Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement 

Revise the PICOT statement you wrote in the Topic 1 assignment.

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question

Considering Mr. P’s condition and circumstance, write an essay of 500-750 words that includes the following:

· Describe your approach to care.

· Recommend a treatment plan.

· Describe a method for providing both the patient and family with education and explain your rationale.

· Provide a teaching plan (avoid using terminology that the patient and family may not understand).

·  

In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite references to support your positions.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are required to submit this assignment to TURNITIN

 THIS IS THE ANSWER FROM ONE THE STUDENT FROM CLASS WHAT I WANT IS A REPLY TO THIS WITH REFERENCES THANK YOU. 

Chapter 28

You are meeting with a newly diagnosed 8-year-old acute lymphocytic leukemia (ALL) patient and his family to answer their questions about his illness and plan for treatment. They had sought medical treatment because the boy had experienced unusual fatigue, repeated infections, and unexplained bruising over the past few months.

a.            The patient and his family want to know why he has problems with bruising and infections when their understanding is that leukemia is a problem with too many white blood cells. How would you answer their question using lay language?

b.            The parents are very afraid of the chemotherapy regimen that is being planned, stating that their 40-year-old cousin died of ALL despite receiving powerful chemotherapy drugs that

Acute lymphoblastic leukemia (ALL) is a cancer of the lymphocytes, which are white blood cells that are in charge of the immune system. It is the most common type of cancer in children.
In the (ALL), the lymphoblasts provide the bone marrow and crowd out other normal cells, repressing the generation of red blood cells, several other types of white blood cells. If the bone marrow is not working correctly, the child may encounter anemia, simple bruising, bleeding, or infection.

Anemia is the result of reduced red blood cells. Anemia symptoms include tiredness, irritation, drowsiness, colorlessness, shortness of breath, and a rapid heartbeat.
When lesions occur it is difficult for blood to clot, so bleeding and bruises may happen more easily since there is a low flow of platelets. Additionally, an infection may happen often if the blood lack of normal white blood cells.
Lymphoblasts may also extend to other organs, including the skin, liver, spleen, the spinal fluid, and a girl’s ovaries, and a boy’s testicles

The purpose of chemotherapy in patients with acute lymphocytic leukemia is to achieve remission. As a result, leukemia cells are no longer seen in bone marrow samples, the normal marrow cells respond, and the blood counts become normal.  92% of children begin within a month of induction treatment to then start remission. Patients are required to stay in the hospital for treatment and daily doctor’s check. Complications can be very severe to be life-threatening, but improvements in health care, have made the threat less probable.

References

 Treatment of Children With Acute Lymphocytic Leukemia (ALL). (n.d.). Retrieved from https://www.cancer.org/cancer/leukemia-in-children/treating/children-with-all.html

Pathak, N. (2017, September 8). Acute Lymphoblastic Leukemia (ALL): Survival, Treatments, and More. Retrieved from https://www.webmd.com/cancer/lymphoma/acute-lymphoblastic-leukemia#1.

Books Required; Health Care Ethics: Critical Issues for the 21st Century 3rd Edition Author: Morrison, E.E. & Furlong, B. ISBN: 978-1449665357 Publisher: Jones & Bartlett Learning, (2014) 

Explain in detail using a minimum of 100 words what you think is the most important principle for clinical health care professionals and why?

Many patient symptoms can be tied to multiple disorders, which may lead to misdiagnoses. For instance, consider two digestive disorders of the gastrointestinal tract—inflammatory bowel disease and irritable bowel syndrome. These two disorders are commonly confused because they present similar symptoms. As an advanced practice nurse, you must know the differences to properly diagnose and treat the disorders. How does the pathophysiology of inflammatory bowel disease compare to the pathophysiology of irritable bowel syndrome? How do treatments for the two disorders compare?

To Prepare

• Review      Chapter 36 in the Huether and McCance text and Chapter 13 in the McPhee      and Hammer text.
• Identify      the pathophysiological mechanisms of inflammatory bowel disease and      irritable bowel syndrome. Think about similarities and differences between      the disorders.
• Consider      common treatments for inflammatory bowel disease and irritable bowel      syndrome. Reflect on whether treatments for one disorder would work for      the other disorder.
• Select      one of the following patient factors: genetics, gender, ethnicity, age, or      behavior. Reflect on how the factor you selected might impact the      pathophysiology of and treatments for each disorder.

Post an explanation of the pathophysiological mechanisms of inflammatory bowel disorder and irritable bowel syndrome, including similarities and differences. Then describe common treatments, addressing whether treatments for one disorder would work for the other disorder. Finally, explain how the patient factor you selected might impact the pathophysiology of and treatments for each disorder.

Required Readings

**Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

• Chapter 35, “Structure and      Function of the Digestive System”

This chapter provides information relating to the structure and function of the digestive system. It covers the gastrointestinal tract and accessory organs of digestion.

• Chapter 36, “Alterations of      Digestive Function”

This chapter presents information relating to disorders of the gastrointestinal tract and accessory organs of digestion. It also covers the pathogenesis, clinical manifestations, evaluation, and treatment of gastroesophageal reflux disease, gastritis, peptic ulcer disease, inflammatory bowel disease, and irritable bowel syndrome.

• Chapter 37, “Alterations of      Digestive Function in Children”

This chapter presents information relating to disorders of the gastrointestinal tract and liver that affect children. It focuses on congenital impairment, inflammatory disorders, metabolic disorders, as well as the impairment of digestion, absorption, and nutrition.

**Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

• Chapter 13,      “Gastrointestinal Disease”

This chapter provides a foundation for exploring gastrointestinal disorders by reviewing the structure and function of the GI tract. It also describes mechanisms of regulation of GI tract disorders such as acid-peptic disease, inflammatory bowel disease, and irritable bowel syndrome.

• Chapter 14, “Liver Disease”

This chapter reviews the structure and function of the liver. It then explores the clinical presentation, etiology, pathogenesis, pathology, and clinical manifestations of three liver disorders: acute hepatitis, chronic hepatitis, and cirrhosis.

• Chapter 15, “Disorders of      the Exocrine Pancreas”

This chapter begins by reviewing the anatomy, histology, and physiology of the exocrine pancreas. It then examines the clinical presentation, etiology, pathology, pathogenesis, and clinical manifestations of acute and chronic pancreatitis, pancreatic insufficiency, and pancreatic cancer.

**de Bortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., & Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787

– This work should have Introduction and Conclusion

– It should have at least 3 current references (Year 2013 and up)

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com