Category: Nursing

a 25- year-old college student, is in your clinic because of sore throat. 7 days ago, he developed fever which was low (99 F) to moderate grade (101.1 F). This was associated with swollen and tender neck glands. He has sore throat but denies having cough. He has no abdominal pain but feels as if his upper abdomen has become swollen and he has lost his appetite. He has no nausea, vomiting or change in bowel movements. Since yesterday, he has noticed that his eyes and skin have turned a yellow color. He has no past medical history of jaundice, hepatitis, blood transfusion, body piercing, tattoos or eating shellfish. He does not drink, smoke cigarettes, or use illicit drugs. He doesn’t take any medications. He hasn’t traveled recently. He is sexually active and is in a monogamous relationship with his girlfriend of 2 years who is experiencing similar symptoms. He is heterosexual and has had two previous sexual partners. He always used condoms. He received Hepatitis B vaccination prior to starting college.

PPE: Patient is well-developed, in no acute distress. He appears concerned and anxious.

VS: BP – 130/80, PR- 110/min, RR – 20/min, T – 101.4 F, SpO2 – 99%.

HEENT: PERRLA, EOMI, icteric sclerae, pink conjunctivae, Tonsillo-pharyngeal area erythematous with exudate.

Neck: posterior cervical lymph nodes swollen, tender and movable, bilaterally. Supraclavicular lymph nodes not enlarged. Heart and lungs:

Normal abdomen: Normal bowel sounds, liver – 14 cm in midclavicular line by percussion, diffuse tenderness over both right and left upper quadrants on palpation. Neurological exam: no deficits.

Background Questions and PICOT Question

The topic I am interested in researching involves the integration of palliative care and early conversations with patients who have been diagnosed with terminal illness. My background questions are:

(1) When should palliative care discussions be initiated?

(2) Does early initiation of palliative care conversations promote better quality of life?

(3) What conversations are essential for patients to have the knowledge they need to make informed decisions about advanced care planning?

My PICOT question is as follows:

P (population): patients diagnosed with a terminal illness

I (intervention): early integration of the palliative care team and palliative care conversations by the interdisciplinary team

C (comparison): early palliative care discussions and advanced care planning vs. minimal conversation coupled with aggressive treatment options

O (outcomes): opting out of aggressive treatment and improved quality at the end of life

T (time): the last 6 month of life

In patients with terminal illness, what is the effect of early palliative care conversations by the interdisciplinary team compared to minimal conversation coupled with aggressive treatment options on the quality of the last 6 months of life?

Barriers to the Implementation of Evidence Based Practice

PICOT Question Rubric

1

Unsatisfactory 0-71%

0.00% 2

Less Than Satisfactory 72-75%

75.00% 3

Satisfactory 76-79%

79.00% 4

Good 80-89%

89.00% 5

Excellent 90-100%

100.00%

80.0 %Directions: Submit your PICO question, include a title page. There will be no references

80.0 %Content/Resource Requirements:Clinical inquiry question using the PICOT format. PICOT question is missing most of the components required. n/a All components are addressed. n/a PICOT question has all components, and is clear and concise.

10.0 %Organization and Effectiveness

10.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use) Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present. Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.

10.0 %Format

10.0 %Presentation The piece is not neat or organized, and it does not include all required elements. The work is not neat and includes minor flaws or omissions of required elements. The overall appearance is general, and major elements are missing. Presentation is good. Overall appearance is generally neat, with a few minor flaws or missing elements. Work is well-presented and includes all required elements. The overall appearance is neat and professional.

Casey is a 17-year-old high school student admitted to the ER with a compound fracture of the left leg obtained falling at the local skateboard park while practicing for a national competition. He has never been hospitalized before. His mother has been notified and is on her way. The EMTs gave him morphine and he reports his pain level as “okay.” What part of the interview and examination can be done prior to his mother’s arrival? As you enter the room for the first time, what should you observe as part of the general survey? As you complete his history, what areas are especially important? What are the important developmental considerations for Casey?

Research Critique

Prepare a critical analysis of a quantitative study focusing on protection of human participants, data collection, data management and analysis, problem statement, and interpretation of findings. The quantitative research article can be from your previous literature review or a new peer-reviewed article.

Each study analysis will be 1,000-1,250 words and submitted in one document. As with the assignments in Topics 1-3, this should connect to your identified practice problem of interest.

Refer to the resource entitled “Research Critique Part 2.” Questions under each heading should be addressed as a narrative, in the structure of a formal paper. You are also required to include an Introduction and Conclusion.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this Research Critique assignment to Turnitin.

Submit the Research Critique assignment along with an electronic version of the article used for the analysis. If an electronic version is not available, submit a clean unmarked copy of the article.

