1. What are 3 detailed examples of hyper and hypothyroidism?
2. Topic is: Explain the process of the lymphatic system.
How does this topic relate to something you might see in clinical practice:This topic relates to something that may be seen in clinical because as defined, the lymphatic system is the responsible system for “immune function, fluid balance, and transport of lipids, hormones, and cytokines and is considered to be part of the circulatory system” (McCance & Huether, 2022). The lymphatic system contains lymph, which is composed of “water, small amounts of dissolved proteins (mostly albumin), lymphocytes and antigen-presenting cells” which are then filtered through lymph nodes (McCance & Huether, 2022). In a clinical setting, when a patient presents with swollen or enlarged lymph nodes, it indicates that the patient is having an infection in a nearby area to the enlarged lymph nodes. Swollen lymph nodes are also associated with inflammation or cancers (Cleveland Clinic, 2020).
- Which ideas make the most sense and why?
The idea of the lymphatic system is that it is a part of the circulatory process, in which its primary functions are to “maintain fluid levels in your body, absorbs fats from the digestive tract, protect body from foreign invaders, and transports and removes waste products and abnormal cells from lymph” (Cleveland Clinic, 2020). Since the lymphatic system is a circulatory system, it filters and drains fluids throughout the body. Because it contains lymphocytes and antigen-presenting cells, it is also an important aspect in the body’s immune system to help the body fight against infections (McCance & Huether, 2022). Hence, an individual may have enlarged lymph nodes in areas nearest the infection source.
- How does this topic relate to current events?
Since the lymph nodes may become enlarged during periods of infection, inflammation, or cancers, these are current events that are present and may be experienced by a large number of individuals. For example, as identified by Cleveland Clinic (2020), “common infections that can cause enlarged lymph nodes include strep throat, mononucleosis, HIV infection and infected skin wounds” as well as cancers such as Hodgkin’s and non-Hodgkin’s lymphoma.
- What might make this problem more treatable?
There are several ways to keep the lymphatic system healthy. Cleveland Clinic (2020) has found that staying hydrated by drinking plenty of water can help lymph circulate through the lymphatic system seamlessly, reducing the potential for lymph build up in lymph nodes. In addition, staying healthy by exercising regularly and maintaining a healthy lifestyle and diet can improve lymph circulation (Cleveland Clinic, 2020). Lastly, avoiding toxins such as pesticides or cleaning products can reduce build up in the lymphatic system, because these chemicals are difficult to filter out of the body (Cleveland Clinic, 2020).
3. My topic for this week’s video presentation is to describe the clinical presentation and pathophysiology of gonorrhea. Through my research this week I have been able to learn so much beneficial information.
- How does this topic relate to something you might see in clinical practice?
As a future psychiatric mental health nurse practitioner, this topic relates to something I might see in clinical practice because it’s common to see patients that lack impulse control as well as health education. Many patients seen in the psychiatric setting are homeless or lack access to healthcare. This decreases the chance that they are routinely screening for STI’s. Using the information I have learned from this week’s assignment can help me to appropriately screen for high risk patients as well as provide resources when needed.
Which ideas make the most sense and why?
The most sensible ideas discussed in my presentation are the preventative measures. Preventing gonorrhea through the use of condoms is important in decreasing the amount of people infected. It’s also important to increase sexual health education to high risk groups. This can teach people to engage in safe sex, get routine screening, and know which signs and symptoms to look out for. I think through public health education, a decrease in the rates of gonorrhea can occur.
How does this topic relate to current events?
This topic relates to current events because rates of gonorrhea have been drastically increasing over the years. According to our text, 616,392 cases were reported in 2019, a 56% increase since 2015 (Rogers, 2023). As numbers continue to rise we are also faced with issues in treating the infection. Currently the CDC only has one recommended drug to treat gonorrhea due to developed antibiotic resistance. If this continues, it is possible that a resistance to all current treatment plans can occur (Rogers, 2023).
What might make this problem more treatable?
Knowing the signs and obtaining early screenings for gonorrhea can help make the infection more treatable. Oftentimes people can be asymptomatic, delaying treatment of infected people as well as increasing transmission rates. Once a person is aware of their infection they can start antibiotic treatment to address the infection.
4. My research topic compares the likelihood of stroke in adult patients during their lifetime with controlled versus uncontrolled hypertension. The research questions will cover the following:
- How does uncontrolled hypertension contribute to stroke?
- What is the prevalence of stroke in patients with controlled versus uncontrolled hypertension?
