nur 691week 3

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Library

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How comfortable do you now feel in accessing the virtual library or the on-campus library? 

Also, are you familiar with Google Scholar as another resource to retrieve scholarly articles as well?

Nursing NUR 514 Lecture Assignment 1

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Lesson 4a

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  1. Questions are the driving force behind EBP.  If there were no questions, EBP would be unnecessary. Using the identified clinical problem in discussion #3.
  2. Formulate a PICOT question by identifying:
    1. P – Patient or Problem: Who is the patient? What are the most important characteristics of the patient? What is the primary problem, disease, or co-existing condition?
    2. I – Intervention: What is the main intervention being considered?
    3. C – Comparison: What is the main comparison intervention? (optional)
    4. O – Outcome: What are the anticipated measures, improvements, or effects?
  3. Convert this PICOT to a clinical question.
  4. indicate the best study method to answer this PICOT question (use the PICOT worksheet) Actions and attached to this discussion post).
  5. Title the discussion with the PICOT question.
  6. Initial post: Your post should be within a range of 150-240 words

Cite your references APA 7th  ed. (not included in the length of the post)

slide discussion

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find attached documents

Nursing assignment

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Nursing homework

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Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders

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Instructions attached

Case study for assignment: 

https://video.alexanderstreet.com/embed/training-title-82

Primary Care NP Role vs. APN Roles

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Create a discussion using APA 7 format, and scholarly references no older than 5 years

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Create a discussion of a minimum of 300 words with the following

Question: Does my patient have significant aortic stenosis?

A 72 year-old woman with a history of CHF presents with several weeks of gradually progressive dyspnea on exertion (DOE). At her baseline, she is able to walk several blocks, but now feels winded. She denies chest pain, palpitations, syncope/near syncope, cough, orthopnea, or PND. She states she is compliant with her medications and diet. She has had a recent functional study that showed minimal ischemia.

Meds

aspirin
digoxin 0.125 qd
lisinopril 20 mg qd
furosemide 20 mg qd
KCl 10 mEq qd

PE

HR 90, regular
PB 134/70

Labs

chem 7:
Na 132
K 5
Cl 94
HCO3 30
BUN 18
Cr 1.3
CBC: notable for Hgb 14 g/dL (Hct 43%)

CV

RRR, normal S1 and S2
No S3 but has S4
2/6 mid-peaking systolic murmur at the LUSB that radiates to the carotids.

PMI is mildly enlarged and sustained

Neck

Carotid pulse is brisk.
JVP flat
Positive abdominojugular reflux

CXR

Xray shows cardiomegaly and mild vascular redistribution

ECG

Unchanged with an incomplete LBBB pattern

Clinical Diagnosis

Worsening of her congestive heart failure (positive AJR, enlarged and sustained PMI, cardiomegaly, and vascular redistribution).

Clinical Questions

Is this patient’s worsening CHF due to significant aortic stenosis? 

Please elaborate why you think it may be aortic stenosis according to the patient’s symptoms and how do you assess each symptom.