Yulang Lei, an 82-year-old Vietnamese man, was admitted to your floor with dehydration and a urinary tract infection following a fall at home. He is alert and oriented, but weak. He appears frail. His admission history includes the following. He lives alone; his wife died 6 months ago. He states he ran a traditional Vietnamese family, unlike his children, who are married and have now moved away. His wife did all the cooking and he hasn’t had much of an appetite since she died. He eats rice and some vegetables, but rarely “bothers to cook meat for just one person.” Usual daily activity is reading the Vietnamese community newspaper with his morning tea for breakfast. He says he usually eats lunch, but can’t remember what he usually eats. He has rice and a few vegetables for dinner. You notice that his clothes fit very loosely. He states he weighed 140 pounds at his doctor’s office 5 months ago. When you weigh him, he weighs 123 pounds and is 5’8″ tall. Look at the list of nursing diagnoses in Appendix A of your text. What nursing diagnoses would you choose for Mr. Lei? What additional questions would you ask to confirm your diagnosis? What physical examination and laboratory findings would you expect Mr. Lei to have? What psychosocial and cultural factors should you consider when assessing Mr. Lei?

How to Critique in nursing Research

Research Critique

To write a critical appraisal that demonstrates comprehension of the research study conducted, and respond to each of the action itemslisted under the headings below. Successful completion of this assignment requires that you provide a rationale,include examples, or reference content from the study in your response.

CRITICAL APPRAISAL GUIDELINES: QUANTITATIVE STUDY

Introduction of How to Critique in nursing Research

• Develop a topic sentence in which you will define the purpose of the Research Critique, Part 2

• Formulate a thesis statement which briefly provides a broad indication of your point of view in composing this assignment.

• Include a summary outline to describe the organization and main topics you will include in the body paragraphs of the assignments (see below sections).

Protection of Human Participants

• Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify?

• Was informed consent obtained from the subjects or participants?

• Did it seem that the subjects participated voluntarily in the study?

• Was institutional review board approval obtained from the agency in which the study was conducted?

Data Collection on How to Critique in nursing Research

• Are the major variables (independent and dependent variables) identified and defined? What were these variables?

• How were data collected in this study?

• What rationale did the author provide for using this data collection method?

• Identify the time period for data collection of the study.

• Describe the sequence of data collection events for a participant.

Data Management and Analysis on How to Critique in nursing Research

• Describe the data management and analysis methods used in the study.

• Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis?

• What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses?

Findings / Interpretation of Findings: Implications for Practice and Future Research

• What is the researcher’s interpretation of findings?

• Are the findings valid or an accurate reflection of reality? Do you have confidence in the findings?

• What limitations of the study were identified by researchers?

• Was there a coherent logic to the presentation of findings?

• What implications do the findings have for nursing practice? For example, can the study findings be applied to general nursing practice, to a specific population, to a specific area of nursing?

• What suggestions are made for further studies?

Conclusion on how to critique in nursing Research

• Emphasize the importance and congruity of the thesis statement

• Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.

• Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.

• Integrate asummary of the knowledge learned.

Reference

Burns, N., & Grove, S. (2011). Understanding Nursing Research (5thed.). Elsevier. ISBN-13: 9781437707502

How to Prepare Evidence-Based Practice Presentation

This is a Collaborative Learning Community (CLC) assignment on Evidence-Based Practice Presentation.

Choose a nursing problem from your current practice setting, and identify a possible solution to that problem.( we choose Nurse to Patient Ratio as a problem)

Conduct a search of the literature related to this problem.

Analyze and critically appraise evidence-based literature to support the solution to the identified problem. A minimum of six peer-reviewed articles must be identified. These can be the same articles from the previous selected literature review or a mixture of new and previous articles. This may also include guidelines from the National Guideline Clearing house, Joanna Briggs Institute, or a review from the Cochrane Database of Systematic Review.

Include the following components into the presentation:

Present the nursing practice problem with the PICOT question. Discuss your appraisal of the literature that addresses the problem. Present the proposed practice changes from an integration of the findings.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This How to Prepare Evidence-Based Practice Presentation assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this How to Prepare Evidence-Based Practice Presentation assignment to Turnitin. Takes 3 articles-( on the topic or problem Nurse to patient Ratio) discuss the literature and propose practice changes.

The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Review the PICOT article “Evidence-Based Practice, Step by Step: Asking the Clinical Question: A Key Step in Evidence-Based Practice” along with the ” Using Research in Evidence-Based Nursing Practice” PowerPoint resource.

The first step of the EBP process is to develop a question from the practice problem you drafted in Topic 1. Start with the patient and identify the clinical problems or issues that arise from clinical care. Consider the research and writing you completed in Topics 1-4.

Following the PICOT format, write a PICOT statement in an area of interest to you, which is applicable to your proposed capstone project.

APA format is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Using Research in Evidence-Based Practice Nursing

Using Research Evidence Based Nursing Practice

Research Utilization Versus Evidence-Based Practice

Research utilization (RU)

The use of study findings in a practical application unrelated to the original research

Evidence-based practice (EBP)

Basing clinical decisions on best possible evidence—especially high-quality research