Part 1: An Introduction to Clinical Inquiry

Create a 4- to 5-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen 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
• Describe how you used keywords to search on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four peer-reviewed articles you selected.

Part 2: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• The full citation of each peer-reviewed article in APA format.
• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
• A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

1) Minimum 3 full pages 

2)¨**********APA norms, please use headers 

            All paragraphs must be narrative and cited in the text- each paragraphs

            Bulleted responses are not accepted

            Dont write in the first person.)

3) It will be verified by Turnitin and SafeAssign 

4) Minimum 4 references not older than 5 years. 

5) Identify your answer with the numbers, according to the three parts of this question.

6) The lines of your answer will be counted. Please make sure you meet the requirements.

 ____________________________________________________________

Mandatory Dicrections:

Taking into account files 1 and 2  answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

Read File 1 (This is the main case)

Use the chart you completed and questions you answered in File 2 as the basis for your responses in this assignment.

___________________________________________________________

Taking into account files 1 and 2  answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

1) At least 17 lines respond to the following: 

Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.

2) At least 36 lines respond to the following: 

How ought the Christian think about sickness and health? 

How should a Christian think about medical intervention? What should Mike as a Christian do? 

How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?

3) At least 17 lines respond to the following: 

How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Course Reflection Guidelines

Purpose

The purpose of this assignment is to provide the student an opportunity to reflect on selected RN- BSN competencies acquired through the NUR3165 course.

Course Outcomes

This assignment provides documentation of student ability to meet the following course outcomes:

• –  The student will be able to produce a complete research paper.
• –  The student will identify the research methods, sources and application in nursing practice.
  POINTS

This assignment is worth a total of 100 points (10%).

Requirements

1. The Course Reflection is worth 100 points (10%) and will be graded on quality of self- assessment, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.
2. Follow the directions and grading criteria closely. Any questions about your essay may be posted under the Q & A forum under the Discussions tab.
3. The length of the reflection is to be within three to six pages excluding title page and reference pages.
4. APA format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered):
   Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).
   a. Course Reflection b. Conclusion

Preparing Your Reflection

The BSN Essentials (AACN, 2008) outline a number of healthcare policy and advocacy competencies for the BSN-prepared nurse. Reflect on the NUR3165 course readings, discussion threads, and applications you have completed across this course and write a reflective essay regarding the extent to which you feel you are now prepared to:

1. “Explain the interrelationships among theory, practice, and research.
2. Demonstrate an understanding of the basic elements of the research process and models for

applying evidence to clinical practice.
3. Advocate for the protection of human subjects in the conduct of research.

1. Evaluate the credibility of sources of information, including but not limited to databases and Internet resources.
2. Participate in the process of retrieval, appraisal, and synthesis of evidence
   in collaboration with other members of the healthcare team to improve patient outcomes.
3. Integrate evidence, clinical judgment, interprofessional perspectives,
   and patient preferences in planning, implementing, and evaluating outcomes of care.
4. Collaborate in the collection, documentation, and dissemination of evidence.
5. Acquire an understanding of the process for
   how nursing and related healthcare quality and safety measures
   are developed, validated, and endorsed.
6. Describe mechanisms to resolve identified practice discrepancies between
   identified standards and practice that may adversely impact patient outcomes.” (p. 16).

The purpose of this assignment is to synthesize and apply the knowledge you gained in class into a well-written research paper. For this assignment, you will conduct research and write a paper containing three parts:

1. Part I: Analyze diet
2. Part II: Evaluate how the patient’s diet affects:
   • The person’s health (anatomy)
   • The progression of the illness (pathophysiology)
   • Common medications associated with the disease
3. Part III: Create patient SMART goals and an evidence-based plan of care (patient education)

Begin by viewing the patient profiles and assignment details in the the Worksheets, Forms, and Templates area at left. Choose one patient profile and use it to complete Parts I–III of the assignment.

In addition to the assignment specifics, your paper should: 

• Be 4–5 pages, not including the title and reference pages.
• Source(s) should be integrated into the paragraphs. Use in-text citations pointing to evidence in the literature and supporting your ideas.
• Incorporate a minimum of two peer-reviewed sources into your paper.
• Use current APA format to style your paper and to cite your sources. Follow the list structure of the sample paper for the section on calculations. You can download a sample paper in the Worksheets, Forms, and Templates area at left.
• Include a title page and a reference page listing the sources you used. Be sure to plan enough time for proofreading and editing.

Alzheimer’s Disease”

o Prepare

· Review the interactive media piece assigned by your Instructor. 

· Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.

· Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.

· You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

Write a 1- to 2-page summary paper that addresses the following:

· Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.

· Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.

· What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.

· Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

Interactive media piece case study below:

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 you perform 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 you 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.

Op

Options for Decisions below: Tips. Pick one that be a better option and answer all questions above. Need 3 x references

1. Begin Exalon 1.5 mg po bid with an increase to 3 mg po bid in two weeks( pt not feeling better).

2. Increase Exelon to 4.5mg orally bid( pt not feeling better)

3. Increase Exelon to 6mg po bid. ( Pt improved, dose could be maintained and checked in 4 wks, Namenda could also be added).

OR

1. Begin Aricept 5mg po bedtime ( pt no feeling better)

2. Increase Aricept to 10mg po ( Pt still not feeling Better NB Aricept at 5mg can be effective)

3. Continue Aricept 10 mg ( pt not any better) or ( 5mg with Namenda can be effective). 

OR

1. Begin Razadyne 4 mg ( pt not feeling better)

2. Increase Razadyne to 24 mg extended release( Pt has seizures/SE)

3. Retart Razadyne ( pt has more s/e). Respidal not apprappriate.

Resource for references

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

· Chapter 10, “Basic Principles of Neuropharmacology” (pp. 73–77)

· Chapter 11, “Physiology of the Peripheral Nervous System” (pp. 79–90)

· Chapter 12, “Muscarinic Agonists and Antagonists” (pp. 91–107)

· Chapter 13, “Adrenergic Agonists” (pp. 109–119)

· Chapter 14, “Adrenergic Antagonists” (pp. 121–132)

· Chapter 15, “Indirect-Acting Antiadrenergic Agents” (pp. 133–137)

· Chapter 16, “Introduction to Nervous System Pharmacology” (pp. 139–141)

· Chapter 17, “Drugs for Parkinson Disease” (pp. 143–158)

· Chapter 18, “Drugs for Alzheimer Disease” (pp. 159–166)

· Chapter 19, “Drugs for Epilepsy” (pp. 167–189)

· Chapter 20, “Drugs for Muscle Spasm and Spasticity” (pp. 191–201)

· Chapter 57, “Drug Therapy of Rheumatoid Arthritis” (pp. 629–641)

· Chapter 58, “Drug Therapy of Gout” (pp. 643–651)

· Chapter 59, “Drugs Affecting Calcium Levels and Bone Mineralization” (pp. 653–672)

American Academy of Family Physicians. (2019). Dementia. Retrieved from http://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=5

This website provides information relating to the diagnosis, treatment, and patient education of dementia. It also presents information on complications and special cases of dementia.

Learning Resources

Required Media (click to expand/reduce)

Laureate Education (Producer). (2019b). Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.

In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat Alzheimer’s disease.