NRS 445 Final Draft - Research Critiques and Evidence-Based Practice Proposal

Grand Canyon University NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal– Step-By-Step Guide

This guide will demonstrate how to complete the Grand Canyon University NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal

Whether one passes or fails an academic assignment such as the Grand Canyon University NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal

The introduction for the Grand Canyon University NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

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How to Write the Body for NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal

After the introduction, move into the main part of the NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NRS 445 Final Draft – Research Critiques and Evidence-Based Practice Proposal

Evidence-based practice in nursing is important for the provision of care that optimizes outcomes. Nurses utilize their experiences in the care process and leadership to identify issues that can be addressed and improved with evidence-based interventions. Organizations strive to create environments that support best practices. The aim is to enhance safety, quality, and efficiency outcomes (Shayan et al., 2019). Health problems such as catheter-associated urinary tract infections (CAUTIs) greatly affect the patient’s health, health systems, and nursing care. Specific populations such as those with chronic conditions admitted to long-term care facilities have an increased risk of developing CAUTIs Carter et al., 2016; Shadle et al., 2021; Smith et al., 2019). Nurses should explore and adopt best practices for CAUTIs among this population.

This paper reviews the literature on the use of best practices, including CAUTIs bundles for CAUTIs prevention and rates in long-term care settings. CAUTIs are among the most common healthcare-associated infections in health institutions. It develops among patients with indwelling catheters. CAUTIs develop due to factors such as prolonged catheterization, lack of sterility in catheter insertion, and contamination from bowel movements (Shadle et al., 2021). CAUTIs act as a source of significant disease burden to patients, families, and health organizations. CAUTIs contribute to about 9% of all hospital-acquired infections in health organizations. They also increase care costs due to prolonged hospitalization and the demand for complex care. CAUTIs are preventable. Bundle interventions have demonstrated effectiveness in preventing and reducing CAUTIs in healthcare (Decker et al., 2021). However, their effectiveness has not been explored in the practice site, hence, the project’s focus.

PICOT Question

In the dilapidated patients admitted to long-term care units and using indwelling catheters, how does the use of CAUTI bundles compared to securing and positioning of catheters affect CAUTI rates within eight weeks?

Quantitative Studies: Methods

Two quantitative studies were used in this literature review. They include the studies by Decker et al. (2021) and Shadle et al. (2021). The study by Shadle et al. (2021) investigated the effectiveness of a bundle-based approach in preventing CAUTIs in the intensive care unit. The increase in the number of CAUTIs above the benchmark data informed this study. Accordingly, the institution reported 13 CAUTIs against the hospital benchmark of 4 or fewer CAUTIs annually. The project targeted a 30% reduction in CAUTIs, a 20% reduction in urinary catheter days, and a 75% compliance rating in catheter-related documentation in the intensive care unit (Shadle et al., 2021).

The methods used in the research by Shadle et al. (2021) were appropriate. A pre-post design over 2 consecutive 4-month periods was used in the research. The intervention targeted critically ill patients aged 18 years and above and admitted to the intensive care unit and catheterized. The bundle interventions included staff education, nurse-driven removal protocol for indwelling urinary catheters, and an electronic daily checklist. The obtained data was analyzed using mixed statistics such as Fisher exact tests and independent sample t-tests. Methods such as a pre-post design are appropriate for the project aim because it shows the impact of the bundle interventions on the rate of CAUTIs (Shadle et al., 2021). The selected bundled interventions also support the use of best practices to address CAUTIs.

The other quantitative study selected for the literature review is the research by Decker et al. (2021). Decker et al. (2021) investigated the effect of bundle interventions on CAUTIs in critical care units. Decker et al. (2021) study was conducted in Boston Medical Center to decrease CAUTI rates in the intensive care units using five bundles. The bundles included new processes for catheter insertion and maintenance, indications for catheter insertion, appropriate testing for CAUTIs, alternatives to indwelling devices, and sterilization techniques. Unit nursing supervisors performed daily rounds to determine appropriate catheter use in the unit. The interventions by Decker et al. (2021) are appropriate since they demonstrate the effectiveness of nurse-led bundle interventions in addressing CAUTIs.

