Comment 1:

The p-value is a crucial statistical measure that plays a significant role in hypothesis testing. It determines the significance of the results obtained from a study and represents the probability of obtaining results as extreme as the observed results, assuming that the null hypothesis is true. It is important to note that a commonly used threshold for statistical significance is a p-value of 0.05 or lower. When the p-value is less than 0.05, it suggests that the results are unlikely to have occurred by random chance alone, leading to the rejection of the null hypothesis in favor of the alternative hypothesis. Conversely, if the p-value is greater than 0.05, it indicates that the results are not statistically significant, meaning there’s insufficient evidence to reject the null hypothesis (Andrade ,2019). It is crucial to understand that even if the p-value is not statistically significant (greater than 0.05), it does not mean that the findings are meaningless. Instead, it suggests that the observed results could occur due to chance, rather than the effects of the variables being studied. Moreover, the generalizability of research is affected by sample characteristics, study design, and contextual factors. Sample characteristics refer to the demographics and characteristics of the participants involved in the study. Study design encompasses the methods used to collect data, including the experimental setup, measures, and procedures. Contextual factors include the setting in which the study was conducted and any unique circumstances that may influence the findings. (Guetterman ,2019). Therefore, while assessing the generalizability of a research article on pain to a nursing problem, it is essential to carefully consider these factors. If the study involved a diverse sample of patients with diverse types of pain and was conducted in a clinical setting relevant to the nursing problem, it may be more applicable. However, if the study had limitations in its sample size, design, or context that limit its relevance to the nursing problem under consideration, its generalizability would be reduced. It is crucial to critically evaluate these factors when determining the applicability of research findings to specific nursing contexts (Kamper ,2020).

Comment 2:

This study looks at varied factors comparing opioid free anesthesia (OFA) to the control group of standard anesthesia practices. The surgical procedure in this study is an anterior approach total hip arthroplasty (THA). The statistical significance of the results is measured in p-value, or probability value. A P value that is less than or equal to 0.05 is considered statistically significant in that the effect is real rather than chance. This study found that OFA showed both statistically significant and insignificant effects. Time to extubating, morphine required in PACU, and time to discharge home were statistically significant with a p values all greater than 0.05. Time to PACU discharge was not statistically significant with a p-value of p=0.45. 

Certain results have higher clinical significance. These results decrease patient stay, length of intubation, patient safety, and costs. The most clinically significant result noted is patients discharge earlier with a p<0.001 and decreased oxygen requirements in PACU p=0.003. Working in PACU these are real world improvements. 

These results should be generalized and applicable to other surgeries. Aspects that affect generalizability include population details, a large random sampling, and analysis or control of all variables. Detailed population and large random sampling both lead to generalizability by eliminating biases, statistical outliers and accurately representing the population in question. Analyzing or controlling all factors leads to higher accuracy and more information that may be applicable to specific populations.  

The research in this paper is generalizable in that the technique was specific and accurate. The sample size was small, and all data came from 1 facility. To improve generalizability, a higher sample size and data from multiple locations in multiple regions. The data is also only applicable to anterior THR. Data from different total joint replacement procedures, or many diverse types of surgery would make this study generalized to OFA as an alternative to traditional anesthesia.

Comment 3:

The p-value is a measurement used in research testing to determine the strength of the evidence against the null hypothesis. It indicates the probability of obtaining the observed results if the null hypothesis were true. Clinical significance refers to the practical importance or relevance of the study results in real-world settings. Even if the p-value is not statistically significant, the results may still be clinically meaningful if they have a meaningful impact on patient outcomes or practice.  

According to the article “Honey for Wound Management: A Review of Clinical Effectiveness and Guidelines,” the null hypothesis would be that there is no difference in wound healing between honey and standard wound care. The alternative hypothesis would be that there is a difference, with honey being either more effective or less effective than standard care. Any observed differences in wound healing between honey and standard care could be due to random chance rather than a true difference in effectiveness. However, according to the article, there was a statistical difference between those treated with honey and those treated with standard wound management. The P value would be great in strength and therefore counteract the null hypothesis making it void. The P value holds clinical strength in the notion that honey therapies are substantial in treating wounds. Honey has been proven clinically effective and applicable to similar clinical settings and patient populations. 

