerk, was found to have osteoporosis on a bone density scan after a fall onto her wrist that did not break it. Her clinic prescriber has started alendronate once weekly, a bisphosphonate that slows the cells that break down bone, and advised calcium and vitamin D. She has mild reflux controlled by diet, takes levothyroxine each morning, and sees a dentist once a year. The classroom frames this as a new outpatient start with a nurse telephone follow-up at two weeks and a clinic visit at three months.
Part One: What Would Be Followed
M1. Swallowing and upper-gut symptoms: heartburn, pain on swallowing, pain behind the breastbone. Asked at the two-week call and every visit. Bisphosphonates can irritate the esophagus if the tablet lodges or is taken lying down, and her reflux makes her more vulnerable (Burchum & Rosenthal, 2022).
M2. Calcium and vitamin D status: blood calcium and a vitamin D level before starting and as the prescriber orders. Low calcium should be corrected before a bisphosphonate is started.
M3. Kidney function: creatinine and estimated clearance before starting, since the drug is cleared by the kidneys and is not recommended when function is severely reduced.
M4. Dental health: whether she has planned extractions or implants. Osteonecrosis of the jaw is rare with oral bisphosphonates for osteoporosis, but invasive dental work is when it is most likely.
M5. New thigh or groin pain: asked at each visit. Unusual fractures of the thigh bone are a rare complication of long-term use and may be preceded by aching for weeks (Black & Rosen, 2016).
M6. How she is taking it: day of the week, timing, and missed doses, at the two-week call and each visit.
M7. Bone density and the length of treatment: a repeat scan as ordered, and a review of continuing after several years. Guidance suggests reassessing after 3 to 5 years of treatment and considering a pause in lower-risk patients (Shoback et al., 2020).
Part Two: What She Is Told
T1. Take it on the same day each week, on waking, before anything else, swallowed with a tall glass of plain tap or bottled water (not coffee, juice, or mineral water). Supports M6 and M1. Food and other drinks sharply reduce absorption, and the water helps the tablet reach the stomach.
T2. Wait at least 30 minutes before eating, drinking anything else, or taking other medicines, including her levothyroxine. Supports M6. For her, this means taking alendronate first on its weekly day and moving that day's levothyroxine after the wait, in a way the prescriber or pharmacist confirms, since both need an empty stomach.
T3. Stay upright, sitting or standing, for at least 30 minutes after taking it; do not take it at bedtime. Supports M1.
T4. Stop and call if swallowing becomes painful, or if new or worse heartburn or chest pain appears. Supports M1.
T5. Take calcium and vitamin D as advised, but not at the same time as alendronate. Supports M2 and M6.
T6. Tell your dentist you take this medicine, and tell the prescriber before any tooth extraction or implant. Supports M4.
T7. Report any new aching in the thigh or groin, even without a fall. Supports M5.
T8. If a weekly dose is missed, take it the next morning and return to the usual day; do not take two on one day. Supports M6. This follows the product's instructions as described in the course text (Burchum & Rosenthal, 2022).
How the Two Halves Meet at the Two-Week Call
The two-week telephone call is where the halves are joined in practice. The nurse asks her to describe, in her own words, what she did on her last weekly dose: the time, what she drank it with, how long she waited before breakfast and her thyroid tablet, and whether she sat or lay down afterward. Her answer checks T1 to T3 and gives the M6 finding directly. The nurse then asks the M1 questions about swallowing and heartburn, which tests whether T4 was understood. If she reports new heartburn, the call has found the problem the teaching was meant to prevent, and the prescriber is told the same day. This is the reason each teaching point names a monitored item: a point that cannot be checked at the follow-up has not really been taught.
Points the Source Offers That Do Not Fit Her
Teaching about the monthly or intravenous forms of bisphosphonates is not included, since her prescription is weekly by mouth. Advice about the liquid form for people who cannot swallow tablets does not apply. General fall-prevention teaching is important for her but belongs to a separate plan rather than to this medication brief. The patient is a composite; the timing and instructions are those given in the course reading and must match the prescriber's order and product labeling in practice.
References
Black, D. M., & Rosen, C. J. (2016). Postmenopausal osteoporosis. New England Journal of Medicine, 374(3), 254-262. https://doi.org/10.1056/NEJMcp1513724
Burchum, J. R., & Rosenthal, L. D. (2022). Lehne's pharmacology for nursing care (11th ed.). Elsevier.