Qualitative Studies: Methods

Qualitative studies by Quinn et al. (2020) and Parker et al. (2020) were included in the literature review. The study by Quinn et al. (2020) explored persistent barriers to detecting and removing unnecessary catheters in healthcare settings. The authors adopted a multi method qualitative study design that included in-person interviews and observations of clinicians working in a large hospital. Some of the observations included shadowing nurses during shift changes and when admitting patients and observing doctors during morning rounds. Unstructured field notes were used to gather observational data. Semi structured interviews were conducted, audiotaped, and transcribed. Qualitative content analysis was used to identify the main themes. The methods used in the study by Quinn et al. (2020) were appropriate for the project’s aim. For example, the use of multimethod qualitative approaches enriched the data obtained on the barriers to detecting and removing unnecessary catheters. Unstructured field notes and semistructured interviews ensure the relevance and accuracy of the data.

The study by Parker et al. (2020) provided insights into clinicians’ experiences in implementing multifaceted bundled urinary catheter care interventions in four acute care hospitals in New South Wales, Australia. The researchers adopted a pre and post-intervention study design to implement the catheter care bundle. A focus was on implementing the intervention in all adult inpatient wards, operating theaters, inpatient wards, and emergency departments in the four hospitals. The bundle interventions focused on improving clinician’s decision-making on catheter insertion, care, and removal practices. Focus groups were conducted in the four hospitals to understand the implementation process from the clinicians’ perspective, and identify barriers and enablers to successful implementation (Parker et al., 2020). The adopted interventions in this study answer the project focus. For example, the use of bundle interventions provides insights into the effectiveness of the proposed project change.

Summary of Findings

The study by Parker et al. (2020) found that the main complexity and challenges associated with the implementation of bundle intervention could be understood from varied themes. They included early and sustained engagement with key stakeholders, good planning but remaining flexible, managing the burden of practice change, and adopting and sustaining practice change. Therefore, the researchers recommended the need for interventions that address the institutional barriers that hinder the use of bundle interventions for CAUTIs.

The study by Quinn et al. (2020) found themes that relate to barriers to detecting and removing unnecessary catheters. They include catheters being hard to find, not accurate, or not available, catheter removal is not a priority, confusion about who has the authority to remove catheters, and lack of agreement on and awareness of standard protocols and indications for removal and communication barriers. These barriers should be eliminated to ensure consistent use of best practices that prevent CAUTIs in nursing practice.

The study by Shadle et al. (2021) found that the implementation of the bundle interventions led to no CAUTIs during the intervention period and reduced the rate by 1.33 per 1000 catheter days. There was also a statistically insignificant increase in catheter days by 10.5%. Documentation compliance increased significantly from 50.0% before to 83.3% during the intervention. This study provides insights into the effectiveness of bundle interventions in preventing CAUTIs.

The study by Decker et al. (2021) found that bundle interventions reduced CAUTIs from 53 in 2013 to 9 in 2017 and a 33.8% reduction in the utilization of indwelling catheters. CAUTIs awareness education, insertion, and removal protocols, and implementation of PureWick female incontinence devices had significant and clear effects on reducing CAUTIs rates (Decker et al., 2021). Therefore, the results inform the need for interventions such as training and education for nurses on the effective use of bundle interventions to prevent and reduce CAUTIs.

Anticipated Outcomes for PICOT Question

The PICOT question is associated with some anticipated outcomes. Firstly, the use of bundle interventions is expected to reduce CAUTI rates in long-term care facilities. Evidence obtained from the included studies demonstrates a decrease in CAUTI rate with the use of bundle interventions (Quinn et al., 2020; Shadle et al., 2021). The other anticipated outcome is the increase in the provider’s knowledge about indications, contraindications of indwelling catheters, and indwelling urinary catheter care. Bundle interventions such as education and training increase the provider’s knowledge about the safe use of indwelling urinary catheters. The third anticipated outcome is the reduction in hospital stay and hospitalization costs for patients with indwelling urinary catheters. CAUTIs increase the length of hospital stay and costs incurred in treating hospitalized patients (Ling et al., 2022; Smith et al., 2019). The proposed bundle interventions will reduce and prevent CAUTIs, hence, efficiency in long-term facilities.

Comparison of Outcomes of the Selected Studies to the Anticipated PICOT Outcome

The outcomes of the selected studies align with the anticipated PICOT outcomes. The PICOT question anticipates that the use of bundle interventions would reduce CAUTIs in nursing practice. This anticipation aligns with the results reported in the selected studies. For example, Shadle et al. (2021) found that bundle interventions eliminated CAUTIs, which support the PICOT outcomes. Similarly, Decker et al. (2021) revealed that bundle interventions reduce CAUTIs and increase healthcare provider’s knowledge of the appropriate use of indwelling urinary catheters.