- What are effective interventions in managing hypertension in order to reduce the risk of stroke?
The most appropriate data collection method for this study will be to follow a prospective cohort study over a period of 15 years. The participants will be recruited from multiple clinics with a questionnaire administered to collect demographic information, medical history, and lifestyle factors such as smoking and alcohol use. Additionally, I would need to gather which patients are receiving pharmacological management, and if so then with which drugs, and which are not. The most important data to collect will be blood pressure readings at quarterly intervals. Potential issues with the data collection plan are participant recruitment and retention. Sometimes this can be the most difficult part. In order for the study to be valid and reliable there must be a sufficient amount of participants throughout the duration of the study. The participants will need to meet specific inclusion criteria. Furthermore, retention can also become an issue. Participants can drop out of the study or not follow up accordingly. Dropouts are common in clinical studies with a rate of 20% in a review of 71 randomized studies (Bell at al., 2013). Additionally, those on medication management may not adhere to the plan and thus also yield inaccurate results. To overcome these challenges I will need to collaborate with multiple medical offices and healthcare facilities to increase the pool of potential participants. While this can be timely in the beginning of the study, it will be beneficial because I will have a large participation group where the data will not be significantly affected if participants drop out. To ensure follow-ups at appropriate intervals, I would need to maintain regular communication with the participants and even send reminders for follow-up visits.
5. When gathering valuable data for a research project, the researcher must get scholarly, peer-reviewed, and up-to-date information on current practice. Fortunately, West Coast University has a library that students can use to gather data. My process for gathering data based on my topic involves collecting data on the effectiveness of psychotherapy in adolescents diagnosed with Bipolar Disorder. Then, gathering data on pharmacotherapy and its effectiveness. Once I can compare data from both, I can identify the differences and where they may overlap. One of the challenges I must overcome is the need for more experience in research. Although we have taken courses on similar topics throughout our nursing career, this course is focused solely on research in nursing. Suppose novice researchers are released into the field without adequate preparation. In that case, they risk damaging their credibility and professional standing by failing to adequately address various methodological and practical issues related to research (Thummapol et al., 2019).
6. In the interactive video, I played the role of clinical research coordinator (CRC), nurse Jan Klein. From the various interactions, particularly with the principal investigator (PI) I learned that there can be numerous ethical issues. On several occasions, the PI asked nurse Jan to deviate from the protocol by enrolling inappropriate candidates for the study. Similarly, as bedside nurses must advocate for the patient’s safety, the CRC must also advocate on behalf of the participants. The CRC is responsible for protecting the rights and welfare of the participants, being familiar with the protocol requirements for the study, ensuring approval from IRB before a study is initiated, and participating in the informed consent process (irb.ucsf.edu, 2022). I think there can be a lot of gray areas in research, which also depend on the type of individuals involved. Unfortunately, not everyone has strong ethics for one reason or another. In the scenario when it came time to obtain consent from a participant, nurse Jan could have cut corners and skimmed over the consent. However, this is extremely unethical because the participant must be fully aware and understand exactly what they are signing up for. For this reason, I selected to continue with the full and proper consent process and asked the participant to explain in her own words (teach-back) what the study would entail. In order to ensure my research is conducted in an ethical manner I will be familiar with all regulations and protocols, and have proper and truthful documentation of all data. There should also be frequent and clear communication between all team members. Since my study will focus on data collected from various medical offices, one potential challenge could be the accuracy of the patient’s blood pressure readings. I would need to find a way to ensure that all blood pressure equipment is working accurately and correctly, otherwise the data would not be valid for the study.
7. In the interactive video on ethical research from the nurse’s perspective, several issues could have been addressed to avoid ethical dilemmas in research. The clinical researcher supervisor, doctor, nurse, and assistant all have huge responsibilities. If any of them suspect other members are not following protocol or ignoring misconduct, then the research data’s integrity is compromised. The doctor overseeing the notes is also falsifying data which can lead to legal issues for the entire organization. While ethics in research are not always clear-cut, researchers should keep the project’s integrity by following protocol and not falsifying any documents. The role of any regulatory sector, such as universities, journals/publishers, and governments, in preventing this phenomenon must be entirely focused, and fundamental alternations should be implemented in this regard due to the rise in the competitive academic environment and with the increase in research misconduct (Mousavi & Abdollahi, 2020). I will ensure my research is done ethically by remaining unbiased and gathering scholarly, peer-reviewed data and up to date with current practices.
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