Nursing Research (24 Hours) 2025

1) Minimum 2 full pages ( Part 1: 1 page; part 2: 1 page- Total 2 pages) 2)¨**********APA norms, please use headers All paragraphs must be narrative and cited in the text- each paragraphs Bulleted responses are not accepted Can write in the first person . Dont copy and pase the questions. 3) It will be verified by Turnitin and SafeAssign 4) Minimum 5 references not older than 5 years ( Part 1: 3 references (2 references about PICOT questions and 1 about a potential qualitative research study; Part 2: 2 references). ________________________________________________________________ Part 1: 1) Qualitative research. 2) Locate and cite two different types of qualitative research articles related to your PICOT project. My PICOT question is ‘will off springs of diabetic patients (P), undergoing thiazolidinedione therapy (I), benefit by not becoming diabetic (O) later in life (T)?’ 3) Provide a brief explanation of each design. 4) Identify a potential qualitative research study that is important to nursing and describe a) which design you would use for this study b) why you would use that design c) how the information generated from the study could be applied in nursing practice. 5) Reflect on the value of qualitative research adding to the science, knowledge, and practice of nursing. Part 2: 1) Define the core functions of epidemiology. 2) Select one of the epidemiologic core functions a) provide an example of the how the core function might be demonstrated in clinical practice by a Masters prepared Registered Nurse. b) Can you relate this or one of the other functions to an example or content in your text readings?

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Assessing And Treating Clients With Dementia 2025

BACKGROUND Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal. According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.” Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation. SUBJECTIVE During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia. MENTAL STATUS EXAM Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation. Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive) RESOURCES § Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources. Decision Point One Select what the PMHNP should do: Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks Begin Aricept (donepezil) 5 mg orally at BEDTIME Begin Razadyne (galantamine) 4 mg orally BID Decision Point Two Select what the PMHNP should do next: Increase Exelon to 4.5 mg orally BID Increase Exelon to 6 mg orally BID Discontinue Exelon and begin Namenda (memantine) 10 mg orally BID Decision Point Three Select what the PMHNP should do next: Increase Exelon to 6 mg orally BID Maintain current dose of Exelon Add Namenda (memantine) 5 mg orally per day My decisions Decision Point One Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks The client is accompanied by his son who reports that his father is “no better” from this medication. He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall Decision Point Two Increase Exelon to 4.5 mg orally BID RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Client’s son reports that the client is tolerating the medication well, but is still concerned that his father is no better He states that his father is attending religious services with the family, which the son and the rest of the family is happy about. He reports that his father is still easily amused by things he once found serious Decision Point Three Increase Exelon to 6 mg orally BID Guidance to Student At this point, the client is reporting no side effects and is participating in an important part of family life (religious services). This could speak to the fact that the medication may have improved some symptoms. The PMHNP needs to counsel the client’s son on the trajectory of presumptive Alzheimer’s disease in that it is irreversible, and while cholinesterase inhibitors can stabilize symptoms, this process can take months. Also, these medications are incapable of reversing the degenerative process. Some improvements in problematic behaviors (such as disinhibition) may be seen, but not in all clients. At this point, the PMHNP could maintain the current dose until the next visit in 4 weeks, or the PMHNP could increase it to 6 mg orally BID and see how the client is doing in 4 more weeks. Augmentation with Namenda is another possibility, but the PMHNP should maximize the dose of the cholinesterase inhibitor before adding augmenting agents. However, some experts argue that combination therapy should be used from the onset of treatment. Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern.

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