For this discussion, you are asked to review the student learning outcomes for this course and discuss how you met these outcomes. The intention here is to provide you an opportunity to “reflect” on the learning achieved during this term and how you successfully met these learning outcomes. If you do not feel you successfully met the objective, discuss your plans to successfully complete the objective in the future.

Upon completion of this course, the student should be able to:

1. Critically analyze current practice to formulate researchable problems.

2. Evaluate research as the basis for decision-making to improve outcomes through translation into evidence-based practice. 

3. Synthesize an understanding of the research process through development of a proposal to address a nursing problem or focus area identified in nursing practice.

4. Investigate ethical issues related to the conduct of scientific research, including informed consent, data management, data analysis, and protection of human subjects.

5. Explore national and international initiatives and research priorities.

Hi

I already completed my research paper for my advanced pathophisiology with the question below:

” What is the pathophysiologic difference between stable angina and unstable angina? “

Please make correction with grammar and sentences structure.  Thank you very much for your help!

Angina is a coronary artery disease that occurs when there is an imbalance between oxygen supply and demand in the myocardium (McCance & Huether, 2019). When supply is impaired and doesn’t meet demand, myocardial ischemia happens (McCance & Huether, 2019). There are two important concepts of accumulation of fatty streaks and endothelial dysfunction that explain the process of coronary artery disease (McCance & Huether, 2019). The coronary artery is made up of vascular smooth muscle and lined with vascular endothelium (McCance & Huether, 2019). 

With normal function, low-density lipoproteins (LDL) circulate throughout the arteries and deliver triacylglycerol fuel to tissues (McCance & Huether, 2019). However, when under abnormal circumstances, a certain percentage of LDLs are mutated by oxidative damage (McCance & Huether, 2019). Normally, macrophages ingest the oxidized LDL, and the body wants to get rid of waste. However, macrophages become engorged and become foam cells (McCance & Huether, 2019).  The foam cells become very big and accumulate and lodge in the layer of the vascular smooth muscle (McCance & Huether, 2019). When the foam cells accumulate, it displays the fatty steaks in the artery (McCance & Huether, 2019). The foam cells and lipid deposits will burst through the endothelial lining of the artery and cause a break in the artery. Besides the accumulation of fatty streaks, the dysfunctional endothelial cells have been damaged for many years and are result in the development of atherosclerosis (McCance & Huether, 2019). They cannot produce nitric oxide and cause the reduction of vasodilatation (McCance & Huether, 2019). As a result, the blood blow through the artery becomes restricted, oxygen supply to the distal tissues is diminished, and causing angina and heart attack.

Angina is a type of chest pain caused by reduced blood flow to the heart with a condition called myocardial ischemia and is a symptom of coronary artery disease (Mayo Clinic, 2020). Stable angina is not a heart attack and association with transient ischemia and no permanent damage and no infarction (American Heart Association, 2020). Patients usually feel uncomfortable pressure, fullness, squeezing, and pain at the center of the chest (American Heart Association, 2020). Stable angina is caused by fixed obstruction with a high cholesterol level (Huff, Boyd, & Jialal, 2020). Stable angina can be predictable, and patients are familiar with pain patterns, prompted by physical exertion such as exercise, emotional stress, cold temperatures, and having heavy meals (American Heart Association, 2020). Stable angina is not happened at rest, subsides with rest, and responds well to medications (American Heart Association, 2020).

On the other hand, unstable angina is unpredictable, even at rest, with unexpected chest pain (American Heart Association, 2020). It changes pain patterns, more severe, lasts longer and doesn’t respond well to medications (American Heart Association, 2020). As the coronary arteries are narrowed by fatty buildups, they can rupture, causing blood clots and blockage the flow of the heart muscle (American Heart Association, 2020). When having plaque ruptured, patients could have a heart attack and should be treated as a medical emergency (American Heart Association, 2020). 

Patients with angina is usually having ST-segment depression during attacks that display on the electrocardiograms (Ginghina, Ungureanu, Vladaia, Popescu, & Jurcut, (2009).). Providers can refer patients to have a stress test to perform during exercise (Mayo Clinic, 2020). Using an angiogram can also help detect obstruction and show the abnormal coronary (Mayo Clinic, 2020). The treatment of angina by relieving symptoms reduces the frequency of future anginas and reduces the risks of heart attacks. Patients can take nitroglycerin, long-lasting nitrates, antiplatelet drugs such as aspirin to relieve and prevent the symptoms (Mayo Clinic, 2020). They should also have lifestyle changes that include stop smoking, limit alcohol, keep a healthy weight, healthy diet, and regular exercise, but avoid exertion, avoid stress, and avoid large meals (Mayo Clinic, 2020). There are surgical procedures to restore normal blood flow, including a balloon or stent, coronary bypass, to wider the effective artery (Mayo Clinic, 2020). 

Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session. Do not select the same family you selected for Week 2.

Then, address in your Practicum Journal the following:

• Using the Group Therapy Progress Note in this week’s Learning Resources, document the family session.
• Describe each client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
• Using the DSM-5, explain and justify your diagnosis for each client.
• Explain whether solution-focused or cognitive behavioral therapy would be more effective with this family. Include expected outcomes based on these therapeutic approaches.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

DUE IN 24 HOURS

DF Instructions: Community Discussion Forum-Epidemiology & Disease prevention and outcomes

Select A or B  for your primary discussion posting. 

A-        How can data collection for notifiable diseases be improved?
            Why is tracking vital statistics so important?
            How does calculating Years of Potential Life Lost change the way we think about community health efforts?

  or

B-      Which components of the Multicausation Disease Model can communities most effectively impact?
         Which level of prevention is most important for better community health outcomes and why?
         Who plays a more significant role in preventing diseases, individuals or communities?

Directions for the primary posting

1) Limit your initial post to 250-300 words.

2) Use at least 2 literature resources to support your work in APA 7th format. Your textbook can be one of the resources.

3) Address all three assigned items above that included in section A or B.