This week’s assignment is Part 2 – Project Purpose Statement, Background & Significance and PICOt Formatted Clinical Project Question.

1. Provide a title that conveys or describes the assignment.
2. Introduction (this is a part of Part 1–you’ve already done this–just make what changes you want to it (if any) and cut and paste it to this report 
3. Overview of the Problem–you’ve already done this–just make what changes ypu want to it (if any) and cut and paste it to this report.
4. Project Purpose Statement – Provide a declarative sentence or two which summarizes the specific topic and goals of the project.
5. Background and Significance – State the importance of the problem and emphasize what is innovative about your proposed project. Discuss the potential impact of your project on your anticipated results to the betterment of health and/or health outcomes.
6. PICOt formatted Clinical Project Question – Provide the Population, Intervention, Comparison, Expected Outcomes and timeframe for the proposed project.
7. Conclusion (this will change with every assignment)

Discussion Question 1

Mike is a 46-year-old who presents with a complaint of “heartburn” for 3 months. He describes the pain as burning and it is located in the epigastric area. The pain improves after he takes an antacid or drinks milk. He has been taking either over-the-counter (OTC) famotidine or ranitidine off and on for the past 2 months and he still has recurring epigastric pain. He has lost 6 lb since his last visit.

Assessment

His examination is unremarkable. His blood pressure (BP) is 118/72. Laboratory values are normal complete blood count (CBC) and a positive serum Helicobacter pylori test.

1. What would you prescribe initially?
2. How long would you prescribe these medications?
3. What other possible meds could you prescribe to assist with the side effects from the medications prescribed?
4. How would the treatment vary if the patient has GERD instead?

Discussion Question 2

List differential diagnosis that would help confirm GERD while ruling out other diagnosis. Which medication is the best medication for treatment of GERD and why? What labs or other diagnostic tests that are used to confirm GERD? Your response should be at least 350 words.

 Please answer the following Discussion Question. Please be certain to answer the three questions on this week DQ and to provide a well-developed and complete answer to receive credit. Your main discussion answer needs to be at least 3 paragraphs in length with 3 references to justify your answer. Use APA format.

Also, please ensure to have read the assigned chapters for the current week. 

1. Describe quality and safety in Nursing.
2. Describe some quality issues in healthcare.
3. Describe some safety issues in Nursing.

 Instructions:

 Follow the discussion questions participation and submission guidelines.

·      Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

·      All answers or discussions comments submitted must be in APA format according to Publication Manual American Psychological Association (APA) (7th ed.)

·      Minimum of two references for each answer, not older than 2015.

Nursing Research:

QD1.  Discuss the characteristics and requirements that research tools should have on quantitative research to give validity to the study. Give some examples.

QD2.  Describe why you were to chose a specific method to select a sample over other methods. Defend the method you preferred.

Pathophysiology:

 QD1. Digitalis (e.g., digoxin, Lanoxin) is often prescribed for patients with atrial fibrillation. A common precaution prior to digitalis administration is to take an apical pulse.

a. Based on your understanding of the mechanisms of atrial fibrillation, why is taking a pulse by palpating the radial or other peripheral artery insufficient?

If there is a difference between the apical pulse and the radial pulse, discuss why the decision to administer or hold digitalis is based on the apical pulse rather than the radial or other peripheral pulse. In other words, why is the apical pulse considered “more accurate” in this situation?

QD2. A 10-year-old patient has developed cardiomyopathy and biventricular heart failure due to radiation and chemotherapy treatments received for pulmonary neuroblastoma. He has tachycardia, has tachypnea, and becomes winded and exhausted with minimal exertion.

1. How, if at all, would you expect the manifestations of this patient’s biventricular failure to differ from those in a patient with biventricular failure from a massive left anterior wall myocardial infarction (MI)?
2. How, if at all, would treatments for this patient’s biventricular failure differ from those for a patient with biventricular failure from a massive left anterior wall MI?