2025 Respond to at least two of your colleagues who were assigned a different patient

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Post- Chrismene 2025

Respond to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why. Main Post CASE STUDY 2 AG is a 54-year-old Caucasian male who was referred to the clinic to establish care after a recent hospitalization after having a seizure related to alcohol withdrawal. He has hypertension and a history of alcohol and cocaine abuse. He is homeless and is currently living at a local homeless shelter. He reports that he is out of his amlodipine 10 mg which he takes for hypertension. He reports he is abstaining from alcohol and cocaine but needs to smoke cigarettes to calm down since he is not drinking anymore. The Communication Techniques A nurse practitioner chooses to use the RESPECT Modell to communicate with the patient to stay productive and patient-centered in all her communication with the patient. RESPECTS stand for (Rapport, Empathy, Support, Partnership, Explanation, Cultural Competence, and Trust) (Ball, Dains, Flynn, Solomon, & Stewart, 2019). The nurse practitioner establishes rapport by seeking the patient’s point of view to avoid being judgmental. She asked the question of how the patient wanted to be addressed. The nurse practitioner shows empathy by asking the patient how he becomes homeless to understand how she can help him get his life back in order. The nurse practitioner supports the patient by asking him about his financial situation to direct him to the proper agency. The patient is at risk for cardiac diseases, lung cancer, and stroke, so the nurse practitioner partnered with the patient to help him stop smoking (Ball et al., 2019).The nurse practitioner needs to explain to the patient to know what cigarette smoking does to the body. Nicotine is a sympathomimetic medicine that releases catecholamines, increases heart rate and cardiac contractility, constricts cutaneous, and coronary blood vessels, and rapidly increases blood pressure (Benowitz, 2009). It is crucial to present the patient with evidence-based practice to address health risks across cultures, and it is essential to assure the patient that what he said will be kept confidential to establish trust (Ball et al., 2019). The Risk Assessment Instrument The CAGE questionnaire is a precise tool that has been used for many years to screen patients for addictive behaviors. The GAGE questions have been modified to apply to smoke behavior. The CAGE questions are as following: 1) Have you ever felt the necessity to cut down or control your smoking, but had trouble doing so? 2) Do you ever get angry or annoyed with people who criticize your smoking or demanding you quit smoking? 3) Do you feel guilty regarding your smoking or about something you did while smoking? And 4) Do you ever smoke within half an hour of waking up (Eye-opened)? The patient is screen positive to two yes responses. The CAGE instrument is used because it is nonthreatening. A study showed that the CAGE questionnaire was used in a medical outpatient embedded in a self-administered questionnaire regarding health habits. Most of the patients did not know that they were filling out an assessment for addictions. The patient must be willing to stop smoking for treatment to be effective (American Family Physician, 2000). Targeted Questions 1) How do you want to be addressed? 2) How are you feeling? 3) How may we help you? 4) How do you become homeless and tell us about your financial situation? 5) Do you need help getting your prescription refill? 6) When was the last time you drink alcohol or use cocaine? 7) When was the last time you check your blood pressure and take your amlodipine medication? 8) When was the last time you had a seizure episode? 9) When do you start smoking and how many packs do you smoke a day? 10) How can we help you to stop smoking? References Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Benowitz, N. L. (2009). Pharmacology of nicotine: addiction, smoking-induced disease, and therapeutics. Annual review of pharmacology and toxicology , 49 , 57–71. doi:10.1146/annurev.pharmtox.48.113006.094742American Family Physician. (2000). Assessing Nicotine Dependence. Retrieved from https://www.aafp.org/afp/2000/0801/p579.html

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2025 1 Anesthesia administered to a normal healthy patient undergoing an esophageal procedure is

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Advanced Coding: E/M, Medicine, and Anesthesia 2025