The study on honey for wound healing had a sample that closely resembles the population of hospitalized patients with wounds, and the findings are more generalizable to the presented nursing problem. The setting is similar and configures to the nursing study at hand. The study had no methodological flaws, such as bias or confounding variables, and therefore the generalizability is valid.  

Comment 4:

The article chosen by the student was the article published by Han et al. (2021) on effects of a four-year intervention on hand hygiene compliance and incidences of healthcare-associated infections. In this study, the p value was set at 0.01. The p-value is a statistical measure that helps to determine the significance of a hypothesis test. It is the probability of obtaining a test statistic at least as extreme as the one that was actually observed, assuming that the null hypothesis is true. The smaller the p-value, the stronger the evidence against the null hypothesis and the greater the confidence we have in rejecting it. The study found out that The HH compliance increased from 68.90% in 2017 to 91.76% in 2020 and the incidence of HAIs decreased from 1.10 to 0.91% (P?<?0.01) (Han et al., 2021).  This p-value is statistically significant. This means that there is strong evidence against the null hypothesis, which is the hypothesis that there is no difference between groups or no relationship between variables.

Generalizability is the degree to which research findings can be applied to a broader context (Andrew et al., 2022). There are several factors that determine the generalizability of a study, including the randomness of the sample, how representative the sample is of the population, and the size of the sample. The outcomes of the research are generalizable. The sample size is adequate, and thus well representative of the population. There was also adequate randomization. Therefore, these outcomes can be applied to a broader context.  

Comment 5:

Levels of evidence play a crucial role in guiding practice changes by providing a hierarchy of research designs based on their methodological rigor and reliability. Healthcare professionals use levels of evidence to evaluate the strength of research findings and determine the confidence they can place in the results when making clinical decisions or implementing changes in practice (AACN Levels of Evidence – AACN, n.d.).

The most reliable level of evidence is typically systematic reviews and meta-analyses of randomized controlled trials (RCTs), as they synthesize findings from multiple high-quality studies to provide the highest level of evidence. These studies undergo rigorous methodological processes, including comprehensive literature searches, critical appraisal of included studies, and statistical analysis to pool data across studies (Research Guides: Nursing Resources: Levels of Evidence (I-VII), n.d.).

An example of a practice change resulting from this level of evidence could be the adoption of a new treatment protocol for a specific medical condition. For instance, suppose a systematic review and meta-analysis of RCTs consistently demonstrate that a particular medication is more effective than standard treatment in managing a certain disease with minimal adverse effects. In that case, healthcare providers may update clinical guidelines or treatment protocols to recommend the use of this medication as a first-line therapy for patients with that condition. This practice change is based on robust evidence derived from the highest level of evidence, ensuring that patients receive the most effective and evidence-based care.

Comment 6:

Levels of evidence play a crucial role in guiding practice changes in healthcare. These levels are used to categorize the strength of evidence supporting a particular intervention or practice, with higher levels indicating stronger evidence.  Professional organizations and healthcare institutions use levels of evidence to develop clinical practice guidelines and remain up to date in accordance to evidenced based practices. Levels of evidence are used to educate healthcare providers about the strength of evidence supporting different practices. Higher levels of evidence are given more weight in the development of guidelines, leading to practical changes that align with these recommendations. 

Research has shown that the most reliable level of evidence is often considered systematic reviews and analyses of randomized control trials. These studies provide a comprehensive summary of the existing evidence on a particular intervention or practice, making them reliable for guiding practice changes. An example of a practice change that could result from this level of evidence is the adoption of a new treatment protocol for a specific condition based on the findings of a systematic review and meta-analysis demonstrating its effectiveness compared to standard care, such as my ongoing example of using honey-based therapies in the treatment of wounds compared to standard wound management. 

Comment 1:

Experimental research involves two groups, a control vs experimental where the independent variable is changed. Randomized control trials compare the two groups where one group receives the experimental drug, treatment or procedure and other group has no change. A high degree of internal validity can be obtained through similar control and experimental groups. From the GCU library, Zhang et al, (2023) compares the use of solid liquid phase change and determined a causation through their experiment. The use of phase change materials reduces the peak temperature of the motor and greatly improves the overload capacity of the motor (Helbig, 2022). The experiment established a control and treatment group, and noted causation at the end of the experiment. This can be considered experimental if the groups are chosen at random. Quasi-experimental research compares the cause of the results with the control versus the treatment (Helbig, 2022). This type of experiment is looking at comparisons and similarities. For the experiment of solid liquid changes, it would only be comparing similarities during the experiment. Non experimental research, there is nothing new being added to the experiment. It is still comparing the two groups, but still no randomization or causation. The data collected can be retrospective or prospective and can be used to formulate a theory or as a foundation for a randomized control trial (Helbig, 2022). For the experiment from the GCU library, there would be no new product added to the experiment, only a way to organize the theory that using solid liquid reduces the peak temperature of a motor.

