Angel Sheppard

9:01am Oct 23 at 9:01am

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Hello Professor and class,

I chose case study #3 of an 80 year old retired army officer living along with type 2 diabetes, who had episodes of hypoglycemia using insulin and OHA’s.  The patient was dependent on an attendant to administer injections and due to irregularity of insulin dose administration this would lead to episodes of hypoglycemia.  The patient was then put on Degludec insulin and over a period of time, the patient’s HgBA1C and fasting blood sugars showed improvement. The patient also had no further episodes of hypoglycemia (Kumar, 2015.  p. 877).

Formulating a clinical question in the PICO (T) format I questioned: Do elderly patients with Type 2 diabetes show improvement with episodes of hypoglycemia, FBS and HgBA1C with Degludec?

According to (Stillwell et al, 2010. p. 59), PICOT is an acronym used for elements of the clinical question.  They are helpful for summarizing research question that explore the effects of therapy (Riva et al, 2012. p. 168).

P- Patient population

I-Intervention or issue of interest

C- Comparison of intervention or interest

O- Outcome of intervention or interest

T- Time it takes for intervention to be effective

(Stillwell et al, 2010. p. 59), Also points out there are 2 types of clinical questions, background and foreground.  Foreground question appear to use questions asked using the PICOT format to determine which interventions are most successful for patient outcomes.

Nursing research strives to understand phenomena that impact health, seeks solutions to problems, tests approaches to improving nursing care, and generates new knowledge to further our profession (CCN, 2017)

My clinical question using the PICOT format:

P- Elderly patients with type 2 diabetes

I- On Degludec and OHA’s

C- On regular insulin and OHA’s

O-Improvement of FBS, HgBA1C and no further episodes of hypoglycemia

T- No time frame measured

In asking the question: Is Degludec effective in improving hypoglycemic episodes the focus of my question would be on the prognosis of treatment.  Are patients having less episodes of hypoglycemia, is disease control with treatment?  According to the case study once the patient had started on Degludec it was noted that there was improvement in FBS and HgBA1C and no further evidence of hypoglycemia.

 

References:

Chamberlain College of Nursing. (2017). Introduction to Evidence Based. Practice.  Week 1 [Online lesson].  Downers Grove, IL  DeVry. Retrieved from: https://chamberlain.instructure.com/courses/12226/pages/week-1-lesson?module_item_id=1191535

 

Riva, J. J., Malik, K. M., Burnie, S. J., Endicott, A. R., & Busse, J. W. (2012). What is your research question? An introduction to the PICOT format for clinicians. Journal of the Canadian Chiropractic Association, 56(3), 167-171. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=awh&AN=88935392&site=eds-live&scope=site (Links to an external site.)Links to an external site.

 

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000446-201003000-00028&LSLINK=80&D=ovft (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.

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Compose an analytical essay of at least 1,200 words in which you offer an interpretation of a literary element in one of the assigned short stories. Write your analysis focusing on one of the following elements in one of the assigned stories:

• Character
• Theme
• Symbolism
• Imagery
• Setting

Start by selecting one of the short stories assigned by your instructor. Brainstorm to identify the literary element that you would like to explore in the story. Choose from character, theme, symbolism, imagery, or setting. Then, develop a thesis that offers a specific interpretation of this element. If you have trouble coming up with a thesis, contact your instructor, who will help you. Do not do any outside research at this point. When finished, the draft should be at least 1,200 words (approximately four double-spaced pages).

Tips for the Essay

1. Open your introduction with an engaging opener, such as a question, quote from the story, or interesting idea. Then, connect to the short story and mention the title and the author. End your introduction with a thesis statement that interprets one literary element of the story (such as theme, symbolism, or characterization).
2. The body paragraphs should support your thesis. Present specific aspects of the short story that help to illustrate your points. Make sure to quote from the story and analyze specific lines that support your argument.
3. Include a strong concluding paragraph that summarizes your main points and explains the significance of the thesis.

APA Reminder

Use APA style for formatting the essay and for source citations. Begin with a title page. Include a running header, and use proper font and spacing. End with a separate references page. Refer to the Week 1 lecture on avoiding plagiarism for an APA essay template and additional resources.