1. Anesthesia administered to a normal, healthy patient undergoing an esophageal procedure is coded as A. 00500-P1. B. 00502-P1. C. 00500-P2. D. 00506-P1. 2. A new patient comes into the doctor’s office for her annual gynecological exam. During the course of the exam, she undergoes a screening cervical cytopathology smear, which is performed by an automated system under the supervision of a physician. What HCPCS code is assigned? A. G0185 B. G7869 C. G7452 D. G0147 3. A new patient is seen for a home visit that involves a comprehensive history, examination, and medical decision making of high complexity. What code should be assigned? A. 99349 B. 99345 C. 99342 D. 99350 4. A prolonged evaluation and management service before and/or after direct patient care for one hour is coded as A. 99359. B. 99358. C. 99361. D. 99360. 5. A 57-year-old patient is admitted to the hospital for a hip arthroscopy procedure. The patient is a normal healthy patient with no systemic disease. What anesthesia CPT code should be assigned? A. 01242-P2 B. 01202-P1 C. 01202-P3 D. 01202-P5 6. Anesthesia for procedures performed on the larynx and trachea in an 11-month-old child would be assigned to code A. 00620. B. 00625. C. 00326. D. 00532. 7. A patient returns for a follow-up office visit regarding the repair of her fractured knee. The office visit consists of a detailed history, detailed examination, and medical decision making of moderate complexity. What CPT code is assigned? A. 99213 B. 99212 C. 99211 D. 99214 8. Intramuscular nonhormonal antineoplastic chemotherapy administration would be assigned to code A. 96402. B. 96405. C. 96406. D. 96401. 9. Home infusion with specialty drug administration during a 6-hour visit would be assigned what codes? A. 99606, 99607 ×3 B. 99601, 99602 ×4 C. 99604, 99605 ×2 D. 99603, 99604 ×2 10. A patient is seen for a psychiatric diagnostic evaluation. The physician obtains a complete history of the patient’s mental status and does a complete biological and psychosocial assessment along with a complete physical examination. The physician’s final diagnosis is recurrent episode of severe major depressive disorder, without any psychotic behavior involved. The patient also has a history of psychological trauma. What codes are assigned? A. F33.2, Z91.49 B. F33.1, Z91.47 C. F34.2, Z91.49 D. F36.2, Z91.46 11. A 17-year-old patient is diagnosed with a severe form of nutritional anemia. What ICD-10-CM code should be assigned? A. D45.9 B. D53.9 C. D74.9 D. D65.9 12. A 32-year-old patient receives anesthesia for spinal surgery. The anesthesia is complicated by utilization of controlled hypotension. What add-on anesthesia code would be assigned? A. 99174 B. 92117 C. 99100 D. 99135 13. Nursing facility discharge day management of 19.5 minutes would be assigned to code A. 99317. B. 99319. C. 99316. D. 99315. 14. A patient is admitted to the hospital for leukemia. She has a comprehensive history, comprehensive examination, and medical decision making of high complexity. What CPT code should be assigned? A. 99202 B. 99223 C. 99213 D. 99251 15. A service that is rarely provided, unusual, variable, or new may require a A. physician’s authorization. B. patient’s authorization. C. staged or related procedure. D. special report. 16. A new patient is seen for a prescription refill. During the visit, the physician obtains a problem focused history, problem focused examination, and medical decision making is straightforward. What CPT code should be assigned for this service? A. 99214 B. 99215 C. 99213 D. 99201 17. A 7-year-old child is brought to the clinic due to recurrent ear infections. The physician performs a bilateral tympanostomy under general anesthesia. What CPT code should be assigned? A. 69436-50 B. 69536-50 C. 69426-50 D. 69736-50 18. Code 00906 is assigned for A. an angioscopy. B. anesthesia for surgery performed on the bony pelvis. C. an osteotomy. D. anesthesia provided for a vulvectomy. 19. A 25-year-old patient receives a Hepatitis A vaccination. The vaccine is administered intramuscularly in the clinic. What CPT codes should be assigned? A. 90632, 90471 B. 90541, 90489 C. 90637, 90472 D. 90672, 90451 20. A dark adaptation examination with interpretation and report is assigned to code A. 92326. B. 92284. C. 92287. D. 92325.