Health organizations experience challenges when implementing best practices to address practice issues such as CAUTIs. Issues such as the lack of knowledge and skills on the translation of best practices into nursing care and protocols hinder the use of best practices in the delivery of nursing care. It is anticipated in the project that some of these challenges might be experienced. As a result, this anticipation aligns with the findings in the studies by Parker et al., (2020) and Quinn et al. (2020). The authors provide insights into the potential barriers such as lack of protocols and providers not prioritizing catheter removal. The barriers might be experienced when implementing the proposed bundle interventions, hence, the need for anticipatory strategies to overcome the barriers when implementing the proposed initiative.

The Link between the PICOT Question, Research Articles, and Identified Nursing Problem

The identified nursing problem is CAUTI. The existing evidence shows the increased risk of CAUTIs among hospitalized patients with indwelling catheters. CAUTIs have adverse outcomes such as prolonging the length of hospital stay, increasing care costs, predisposing patients to other complications, and premature deaths (Carter et al., 2016; Shadle et al., 2021; Smith et al., 2019). Nurses should adopt best practices with the aim of preventing and reducing CAUTIs. The selected research articles provide insights into the effectiveness of bundle interventions in preventing and reducing CAUTIs. They also inform about the barriers that might be encountered in implementing the proposed change in the project. The PICOT question seeks to determine the effectiveness of bundle interventions in reducing and preventing CAUTIs. Therefore, the PICOT question, research articles, and the identified nursing problem are interrelated.

Proposed Evidence-Based Practice Change

The proposed evidence-based practice change based on the reviewed evidence is the implementation of bundle interventions to prevent and reduce CAUTIs in long-term care facility. The bundle interventions include educating nurses on indications, contraindications, evaluation, care, and removal of urinary catheters, the introduction of a daily checklist for indwelling urinary catheters, and nurse-driven protocol for catheter removal. The practice change will address CAUTIs by strengthening the consistent use of best practices in catheter insertion, care, and removal. Staff training will equip them with the required competencies in assessing the need, caring for, and removing indwelling urinary catheters. The proposed change is evidence-based as seen from the evidence from the included studies in this review.

Organizational factors such as leadership support and supporting the consistent use of best practices will influence the success of the proposed change. Leadership support in forms such as mentorship and coaching will encourage the staff to explore additional interventions that would support excellence in service provision. Regular feedback from the implementers of the project information will be obtained to inform improvement strategies for the proposed change.

Conclusion

In summary, this paper has reviewed two quantitative and two qualitative articles that relate to the developed PICOT question and the project’s focus. The reviewed articles showed the effectiveness of bundle interventions in reducing and preventing CAUTIs. The articles also identified barriers that might be experienced when implementing bundle interventions and evidence-based practices for CAUTIs. Outcomes in the selected studies align with the anticipated PICOT outcomes. The anticipated PICOT outcomes include reduction and prevention of CAUTIs, increase in providers’ knowledge about CAUTIs prevention and reduction, and reduction in the length of hospital stay and costs for patients with indwelling urinary catheters. Based on the findings of this review, this paper proposes the use of bundle interventions to prevent and reduce CAUTIs among hospitalized patients in long-term care settings.

References

Carter, E. J., Pallin, D. J., Mandel, L., Sinnette, C., & Schuur, J. D. (2016). A Qualitative Study of Factors Facilitating Clinical Nurse Engagement in Emergency Department Catheter-Associated Urinary Tract Infection Prevention. The Journal of Nursing Administration, 46(10), 495–500.