Shoback, D., Rosen, C. J., Black, D. M., Cheung, A. M., Murad, M. H., & Eastell, R. (2020). Pharmacological management of osteoporosis in postmenopausal women: An Endocrine Society guideline update. Journal of Clinical Endocrinology & Metabolism, 105(3), 587-594. https://doi.org/10.1210/clinem/dgaa048
What the NSG 124 Unit 5 instructions ask for
Unit 5 pairs monitoring with patient counseling for one new medication. Expect to describe the patient and drug, list what will be monitored, list what will be taught, show how teaching supports monitoring and set aside points that do not apply. Sections differ on how many teaching points to include. Each teaching point should prevent a problem or help detect one. Monitoring should cover both effectiveness and adverse effects. A follow-up contact is where the two halves meet. Teaching should be in plain language the patient could repeat. Points that do not fit the patient show judgment when left out. Calcium, vitamin D and dental care often belong in bisphosphonate counseling.
How the NSG 124 Unit 5 example is put together
The brief opens with the patient and why the medication was started. Part One lists monitoring items with labels, such as M1 for upper-gut symptoms, and what would prompt action. Part Two lists teaching points with labels, such as T1 for how to take the tablet, written in plain language. The section on the two-week call shows each teaching point paired with a monitoring check, such as asking whether she stayed upright and whether she has heartburn. The set-aside section explains points that do not apply, such as intravenous forms. The labels make every link visible and checkable, so a grader can trace each teaching point to the problem it guards against. Her own words at the call are recorded beside each check.
NSG 124 Unit 5 rubric: what full points look like
Herzing's rubric for a monitoring and counseling brief usually covers the drug and patient, monitoring items, teaching points, links between them, follow-up and judgment about irrelevant points. The pairing of each teaching point with a monitoring check is where most marks sit. Monitoring points reward both effectiveness and adverse effects, including rare serious ones. Teaching criteria look for plain language and correct instructions, such as staying upright for 30 minutes. Follow-up earns credit when it brings the two halves together. Judgment points go to points set aside with reasons. Labels such as M1 and T1 help. Calcium and vitamin D advice is often credited. Black's fracture intervention trial supports the drug's purpose.
Common NSG 124 Unit 5 mistakes, and how to avoid them
Counseling briefs in Unit 5 often slip by listing teaching points without connecting them to monitoring. Another frequent problem is incorrect administration instructions, such as taking a bisphosphonate with food or coffee. Students often forget rare but serious effects such as jaw osteonecrosis and unusual thigh fractures. Teaching is written in clinical language. Follow-up is missing. Irrelevant points are included. Calcium and vitamin D are not mentioned. Dental care before starting is forgotten. Missed-dose instructions are absent, though weekly dosing makes them important. Finally, pair each teaching point with a check, because graders reward a brief where teaching prevents problems and monitoring catches them.
Get a NSG 124 Unit 5 example written to your instructions
Send the Unit 5 instructions and the rubric from your NSG 124 classroom, together with the medication and case the assignment names. We write a custom example that builds the monitoring half first, orders it by timing, cites every point to the reading and sets each point under the item it supports. First custom sample free, back in 24 to 48 hours.
More NSG 124 papers and BSN samples
- NSG 124 Unit 1: Route and form comparison
- NSG 124 Unit 2: Dose calculation worksheet
- NSG 124 Unit 3: Administration rights walkthrough
- NSG 124 Unit 4: Pre-dose assessment record
- NSG 124 Unit 6: Adverse effect escalation chart
- NSG 124 Unit 7: High alert medication file
- NSG 124 Unit 8: Drug classification table
- NSG 298 Unit 5: Content gap map
- NSG 421 Unit 5: Alert response record
- NSG 423 Unit 5: Competing obligations decision record
- NSG 633 Unit 5: Patient identification audit
NSG 124 Unit 5 questions, answered
Could I hand this brief to a patient?
No. The brief is classroom work about why the reading connects particular points to particular monitoring, and it is built on a patient who does not exist. Anything said to a real person depends on that person, on guidance as it stands today, and on the licensed nurse in the room. Keep the document in your file and out of anybody's hands.
How far ahead should the monitoring run?
As far as your instructions ask, and where they do not say, far enough that the timing does some work. A brief covering only the first contact cannot show that follow-up changes as days pass, which is part of what this unit examines. Say when each item would recur and what would shorten the interval, without putting a figure on anything.
Where do the counseling points come from?
From the reading your section assigns and any patient material the instructions name, cited where you use it. Points that were invented because they sound sensible are the usual weakness, and they are also the ones that quietly go stale. Attribution protects you when guidance has been revised, since the edition your classroom works from is what you are marked against.
Where can I find a free NSG 124 Unit 5 sample paper?
You can read the whole NSG 124 Unit 5 bisphosphonate brief here for free, monitoring and teaching linked at the two-week call. A brief for another medication can be written on request.
How should a weekly bisphosphonate be taken?
On the same day each week, first thing on waking, with a full glass of plain water, then staying upright and not eating for at least 30 minutes. This sample pairs that teaching with checks for heartburn and swallowing pain.