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2025 Case Study 1 Patient AO has a history of obesity and has recently gained 9

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Case Study 1:

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed… 2025

Case Study 1: Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following: Atenolol 12.5 mg daily Doxazosin 8 mg daily Hydralazine 10 mg qid Sertraline 25 mg daily Simvastatin 80 mg daily Case Study 2: Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following: Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun Aspirin 81 mg daily Metformin 1000 mg po bid Glyburide 10 mg bid Atenolol 100 mg po daily Motrin 200 mg 1–3 tablets every 6 hours as needed for pain Case Study 3: Patient CB has a history of strokes. The patient has been diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs currently prescribed include the following: Glipizide 10 mg po daily HCTZ 25 mg daily Atenolol 25 mg po daily Hydralazine 25 mg qid Simvastatin 80 mg daily Verapamil 180 mg CD daily To prepare: Review this week’s media presentation on hypertension and hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson text. Select one of the three case studies, as well as one the following factors: genetics, gender, ethnicity, age, or behavior factors. Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes. Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy. Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. With these thoughts in mind: By Day 3 Post an explanation of how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you selected. Then, describe how changes in the processes might impact the patient’s recommended drug therapy. Finally, explain how you might improve the patient’s drug therapy plan.

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2025 Post a summary of the psychotherapy that you selected and explain why it resonates with you the most at this

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Comparing Existential-Humanistic Therapy to Other Types of Therapy 2025

Post a summary of the psychotherapy that you selected and explain why it resonates with you the most at this time. Then compare the psychotherapy you selected with existential-humanistic therapy. What are the strengths and challenges of each type of psychotherapy? Describe a fictional client that you think would be best suited for the therapy you selected and one fictional client you think would be best suited for existential-humanistic therapy. Explain why.

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2025 Nurse scholars have a significant obligation to their community as well Their work must have academic and professional integrity Their efforts

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Strategies to Promote Academic Integrity and Professional Ethics ( MSN ) 2025

Nurse-scholars have a significant obligation to their community as well. Their work must have academic and professional integrity. Their efforts are designed to add to the body of knowledge, advance the profession, and ultimately help in the care of patients. Work that lacks integrity is subject to quickly erode…or worse. Fortunately, there are strategies and tools that can help ensure integrity in academic and professional work. This Assignments asks you to consider these and how you might apply them to your own work. To Prepare: Reflect on the strategies presented in the Resources for this week in support of academic style, integrity, and scholarly ethics. Also reflect on the connection between academic and professional integrity. The Assignment: 1: Writing Sample: The Connection Between Academic and Professional Integrity write a 2- 3-paragraph analysis that includes the following: 1. Clearly and accurately explains in detail the relationship between academic integrity and writing. 2. Clearly and accurately explains in detail the relationship between professional practices and scholarly ethics. 3. Accurately cite at least 3 resources that fully support your arguments, being sure to use proper APA formatting. 1. Clearly and accurately describe in detail how Grammarly, SafeAssign, and paraphrasing contributes to academic integrity. Include sufficient evidence that Grammarly and SafeAssign were utilized to improve responses. Strategies for Maintaining Integrity of Work Clearly identifying and accurately describing strategies you intend to pursue to maintain integrity and ethics of your 1) academic work while a student of the MSN program, and 2) professional work as a nurse throughout your career. Include a clearly developed review of resources and approaches you propose to use as a student and a professional. Remember to include an introduction paragraph which contains a clear and comprehensive purpose statement which delineates all required criteria, and end the assignment Part with a conclusion paragraph.

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2025 Week 2 Discussion 2 my post While interviewing and examining a 17 year old male you discover a white patch