Comment 2:

Experimental research involves manipulating one variable to determine if changes in one variable cause changes in another variable. This type of research establishes cause and effect (BibliU – Reader. (n.d.). An example of experimental research in the article I chose is parallel randomized controlled trial, in which distribution to treatment groups is made on the basis of some randomization method, and each participant receives one (and only one) of the treatments being compared. Outcomes are compared across groups using a statistical method based on considerations such as number of groups to be compared, distribution and type of data size of sample and so on. This kind of experimental research is known to provide high levels of evidence (Stephenson, J. (2022)

Quasi-experimental research is similar to experimental. However, it lacks random assignment to control and experimental groups (BibliU – Reader. (n.d.). This article talks about how patients were assigned to groups depending on whether or not they were already receiving NPWT, rather than by random allocation as would be the case in an RCT (Stephenson, J. (2022).

Non-experimental research involves observing and analyzing without influencing participants (BibliU – Reader. (n.d.). An example of this fromt he article is  called single sample studies. One of the simplest, and possibly the most common study design in wound care, is the single sample study in which changes in patient outcomes between two time points are anylized normally baseline and some follow-up measure taken post-intervention (Stephenson, J. (2022).

Comment 3:

One study that comes to mind is the article by Boucher et al. (2018), which used an experimental design to investigate the effects of a mindfulness-based intervention on stress and anxiety in medical students. In contrast, a quasi-experimental study by Lahti et al. (2019) looked at the effects of a physical exercise intervention on cognitive function in older adults, using a comparison group that did not receive the intervention. Finally, a non-experimental study by Jalali-Farahani et al. (2019) explored the relationship between physical activity and perceived stress among Iranian female adolescents, using a cross-sectional survey design.

In terms of evaluating the effectiveness of the research design, I believe that the experimental design used by Boucher et al. (2018) was appropriate for their research question, as it allowed them to establish a cause-and-effect relationship between the intervention and the outcomes. However, the quasi-experimental design used by Lahti et al. (2019) had some limitations, such as the lack of random assignment to the intervention and comparison groups, which could have introduced selection bias. Overall, the choice of research design should depend on the research question and the feasibility of conducting the study in a particular setting.

Comment 4:

Qualitative research is an array of interpretative techniques which seek to describe, decode, translate and come to terms with the meaning, not the frequency of certain more or less naturally occurring phenomena in the social world (Al-Busaidi, 2008). It’s exploratory and seeks to understand underlying reasons, opinions, and motivations. It provides the insights into the problem and helps to develop ideas or hypotheses for potential quantitative research. Qualitative data collection methods vary using unstructured or semi-structured techniques. Some common methods include focus groups ( group discussions), individual interviews, and participation/observations.

Quantitative research is used to quantify the problem by way of generating numerical data or data that can be transformed into usable statistics. It is used to quantify opinions, behaviors, and and other defined variables – and generalized results from a larger  sample  population. Quantitative Research uses measurable data to formulate facts and uncover patterns in research (Fournier, 2023) Quantitative data collection methods are much more structured than Qualitative data collection methods. 

In my workplace, we used both qualitative and quantitative research in a project to improve patient’s satisfaction. We first conducted qualitative research through focus groups and interviews to understand the patient’s experiences, feelings, and perceptions. The insights from this research helped us to identify key areas for improvement. We then conducted quantitative research through surveys go gather measurable data on these key areas.. The data was  then analyzed to identify trends and patterns , which informed our strategies for improving patient’s satisfaction.

In a health care setting, these research findings can be incorporated in various ways. For instance, qualitative research  can be used to understand patient’s experiences and perceptions of care which can be inform improvements in patient-centered care. Quantitative research on the other hand, can be used to measure the effectiveness of these improvements by comparing patient satisfaction scores before and after the changes. This combination of qualitative and quantitative research understanding of the problem and inform evidence-based practice in health care.