Decker, S. G. V., Bosch, N., & Murphy, J. (2021). Catheter-associated urinary tract infection reduction in critical care units: A bundled care model. BMJ Open Quality, 10(4), e001534. https://doi.org/10.1136/bmjoq-2021-001534

Ling, R., Giles, M., & Searles, A. (2022). Budget impact analysis of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in New South Wales Hospitals. BMC Health Services Research, 22(1), 1000. https://doi.org/10.1186/s12913-022-08313-7

Parker, V., Giles, M., King, J., & Bantawa, K. (2020). Barriers and facilitators to implementation of a multifaceted nurse-led intervention in acute care hospitals aimed at reducing indwelling urinary catheter use: A qualitative study. Journal of Clinical Nursing, 29(15–16), 3042–3053. https://doi.org/10.1111/jocn.15337

Quinn, M., Ameling, J. M., Forman, J., Krein, S. L., Manojlovich, M., Fowler, K. E., King, E. A., & Meddings, J. (2020). Persistent Barriers to Timely Catheter Removal Identified from Clinical Observations and Interviews. Joint Commission Journal on Quality and Patient Safety, 46(2), 99–108. https://doi.org/10.1016/j.jcjq.2019.10.004

Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit. Critical Care Nurse, 41(2), 62–71. https://doi.org/10.4037/ccn2021934

Shayan, S. J., Kiwanuka, F., & Nakaye, Z. (2019). Barriers Associated With Evidence-Based Practice Among Nurses in Low- and Middle-Income Countries: A Systematic Review. Worldviews on Evidence-Based Nursing, 16(1), 12–20. https://doi.org/10.1111/wvn.12337

Smith, D. R. M., Pouwels, K. B., Hopkins, S., Naylor, N. R., Smieszek, T., & Robotham, J. V. (2019). Epidemiology and health-economic burden of urinary-catheter-associated infection in English NHS hospitals: A probabilistic modelling study. Journal of Hospital Infection, 103(1), 44–54. https://doi.org/10.1016/j.jhin.2019.04.010

NRS 445 Case Study Mrs. T. Sample Answer

Case Study: Mrs. T.

Directions: Read the case study below. Evaluate the information and formulate a conclusion based on your evaluation. Complete the critical thinking table and submit this completed template to the assignment dropbox.

Case Study: Mrs. T.  

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. T., presented below.

Health History and Medical Information

Mrs. T., a 42-year-old female, has been living at home with her two high school age children, husband, and dog. She is a schoolteacher whoworks full-time teaching at the local grade school. She tries to be active by walking with her husband and dog for 20 minutes on the weekend but is starting to add weight as she gets older. She has no known allergies. She is a pack-a-day smoker and drinks three glasses of wine/per night after work. She tries to eat healthy but likes to eat out at fast food restaurants to avoid having to cook.

Medical history includes atrial fibrillation controlled with beta blocker, hypercholesterolemia, mild anemia related to heavy menses, and migraines. Current medications include:

Metoprolol 50mg daily

Pravastatin 40 mg at bedtime daily for cholesterol

Birth control pill Microgestin Fe in the AM

Amitriptyline 20 mg/daily for migraines

Case Scenario

You are the school nurse where Mrs. T. works. While at recess duty, another teacher runs up to you and reports that Mrs. T. is not acting like herself. When you approach, you see her sitting on a bench mumbling something to the kids gathered around her. She has dropped her cell phone on the ground, and her right arm appears limp. You try asking her questions and you notice the right side of her face is slacken, and she doesnot seem to be making sense when talking. You call an ambulance, and try to walk her back to your office, but she doesnot move well. You reassure her and try to determine if anything occurred prior to her loss of speech and movement. The other teachers say it came on suddenly, within the last 5 minutes. Mrs. T. shakes her head no to pain.

Objective Data – Completed by Ambulance Personal:

Temperature: 36.5 degrees C

BP 184/92, HR 101, RR 24, Pox 99%

Blood Glucose = 107

Positive FAST & VAN score, NIHSS = 12

Height: 62 inches; Weight 89 kg

Laboratory/Test Results – On Arrival to the Emergency Department (Initial Results)

WBC: 9.4 (1,000/uL)

INR – 0.7

CT Head is normal.

Negative pregnancy test

Cholesterol – 247, Triglycerides – 302

Critical Thinking Table

Clinical Manifestations

Describe the clinical manifestations present in Mrs. T., focusing on what is normal and abnormal and how this relates to her current condition.

Subjective

Abnormal subjective findings in Mrs. T include:
Sudden loss of speech.

Sudden loss of skilled voluntary movement.

Loss of comprehension and use of language

Normal findings include: Lack of pain

Objective

Abnormal objective findings include

High BP- 184/92

Paralysis- slacken face

Positive FAST & VAN score

NIHSS score of 12 indicating mild to moderately severe stroke.