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nursing assessment 2025

Week 2/Discussion 2/ my post While interviewing and examining a 17-year-old male, you discover a white patch on his buccal mucosa and slanting palpebral fissures in his eyes. He also states during the interview that he plays baseball and is hoping to earn an athletic scholarship to college. When the 17-year-old boy says he plays baseball and would like to get an athletic scholarship for college, we can suspect that he spends a lot of time in the field, exposed his self to sun and has been exposed to smokeless tobacco which is prevalent in the baseball sport. An increased use of smokeless tobacco use in sports, mainly in baseball is been reported in 2016 (Jarvis, 2016). ), “Leukoplakia is chalky white, thick raised patch with well-defined borders.” This is attached firmly to the buccal mucosa, even if you scraping hard it will not come off. You can also see it in individual who are heavily tobacco user as well as alcohol (Jarvis, 2016). White patches in the mouth also called excessive Candida you may see it in patient with weak immune system, steroid inhaler user, and HIV infection, use of broad-spectrum antibiotics, leukemia, and malnutrition.Slight upward or downward slanting of palpebral fissures normally occurs on a familial basis or in groups such as people of Asian descent. So in this case the slating palpable fissures in his eyes found during the assessment can be suspect that this patient is Asian or is an Asian descent. In non-Asians, the palpebral fissures are horizontal (Jarvis, 2008). Usually when narrowed, upward slanted palpebral fissures are present it could be indication of Down syndrome. In this case this 17-year-old boy should have been ruled out earlier than the age of 17. I would conduct a cranial nerve examination using Snellen chart test for visual acuity to see if there are any deficits in the optic nerve. Patients near vision could also be assessing (Jarvis, 2016). An ophthalmoscope consult should be place to “examine the ocular fundus to determine the color, size, and shape of the optic disc” (Jarvis, 2016, p. 644). I will also get order for a CT scan to rule out ICP if during retina exam patient’s margins of the optic disc become blurred and indistinct. I would first want to initially suspect that the patient has papilledema, also known as a choked disc which is an increase in cranial pressure (ICP) (Jarvis, 2016). As a Health care professionals we are educated and trained on strategies to teach patients and family members about this condition. First and foremost, would be for the patient to have genetic testing done to confirm a Down syndrome diagnosed. If the test results are positive, then the health care professional can provide the family and patient with the appropriate resources and specialty professionals to aid them in coping with their new diagnosis. The one most important thing that a health care professional can do is to empower the patient and family. This can be accomplished by carrying out interventions in a manner in which family members acquire a sense of control over their own efforts to meet their needs. Health care professionals can also enable families by creating opportunities for family members to become more competent and self-sustaining with respect to their abilities to mobilize their social networks to get their needs met and attain desired goals (Cohen, 2013). It is important to also let the patient know that his career of playing baseball may be limited in college may grossing diminish if other manifestations of condition sets in later in life. Some special considerations that can help to educate the patient and family on health promotion and disease intervention would include continuous monitoring measures, including yearly audiologic assessment and yearly ophthalmologic assessment, ongoing management of manifestation of the disorder and related conditions, as well as discussion of issues identified with the move into adulthood. If it were discovered that the patient has developed the habit of using smokeless tobacco, I would educate him on the harmful effects of smokeless tobacco such as the increase risk for cancer, and encourage him to seek out measures to quit. I would also remind him that at the age of 17 it is illegal to obtain to tobacco products and that he could jeopardize his chances of playing baseball on the collegiate level via an athletic scholarship if caught breaking the law. Furthermore, I would encourage this patient to seek alternative measure to quit smoking, and pick up healthier habits like chewing sugar free gum in place of using smokeless tobacco. References Cohen, W. I. (2003). Health Care Guidelines for Individuals with Down Syndrome-1999 Revision. Down Syndrome , 237-245. doi:10.1002/0471227579.ch17 Jarvis, C. (2016). Physical examination & health assessment. (7th ed.). St. Louis: Elsevier. Jarvis, C. (2008). Pocket companion for physical examination and health assessment. (5thed.). St. Louis: Elsevier. PROFESSOR QUESTION/NEEDS TO ANSWER TO PROFESSOR BASE ON MY POST. For our 1st pt- The diagnosis of whiplash is a key differential diagnosis for our first patient. When we consider the patients complaints; HA, decreased ROM in the neck, vertigo, loss of hearing to one ear, sweating and uncontrollable eye movements, along with the recent possible mechanism of injury; the MVA whiplash does fit a possible diagnosis for this patient. When we think of the causes of whiplash, we think of a force strong enough to whip the patients neck backward and forward, placing a great deal of stress on the neck muscles and ligaments. What additional differential diagnosis is appropriate for our first patient, based on the S/S?

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2025 Follow these guidelines when completing this assignment Speak with your faculty member if you have questions 1 Track performance

