CASE STUDY: Preschool Child: Ricky

Make sure to provide citations/references for your answers in APA  Format

CASE STUDY: Preschool Child: Ricky

Ricky, age 4 years, arrives in the clinic with his mother. Ricky lives with his mother and father, who  both work full-time, and his infant sister. Their extended family lives in a different state more than  100 miles away. Both parents are of average height and in good health. Ricky’s mother mentions  that Ricky often expresses frustration, particularly in regard to food. Conflict over food occurs every  day. Mealtime is a battle to get him to eat, unless his mother feeds him. Ricky’s baby sister seems to  tolerate all baby foods but requires her mother to spoon-feed. Ricky’s mother is quite frustrated and  concerned that he will become malnourished.

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Reflective Questions 1. What additional assessment information would you collect?

2. What questions would you ask, and how would you further explore this issue with the  mother?

3. In what ways does the distance of the extended family influence this family’s approach to  health promotion?

4. What factors would you consider to determine whether malnourishment is a factor in this  family

CASE STUDY: Preschool Child: Ricky

Assessing And Treating Patients With Anxiety Disorders

The Assignment: 5 pages

Examine Case Study: A Middle-Aged Caucasian Man With Anxiety (https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/DT/week_05/index.html). You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. Assessing And Treating Patients With Anxiety Disorders

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

• Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
  

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Decision #1 (1 page)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Assessing And Treating Patients With Anxiety Disorders

Decision #2 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. Assessing And Treating Patients With Anxiety Disorders

Add more references as needed

References

Bui, E., Pollack, M. H., Kinrys, G., Delong, H., Vasconcelos e Sá, D., & Simon, N. M. (2016). The pharmacotherapy of anxiety disorders. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 61–71). Elsevier.

Bendek, D. M., Friedman, M. J., Zatzick, D., & Ursano, R. J. (n.d.). Guideline watch (March 2009): Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd-watch.pdf

https://www.jaacap.org/action/showPdf?pii=S0890-8567%2810%2900082-1

https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/acutestressdisorderptsd.pdf

Ostacher, M. J., & Cifu, A. S. (2019). Management of posttraumatic stress disorder. JAMA, 321(2), 200–201. https://doi.org/10.1001/jama.2018.19290

Assessing And Treating Patients With Anxiety Disorders

 

Nursing Research Discussion Board

A question that I am interested in investigating is what is the task that most nurses find difficulty working on in the ICU unit?

There are  four major types of qualitative research: phenomenology, grounded theory, ethnography, and historical (Mauk, 2019) Phenomenology consists of qualitative research that describes the lived experience to acquire understanding of an experience from the perspective of the participants (Mauk, 2019). On the other hand, grounded theory is a type of qualitative research that examines the process of a phenomenon and concludes in the generation of a theory. A question that can describe this design is “What is the process of recovery following breast cancer?” (Mauk, 2019). In addition, Ethnography emphasizes on the basis of culture such as different practices for different cultures (Mauk, 2019). Lastly, Historical design examines events or people to explain and understand the past to guide the present and future, for example they ask questions about ancient beliefs about diseases and the impact it has had on the medical field. Nursing Research Discussion Board

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Grounded theory is the most appropriate for my qualitative research question because this method is most commonly used in areas where there is little or no previous research (Mauk, 2019). Grounded theory can be used by nurses to explore a phenomenon about which little is known. Nursing Research Discussion Board