Elevated cholesterol levels

High Triglyceride levels

Primary and Secondary Diagnoses

Discuss the primary and secondary medical diagnoses that should be considered for Mrs. T., and why you chose this diagnosis.

Primary medical diagnosis and why you chose this diagnosis.

Hemorrhagic Stroke- Intracerebral hemorrhage.

Intracerebral hemorrhage (ICH) results from bleeding into the brain tissue itself or the subarachnoid space or ventricles. The clinical manifestations of ICH include neurological deficits, headache, nausea, vomiting, decreased levels of consciousness, and hypertension. Patients with ICH often have a sudden onset of symptoms, with progression over minutes to hours because of ongoing bleeding (Murphy & Werring, 2020).

The primary diagnosis of ICH is based on the patient’s presentation of abrupt onset of neurologic deficits and diminished levels of consciousness likely caused by high blood pressure (Murphy & Werring, 2020).

Secondary medical diagnosis and why you chose this diagnosis.

Hypertension

The patient has a high BP of 184/92, which aligns with the diagnosis of Hypertension. Hypertension is the most important cause of Intracerebral hemorrhage. It is a secondary diagnosis since it contributed to the Intracerebral hemorrhage by rupturing a blood vessel (McGurgan et al., 2020).

Formulate a nursing diagnosis from the medical diagnoses

Ineffective cerebral tissue perfusion due to bleeding into the brain tissue and into the subarachnoid space as evidenced by neurologic deficits.

Pathophysiological Changes

Explain the pathophysiological changes in Mrs. T.

What pathophysiological changes would you expect to be happening to Mrs. T.?

The patient is having spontaneous, non-traumatic bleeding in the brain parenchyma caused by the rupture of a blood vessel due to high BP.

Shao et al. (2019) explain that cerebral hemorrhage leads to a hematoma, which mechanically compresses the brain. The hematoma mass in Mrs. T may increase the intracranial pressure, which will compress the brain. Blood from the intracerebral hemorrhage may accumulate as a mass that dissects through and compresses the adjacent brain tissues, causing neuronal dysfunction. This could impair cerebral blood flow and subsequently cause brain hernia. The brain hernia and edema may cause secondary brain injury, leading to poor outcomes.

Furthermore, if the patient’s hemorrhage ruptures into the ventricular system, it leads to intraventricular hemorrhage. The blood may result in acute hydrocephalus, which is an independent predictor for a poorer outcome following intracerebral hemorrhage (McGurgan et al., 2020).

The neuronal dysfunction in the patient is expected to worsen the patient’s neurological deficits unless urgent treatment interventions are implemented.

How will pathophysiological changes transition in the subacute phase after diagnosis and initial treatment?

After diagnosis and treatment of ICH, the patient’s consciousness will return, and the neurologic deficits will slowly diminish to various levels as the extravasated blood is resorbed (Montañ et al., 2021).

Treatment will reduce the intracranial pressure in the subarachnoid space. The water from the cerebral edema will diffuse from the subarachnoid space into the intravascular compartment, causing pressure in the subarachnoid compartment to decrease.

Health Status Effect

Describe the effects Mrs. T.’s current health status may have on her.

Describe the physical, psychological, and emotional effects Mrs. T.’s current health status may have on her.

ICH may contribute to physical, psychological, and emotional effects on Mrs. T.

Physical effects include impaired motor functioning in mobility, respiratory function, swallowing, speech, and self-care abilities. The patient may develop motor deficits such as Loss of skilled voluntary movement, impaired integration of movements, alterations in muscle tone, and alterations in reflexes (Montaño et al., 2021). The patient may also develop problems in communication with impairments in pronunciation, articulation, and phonation. These impairments will affect the patient’s social interactions, which may affect his psychological health, leading to anxiety and depression.

Stroke causes changes in body image and loss of function, which affects patients’ psychological and emotional well-being and increases the risk of depression. According to Devereux and Berns (2023), stroke is associated with psychological effects like depression, anxiety, mania, psychosis, post-traumatic stress disorder, irritability, and apathy. It is also linked with emotional and behavioral disorders. The patient may get frustrated by the mobility and communication problem, resulting in psychological distress and symptoms. Devereux and Berns (2023) explain that the risk of depression after stroke is higher when a patient develops aphasia than a patient without language impairments.

Discuss the impact it can have on her role in the family.