Comment 5:

The goal of qualitative research is to get a better understanding of phenomena via in-depth examinations of people’s perspectives, actions, and experiences. In order to gather thorough and precise information, methods including focus groups, interviews, and observations are used throughout the process. In quantitative research, the goal is to assign a monetary value to trends, patterns, and correlations (H. E. Fischer et al., 2023). The backbones of this kind of research are statistical analysis and numerical data. It encompasses a wide range of methodologies, including statistical modeling, experiments, and surveys, in addition to other methods to quantitative data analysis. To ensure that you choose the appropriate research method for your study based on the questions and goals you have, it is imperative that you have a thorough understanding of these significant distinctions.

When it comes to gaining insights, making choices that are well-informed, and finding solutions to challenges, qualitative and quantitative research methodologies are widely applied in the working environments. In the beginning, qualitative research was used in order to get specific insights into the experiences that users had with the application that was already in place (Portz et al., 2019). Following the completion of the qualitative research, quantitative research was carried out in order to verify and generalize the results obtained from the primary study.

Comment 6:

Qualitative research is defined as data that can be separated into different categories that are distinguished by some non numeric characteristic. Some sources of qualitative data are interviews, focus groups, documents and observation (Qualitative vs. quantitative research: What’s the difference? GCU. (n.d.).  Quantitative research is defined as quantitative data consisting of numbers representing counts or measurements (Visual learner. (n.d.-a). Quantitative research requires different data collection methods. These methods include experiments, questionnaires, surveys and database reports (Qualitative vs. quantitative research: What’s the difference? GCU. (n.d.). 

    In the workplace and example of gathering qualitative data would be triaging a patient. On the maternity floor when triaging a patient we ask questions to find out if the patient is experiencing contractions, any leaking or bleeding, headaches, dizziness, visual disturbances, etc. These are all examples of Qualitative data that we are able to gather by asking the patients questions. These things are considered qualitative data because it is all non numeric data. An example of Quantitative data that we can collect are things like putting the fetal heart monitors on the mothers to measure baby’s heart rate as well as monitor contractions if they are experiencing any. Other quantitative data we can gather are things like vital signs and a nitrazine test to determine if a woman’s water broke. All of these things mentioned are Quantitative data because they give us a numerical measurement.

GIVE A POSITIVE FEEDBACK TO EACH OF THE POST. USE PORPER APA FORMAT.CITE SCHOLARLY SOURCES.

POST#1 Paige: The ability to effectively control oneself, one’s behaviors, thoughts, and emotions in order to accomplish personal and professional goals is referred to as self-leadership. Basically, it’s about leading oneself before others. The relationship between self-leadership and leadership competency is significant because self-leadership serves as a foundation for effective leadership. A leader who possesses strong self-leadership skills is better equipped to understand their own strengths, weaknesses, motivations, and values. This self-awareness enables them to lead with authenticity, integrity, and empathy, which are crucial elements of effective leadership. A leader’s self-leadership skills directly impact those they lead in several ways such as role modeling and empowerment. Self-leadership abilities like emotional intelligence, resilience, and self-control are exhibited by leaders, who provide a good example for their subordinates. Team members are more likely to model their leader’s successful behavior and emotional control when they see it in action, fostering a culture of self-leadership inside the company. Numerous studies have highlighted the connection between employee initiative and improved organizational and individual job performance (Kang et al., 2022).  

One leadership skill that I consider to be a strength is self motivation. Coming from a sports background I have always been competitive with others and myself. I have noticed that I enjoy setting the standard high for myself and attaining those goals.  One leadership skill that I could improved on is assertiveness. Sometimes I feel I do not want to step of toes or challenge other people intellect and them take it personally or a bad way so I will avoid any confrontation. 

One strategy to cultivate my self leadership skills is to clarify my personal goals and values. In order to perform this, I can establish clear, specific, and challenging goals that align with your values and aspirations. These goals are meant to be meaningful and evoke a sense of purpose. Breaking these goals into smaller more attainable goals to maintain motivation. Another strategy is to develop consistent habits. Humans are cultures of habit. Routines and habits that support your goals and enhance productivity are key when you are within the workplace. Consistent habits create a sense of structure and discipline, reducing reliance on fleeting motivation. By implementing these strategies, individuals can cultivate their self-motivation and enhance their self-leadership skills. This enables them to proactively pursue their goals, stay resilient in the face of setbacks, and achieve long-term success and fulfillment. The intrinsic motivation theory suggests that employees exhibit high levels of motivation and engagement in their tasks when they feel a sense of autonomy and control over both themselves and their environment (Inam et al., 2023).