Differentiating statistical significance and clinical significance

Reply 1

In clinical research, statistically significant study outcomes are frequently regarded as clinically significant. Clinical significance represents the study’s influence on clinical practice, whereas statistical significance demonstrates the study’s trustworthiness. According to Ranganathan et. al, (2015), the “clinical significance” of a finding in clinical practice is determined by its consequences for current practice, with treatment effect size being one of the most significant variables driving treatment decisions. Statistical significance is heavily influenced by the sample size of a study; with large sample sizes, even minor treatment effects (which are clinically insignificant) can appear statistically significant; as a result, the reader must carefully consider whether this “significance” is clinically meaningful. Differentiating statistical significance and clinical significance Overall survival was compared in 569 patients with advanced pancreatic cancer who were randomly assigned to receive erlotinib with gemcitabine vs gemcitabine alone, according to a research published in the Journal of Clinical Oncology. The erlotinib plus gemcitabine arm had a “significantly” longer median survival (6.24 months vs. 5.91 months, P = 0.038). The P = 0.038 indicates that there is only a 3.8 percent probability that the observed difference between the groups happened by chance (less than the conventional cut-off of 5%), making it statistically significant. In this case, the “treatment effect” or difference in median survival between 6.24 and 5.91 months – a mere 10 days, which most oncologists would agree is a clinically irrelevant “improvement” in outcomes, especially when considering the added toxicity and costs associated with the combination – is the clinical relevance of this “positive” study. Differentiating statistical significance and clinical significance

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Statistical significance must always be established before clinical significance can be assessed in evidence-based research. Clinical significance, on the other hand, is generally a subjective assessment that cannot be determined by a single experience test. By ensuring that the result is statistically significant, I may leverage clinical significance to support good results in my project outcome. This is because the vast majority of statistically significant discoveries have therapeutic implications.

Reference

Ranganathan, P., Pramesh, C. S., & Buyse, M. (2015). Common pitfalls in statistical analysis: Clinical versus statistical significance. Perspectives in clinical research, 6(3), 169–170. https://doi.org/10.4103/2229-3485.159943
Reply 2

t Sapio 1 postsRe: Topic 8 DQ 2

To successfully implement evidence-based practice, it is important to understand and interpret research. In this regard, it is important to understand the difference between statistical significance and clinical significance. Statistical significance refers to when a relationship between variable is accurate and not random or caused by luck. It is used to determine the reliability of findings. In this regard, statistical significance as a parameter in evidence-based practice shows the extent or the likelihood that finding from research is true and does not occur by a chance (Heavey, 2015).

Clinical significance is essentially a subjective interpretation of research findings as meaningful for patient under care, and therefore likely to influence the behaviour of healthcare provider (Heavey, 2015). A clinically significant result occurs when medical experts believe that the finding is considerable enough to be medically crucial and hence be applied as a guide in provision of care to patients. Differentiating statistical significance and clinical significance

In evidence-based research practice, statistical significance must always be determined before determination of clinical significance. However, clinical significance is usually a subjective evaluation and cannot be established by a single experiential test. I can use clinical significance to support positive outcomes in my project outcome by ensuring that the result is statistically significant. This is because majority of statistically significant findings normally have clinical significance.

References

Heavey, E.(2015). Differentiating statistical significance and clinical significance. American Nurse Today, 10(5): 26-28. Retrieved from https://www.brockport.edu/daily_eagle/doc/2015-04/item_8038_7659.pdf

Differentiating statistical significance and clinical significance

Ethical Issues In Research Discussion

1. Create an original posting with a minimum of 250-300 words.
2. Back up your arguments with reliable evidence.

Ethical Issues In Research

There are many ethical challenges that have specific implications for nursing research. These arise primarily from the emergent and unpredictable nature of the research methods and the nature of the profession. Ethical challenges such as risk-benefit ratio which involves weighing both the benefits and the potential harm must be anticipated by the researcher before any contact with the potential subject. Ethical Issues In Research Discussion

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Instructions:

1. You are planning to conduct interviews about the experiences of women who were the victim of domestic violence. Complete the activities and answer the following questions:
   1. List and discuss in detail the ethical issues that are involved in the early stages of doing a research or evaluation study with these subjects or participants.
   2. is informed consent necessary in this case?  Why or why not?
   3. What steps will you take to minimize the potential risks?  What possible sources of physical and mental harm to the participants be minimized?
   4. How would you protect this specific subject from harm?
   5. What information will you provide to the participants to ensure informed and voluntary consent?
   6. Do the benefits of the study outweigh the risks?

Ethical Issues In Research Discussion