Stroke not only affects the patient but also the patient’s family and significant others. Mrs. T may have difficulties carrying out activities of daily living (ADLs) due to her physical impairments. The patient’s family is likely to develop physical fatigue and burnout as they have to help the patient with almost all ADLs (Kavga et al., 2021). Physical fatigue is linked to emotional and psychological distress, and the family may develop irritability, fatigue, and anxiety. Besides, the family’s psychological wellbeing will be impacted by seeing their loved one lose her independence. Furthermore, limited social interactions may affect their emotional and psychological health as they will spend much time caring for their sick loved ones (Kavga et al., 2021). The family will also be financially affected since they have to pay for treatment costs, clinic visits, and care for the patient.

Treatments and Support

Discuss treatments and support that can be completed for Mrs. T.

Discuss the immediate treatments that can be completed for Mrs. T.

Immediate treatment interventions will aim at lowering BP this will include administering short half-life antihypertensives like labetalol or nicardipine to avoid overshoot hypotension (McGurgan et al., 2020). The target BP will be <140/90.

If the patient has an elevated intracranial pressure, she will be initiated on osmotic therapy with mannitol or hypertonic saline (Shao et al., 2019).

Describe the long-term support she may need to return to baseline activity level.

After the stroke has stabilized for 12 to 24 hours, treatment interventions will shift from preserving life to lessening disability and attaining optimal functioning. In the long-term support, the patient may be transferred to a rehabilitation unit, outpatient therapy, or home care–based rehabilitation (Shahid et al., 2023). The long-term support for this patient should include long-term Hypertensive therapy to attain optimal BP control. To reduce the occurrence of another stroke, the nurse should focus on teaching stroke prevention, including lifestyle risk factors (Shahid et al., 2023).

Explain how the interdisciplinary team is utilized to help her family support and cope with her diagnosis.

The interdisciplinary team will be valuable in helping the family to support and cope with Mrs. T’s diagnosis. The team should comprise physicians, pharmacists, nurses, nutritionists, and physical therapists. Firstly, the family should be given a detailed explanation of what has happened to the patient.

The interdisciplinary team has an excellent opportunity to prepare the patient and family for discharge through Education, demonstration, practice, and evaluation of self-care skills.

The team trains the family to help the patient with her ADLs, including egometrics, to avoid physical injuries like backache. Besides, the team educates the family about the appropriate nutrition, using assistive devices to eat, and maintaining a calm environment. The team also informs the family of community resources to help them care for the patient and access financial resources.

References

Devereux, N., & Berns, A. M. (2023). Evaluation & Treatment of Psychological Effects of Stroke. Delaware journal of public health, 9(3), 62–69. https://doi.org/10.32481/djph.2023.08.011

Kavga, A., Kalemikerakis, I., Faros, A., Milaka, M., Tsekoura, D., Skoulatou, M., Tsatsou, I., & Govina, O. (2021). The Effects of Patients’ and Caregivers’ Characteristics on the Burden of Families Caring for Stroke Survivors. International journal of environmental research and public health, 18(14), 7298. https://doi.org/10.3390/ijerph18147298

McGurgan, I. J., Ziai, W. C., Werring, D. J., Al-Shahi Salman, R., & Parry-Jones, A. R. (2020). Acute intracerebral haemorrhage: diagnosis and management. Practical neurology, 21(2), 128–136. Advance online publication. https://doi.org/10.1136/practneurol-2020-002763

Montaño, A., Hanley, D. F., & Hemphill, J. C., 3rd (2021). Hemorrhagic stroke. Handbook of clinical neurology, 176, 229–248. https://doi.org/10.1016/B978-0-444-64034-5.00019-5

Murphy, S. J., & Werring, D. J. (2020). Stroke: causes and clinical features. Medicine (Abingdon, England : UK ed.), 48(9), 561–566. https://doi.org/10.1016/j.mpmed.2020.06.002

Shahid, J., Kashif, A., & Shahid, M. K. (2023). A Comprehensive Review of Physical Therapy Interventions for Stroke Rehabilitation: Impairment-Based Approaches and Functional Goals. Brain sciences, 13(5), 717. https://doi.org/10.3390/brainsci13050717

Shao, Z., Tu, S., & Shao, A. (2019). Pathophysiological Mechanisms and Potential Therapeutic Targets in Intracerebral Hemorrhage. Frontiers in pharmacology, 10, 1079. https://doi.org/10.3389/fphar.2019.01079