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NURSING 2025

Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions. 1) Track performance for all ATI Capstone assessments by logging NCLEX-RN Client Need Category performance on the Individual Student ATI Assessment Trends: Longitudinal Performance tool. 2) Based on individual performance on the ATI Capstone Assessments, prioritize the top two concepts (topics) of greatest opportunity. 3) Include the following criteria for each identified concept (topic): The NCSBN NCLEX-RN Test Plan will support this process (detailed criteria listed below and in the Grading Rubric must match exactly). a) Each Concept (Topic)- 10 points/20% i) Learning Needs: (1) Required Criteria: (a) Identify the concept (topic) of opportunity. (b) Provide a description of how this aligns with the NCLEX-RN Test Plan as indicated by performance in the Individual Student ATI Assessment Trends Table. ii) Learning Strategies: (1) Required Criteria: (a) Identify a minimum of two learning strategies that you plan to implement to address your learning need. iii) Learning Resources: (1) Required Criteria: (a) Identify a minimum of two resources that you will integrate into your NCLEX-RN Readiness plan to assist you with improving the identified learning need. 2. (1) Required Criteria: (a) 250 word minimum (b) Give three specific examples on how the ATI Capstone assessments Review helped improve your self-identified top two priority concepts (topics) of greatest opportunity from above. (c) Describe three test taking strategies that resonated with you and explain how you will implement these strategies into your NCLEX-RN Success preparation.

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2025 Gastrointestinal GI and hepatobiliary disorders affect the structure and function of the GI tract

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Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders 2025

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Discussion, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan. Consider the following case study: Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs: · Synthroid 100 mcg daily · Nifedipine 30 mg daily · Prednisone 10 mg daily To prepare: · Review this week’s media presentation on pharmacology for the gastrointestinal system. · Review the provided case study. Reflect on the patient’s symptoms, medical history, and drugs currently prescribed. · Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors such as pregnancy, drugs, or a psychological disorder. · Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. With these thoughts in mind: Post an explanation of your diagnosis for the patient including your rationale for the diagnosis. Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed

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2025 Instructions You are attending an international journalist event and have been chosen to give a presentation of

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Week 2 Assignment: The Role of Media in Influencing Government and the Public 2025

Instructions You are attending an international journalist event and have been chosen to give a presentation of the roles of the media in influencing government and its citizens. Identify and describe the roles of the media in influencing government and its citizens using specific descriptive examples. Please create a PowerPoint presentation to assist you in your presentation. As you complete your presentation, be sure to: Use speaker’s notes to expand upon the bullet point main ideas on your slides, making references to research and theory with citation. Proof your work Use visuals (pictures, video, narration, graphs, etc.) to compliment the text in your presentation and to reinforce your content. Do not just write a paper and copy chunks of it into each slide. Treat this as if you were going to give this presentation live. Presentation Requirements (APA format) Length: 8-10 substantive slides (excluding cover and references slides) Font should not be smaller than size 16-point Parenthetical in-text citations included and formatted in APA style References slide (a minimum of 2 outside scholarly sources plus the textbook and/or the weekly lesson for each course outcome) Title and introduction slide required Grading This activity will be graded using the Assignment Grading Rubric.

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2025 Searching Databases APA 7 format and at least 3 4 references When you decide to purchase a new car you

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Discussion: Searching Databases 2025