References

Inam, A., Ho, J. A., Sheikh, A. A., Shafqat, M., & Najam, U. (2023). How self leadership enhances normative commitment and work performance by engaging people at work?. Current psychology (New Brunswick, N.J.), 42(5), 3596–3609. https://doi.org/10.1007/s12144-021-01697-5

Kang, H., Song, M., & Li, Y. (2022). Self-Leadership and Innovative Behavior: Mediation of Informal Learning and Moderation of Social Capital. Behavioral sciences (Basel, Switzerland), 12(11), 443. https://doi.org/10.3390/bs12110443. 

POST#2 ASHLEY: This week course content involved leadership skills and styles in advanced nursing practice. Effective leadership embodies, motivates, and enables professional nursing success. Functional leaders possess foundational emotional intelligence and interprofessional attributes that promote healthcare competency. The relationship of self-leadership to leadership capability is complex. To further elaborate, leadership competency can be described as an ability to impact others to reach projected goals. On the contrary, self-leadership can help stimulate one to obtain goals through self-motivation. Self-leadership and communication skills are known to have a positive result on nursing outcomes (Ae & Sim, 2020). A leader’s self-leadership skills can influence those they lead by providing a pathway example to follow.

As documented in the lesson plan content, self-leadership skills are crucial in the development of organizations and of oneself. One self-leadership skill I consider to be a strength is my own emotional intelligence (EI). Xu et al. (2023) infers that the EI theory impacts relationships, career aspirations, and emotional responses. Self-leadership skills are built by maturity. EI comes from the comprehension and management of emotions and the emotions of those around them. My expressive feelings can be mimicked by my peers or within my patients. Throughout the years that I have been in healthcare, I have successfully been able to manage and identify my emotions. By doing so, I have seen a positive change in the way I provide care. For example, I have learned to set aside my own personal biases and maintain professional boundaries.

One self-leadership skill that I have identified that needs improvement is the topic of self-care. Self-care is detrimental in the growth of a leader. As described in the section of leadership skills for advanced practice nursing, self-care cultivates an atmosphere of resilience. I have found myself overworked, overwhelmed, and burnt out in various situations throughout my career. There are times where I struggle to delegate my time appropriately to tasks that could be done later. When I am faced with a momentous amount of work in my personal or professional life, I seem to want to tackle things all at once. To my demise, the eagerness can become brief and my self-care suffers.

As explained previously, my self-care diminishes as I focus too heavily on tasks that do not need to be performed all at once. Two examples of strategies to help alleviate my stress and improve my self-care techniques could be sustaining my emotional, mental, and spiritual wellness. I can begin on ensuring I develop a sense of gratitude, continue to strengthen my relationships with my family, and separate my work and education when appropriate. By performing these tasks, I can nourish my self-leadership competencies.

References 

Ae, Y. K., & Sim, I. O. (2020). Mediating Factors in Nursing Competency: A Structural Model Analysis for Nurses’ Communication, Self-Leadership, Self-Efficacy, and Nursing Performance. International Journal of Environmental Research and Public Health, 17(18), 6850. https://doi.org/10.3390/ijerph17186850

Xu, J., Zhang, L., Ji, Q., Ji, P., Chen, Y., Song, M., & Guo, L. (2023). Nursing students’ emotional empathy, emotional intelligence and higher education-related stress: a cross-sectional study. BMC Nursing, 22, 1-9. https://doi.org/10.1186/s12912-023-01607-z

POST #3 MONDESTIN: Comprehending the notion of self-leadership is crucial for nurses to cultivate successful leadership abilities. The ability to take the initiative, inspire oneself, and exhibit sincerity in directing one’s own actions and behaviors is referred to as self-leadership. A leader’s talent for internal leadership has a direct bearing on their potential to motivate and sway others under their direction (Diggele et al., 2020). Self-leadership abilities have a significant influence on people under a leader’s direction because they provide a model of sincerity and responsibility. Team members are inspired to trust and believe in leaders that exhibit self-awareness, confidence, and integrity in their behavior. A culture of openness and transparency is fostered by authentic leadership, which promotes teamwork and creativity (Restivo et al., 2022).