Searching Databases (APA 7 format and at least 3-4 references) When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data focused more on these factors and less on color options and sound systems. The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format. In this Discussion, you will transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently. You will share this PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question. To Prepare: Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources. Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles. Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course. By Day 3 of Week 4 Post a brief description of your clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. Then, post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. Describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples. By Day 6 of Week 4 Respond to at least two of your colleagues on two different days and provide further suggestions on how their database search might be improved. Mike RE: Discussion – Week 4/Initial (at least 2-3 references and APA 7 format) Given the diverse nature of the health care industry, the ubiquitous array of multi faceted axillary services, the sector we service the most sometimes becomes the focus of our interest given the opportunity and longevity in such an institution. For the purpose of this discussion post I will be posing a question on post operative pain management since this sector happens to be a critical pivotal point in patient recovery following either inpatient or outpatient surgical interventions. Using the PICOT question format; Does the management of pain using pharmacological and non pharmacological interventions on a post operative surgical adult patient improve pain control in four days post surgery? Following from the PICOT abbreviation, the P represents the population which refers to our surgical patients, I represents the intervention; pain management, C represents comparison; the comparison of pharmacological and alternate pain management strategies, O represents the outcome which is pain management while T speaks to our time frame for achieving this goal which is four days post surgery. According to Melnyk, (2018, p34) “the desire to gather the right information in the right way at the right time is not sufficient. Mastering practical, lifelong learning skills (e.g., asking focused questions, learning to systematically search) is required to negotiate the information rich environment that clinicians encounter.” For the purpose of this post, the search engines I utilized were ProQuest and CINAHL Plus database. My key word search was pain management, which returned 20,494 results and 21,460 respectively. After the utilization of limiters for full text, peer review, date range of 2016 to 2020 the streamlined search result was 13,601 and 15,787 respectfully. The inclusion of Boolean search parameter for surgical patients further helped narrow down the search as follows; 3,070 and 5,179 respectfully, my inclusion of a final modifier for the most recent year of publication “2020” further help streamline my search results as follows ProQuest 232, while CINAHL Plus with full text returned 203 searches. “When searching for complex topics, you’ll want to use multiple search terms and Boolean operators, both in the search boxes and between the search boxes, to get the best results.” (Retrieved September 6th, 2019) With the desire to increase the rigor and effectiveness on my data base search results, some of the strategies I will employ will be the refining of my search limiters which will help streamline my research to the most current year, using year of publication limiters, I will also include key words from my PICOT question like surgical, post surgical, pharmacological and or non pharmacological to help narrow in on the much desired research article that mirrors my PICOT question. “Keyword searching is the process of choosing search terms and entering them into the database search boxes to locate information on your topic.” (Retrieved September 19th, 2018) References Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/searching-basics Lau RE: Discussion – Week 4 I work on an IMCU, and it is hectic. Patient care is often interrupted for transferring improved patients to lower levels of care units to make room for admissions. About 1/3 of the unit will be newly admitted on my shift. The admission process includes asking patients about suicide and depression. I don’t feel awkward asking patients directly about the subject, but I see that patients are surprised that I ask even when I tell them in advance that I will be doing so. I have queried the significance of asking about suicidal ideation when patients are being admitted for a physical illness unrelated to psychiatric disorders. P- patients admitted for physical illness unrelated to psychiatric disorders I- hospital staff asking about suicidal ideation on admission to acute care settings C- not asking about suicidal ideation on admission to acute care settings O- value; decrease in the number of suicide attempts, an increase in patients seeking assistance in mental health care T- one year PICO question: Is there value in asking patients admitted to an acute care setting for physical illness unrelated to psychiatric disorder, about suicidal ideation, compared to not asking over one year. Search phrases could include ask suicide, medical admission, suicide screening, and asq suicide. I used Sage journals and queried “ask suicide” and received 39,212 results (Sage Journals, 2020). Using the same search terms on Taylor & Francis Online there were 75,136 results (Taylor & Francis Online, 2020). Using Boolean operators changed the results returned. Using “and” narrowed my search and “or” broadened my results. Adding more search terms linked together further narrowed the results by approximately 75% by using “and.” Both databases have the ability for the user to narrow searches by searching for terms in specific article type, journal type as well as the publication date. Strategies to increase the rigor and effectiveness of a database search might include using more than one database (UTHealth, 2019). One study on search strategies found a higher number of systematic reviews were obtained using a 2 PICO element search rather than a 4 element search. Additionally, it was found that it was essential to combine at least three databases together to achieve a 90% retrieval of relevant literature (Ho, Liew, Ng, Shunmugam, & Glasziou, 2016). This could provide me with the opportunity to find more significant studies to review. Another strategy would be to combine search terms and phrases with Boolean operators to refine my search. UTHealth libguides also points out that all databases are not created the same (UTHealth, 2019). They each have different rules and quirks. I must familiarize myself with the tool I choose to use, or it will not be effective. References Ho, G. J., Liew, S. M., Ng, C. J., Shunmugam, R. H., & Glasziou, P. (2016, 12). Development of a Search Strategy for an Evidence Based Retrieval Service. PLoS One, 11 (2), e0167170. doi:10.1371/journal.pone.0167170 Sage Journals. (2020). Search Results . Retrieved 12 22, 2020, from Sage Journals: https://journals-sagepub-com.ezp.waldenulibrary.org/action/doSearch?AllField=Ask+Suicide Taylor & Francis Online. (2020). Your search for All: ask suicide . Retrieved 12 22, 2020, from Taylor & Francis Online: https://www-tandfonline-com.ezp.waldenulibrary.org/action/doSearch?AllField=ask+suicide UTHealth. (2019). Best Practices for Developing Search Strategies: Home . Retrieved 12 22, 2020, from UTHealth: https://libguides.sph.uth.tmc.edu/c.php?g=543359

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