Working together and in a team is one self-leadership trait that I think is strong. I am great at encouraging team members to work together, show respect for one another, and accomplish goals as a group. I actively contribute to a healthy work atmosphere and improve team performance by actively participating in collaborative decision-making and appreciating varied opinions. I believe there is room for progress in the self-leadership competency of conflict resolution. Even though I work hard to keep everyone on the team happy, I recognize that I can still improve my skills in conflict resolution. In order to resolve conflicts amicably and foster team unity, effective conflict management needs assertiveness, empathy, and active listening (Smith & Bhavsar, 2021).

In order to enhance my abilities as a self-leader, namely in handling conflicts, I intend to put two tactics into practice. I will look for chances to advance my career and receive instruction in methods of resolving conflicts, such negotiation and mediation (Smith & Bhavsar, 2021). By gaining new information and abilities, I can improve my capacity to resolve disputes amicably and encourage favorable results. In order to identify my conflict management strengths and areas for improvement, I will reflect on my performance and ask for input from colleagues. I can spot possibilities to improve my strategy and create more potent conflict resolution techniques by aggressively seeking out input and remaining receptive to constructive criticism.

Discussion 1: Hematopoietic Case Study

Thaiz 

• Contributing factors to develop Iron deficiency anemia

    Iron deficiency anemia is a prevalent condition characterized by insufficient iron stores leading to impaired red blood cell production. J.D., a 37-year-old woman, presents with symptoms indicative of iron deficiency anemia, including intermenstrual bleeding, menorrhagia, fatigue, weakness, and urinary frequency. Her medical history suggests several contributing factors predisposing her to Iron deficiency anemia (Warner & Kamran, 2023).

    Childbirth is a recognized risk factor for IDA due to significant blood loss during delivery. J.D.’s recent childbirth and multiparity, with four pregnancies in four years, increase her vulnerability to iron depletion, as each pregnancy imposes additional demands on iron reserves (Demuth, 2018).

•     Additionally, chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, for osteoarthritis management can lead to gastrointestinal bleeding and subsequent iron loss (Malik et al., 2023).

Reasons for constipation and/o dehydration

    Constipation and dehydration in J.D. could be related from long-term NSAID use, which can irritate the gastrointestinal tract and disrupt fluid balance. Furthermore, increased urinary frequency and mild incontinence may result from NSAID-induced bladder irritation or diuretic therapy for hypertension management (Malik et al., 2023).

Vitamin B12 and Folic Acid in Erythropoiesis

    Vitamin B12 and folic acid are vital for the normal development of the RBCs during the erythropoiesis, and deficiencies in these vitamins can impair red blood cell production, leading to megaloblastic anemia (Dlugasch & Story, 2024). Given J.D.’s symptoms, deficiencies in vitamin B12 and folic acid should be considered in the diagnostic evaluation.

Clinical Symptoms and signs for Iron deficiency anemia

    Clinical manifestations suggestive of iron deficiency anemia include fatigue, weakness, pallor, and dyspnea. Additional symptoms related to iron deficiency may include pica, brittle nails, and hair loss. Physical examination findings consistent with iron deficiency anemia include pallor of the conjunctiva, nail beds, and mucous membranes that is the most important clinical sign, but this can be evident when the values of the hemoglobin are between 7-8 g/dL (Warner & Kamran, 2023).

    Laboratory evaluation confirms the diagnosis of IDA in J.D. with low hemoglobin (Hb) and hematocrit (Hct) levels, decreased serum ferritin levels, and microcytic, hypochromic red blood cells on peripheral smear.

Appropriate Recommendations and Treatments

    Management of iron deficiency anemia focuses on replenishing iron stores and addressing underlying causes, such as gastrointestinal bleeding. Oral iron supplementation is the first-line treatment for mild to moderate iron deficiency anemia, typically with ferrous sulfate or ferrous gluconate. Iron supplementation should be taken without food to increase absorption. Low gastric pH facilitates iron absorption. Rapid response to treatment is often seen in 14 days. (Warner & Kamran, 2023).

    Counseling on proper iron supplementation administration is essential to enhance absorption and minimize gastrointestinal side effects. Additionally, addressing contributing factors such as NSAID use and menstrual bleeding is crucial to prevent iron deficiency anemia recurrence (Warner & Kamran, 2023).

    In conclusion, J.D. presents with symptoms consistent with iron deficiency anemia, with multiple contributing factors identified in her medical history. Prompt diagnosis and appropriate management are essential to alleviate symptoms and prevent complications associated with iron deficiency. By addressing underlying causes and initiating iron supplementation, J.D. can achieve restoration of iron stores and improvement in her overall health and well-being.

References

Demuth, I. M. (2018). Iron supplementation during pregnancy- a cross-sectional study undertaken in four German states. BMC pregnancy and childbirth, 18(1), 491. https://doi.org/10.1186/s12884-018-2130-5

Dlugasch, L., & Story, L. (2024). Applied Pathophysiology for the advanced practice nurse. Jones & Bartlett Learning.

Warner, M. J., & Kamram, M. T. (2023, August 7). Iron deficiency anemia. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK448065/

Malik, T. F., Gnanapandithan, K., & Singh, K. (2023, June 5). Peptic ulcer disease. National Center for Biotechnology Information. https://pubmed.ncbi.nlm.nih.gov/30521213

Discussion 2 : W.G Case Study. Cardiovascular

Thaiz G

Modifiable and non-modifiable risk factors for patients at risk for developing coronary artery disease and patients diagnose with acute myocardial infarction

    Acute myocardial infarction is a life-threatening condition characterized by the occlusion of coronary arteries leading to myocardial ischemia and necrosis. Mr. W.G., a 53-year-old man, presented with chest discomfort progressing to a crushing sensation, radiating to his neck and jaw, suggestive of acute myocardial infarction. Understanding modifiable and non-modifiable risk factors for coronary artery disease and acute myocardial infarction is crucial in managing patients like Mr. W.G.

    Modifiable risk factors for coronary artery disease and acute myocardial infarction include smoking, hypertension, dyslipidemia, diabetes mellitus, obesity, physical inactivity, and poor diet (Arnett et al., 2019). Non-modifiable risk factors include age, male gender, family history of premature CAD, and genetic predisposition (Arnett et al., 2019). Mr. W.G.’s age and male gender represent non-modifiable risk factors, while lifestyle factors such as smoking and diet may contribute to his risk for coronary artery disease and acute myocardial infarction.

Findings in the EKG compatible with Acute Coronary Event

    Electrocardiogram (EKG), findings consistent with acute myocardial infarction include ST-segment elevation or depression, T-wave inversion, and pathological Q waves (Thygesen et al., 2018). The presence of ST-segment elevation in contiguous leads, such as leads II, III, and aVF, is indicative of inferior wall acute myocardial infarction, which can manifest as chest discomfort radiating to the neck and jaw, as described in Mr. W.G.’s case.

Specific laboratory test to confirm the Acute Myocardial Infarction

    To confirm acute myocardial infarction, cardiac troponin levels are the most specific laboratory test (Thygesen et al., 2018). Cardiac troponins are highly sensitive and specific markers of myocardial injury, with elevated levels indicating myocardial necrosis. Troponin levels typically rise within 3-4 hours of symptom onset and remain elevated for several days, making them ideal for diagnosing acute myocardial infarction.

Increase of Temperature in patients with Acute Myocardial Infarction

    Mr. W.G.’s increased temperature post-MI is likely due to the inflammatory response triggered by myocardial necrosis. Body temperature could increase by more than 1 °C as soon as the first 4 to 8 h after onset of symptoms, peak in the first to second day with an average of 37.5 °C, and decrease in the fourth to fifth day after admission. Inflammation mediators, such as interleukins (IL)-1, IL-6, IL-8, tumor necrosis factor-?, and interferon-?, are released and pass through the blood?brain barrier to influence the temperature regulatory center in the hypothalamus. Prostaglandin E2, which is released afterward, plays an essential role in the development of fever. Fever may persist for several days post-MI as part of the acute inflammatory phase (Chen et al., 2023).

Pain in Acute Myocardial Infarction

    The pain experienced by Mr. W.G. during his MI is attributed to myocardial ischemia and subsequent necrosis. Ischemia leads to the release of pain mediators, such as bradykinin and prostaglandins, stimulating pain receptors in the myocardium. Additionally, ischemia-induced acidosis and stretching of ischemic myocardial fibers contribute to the sensation of pain, often described as pressure, tightness, or squeezing, as Mr. W.G. experienced (Chen et al., 2023).

    In summary, acute myocardial infarction is a critical condition with modifiable and non-modifiable risk factors. Diagnosis relies on clinical presentation, EKG findings, and cardiac troponin levels. Post-MI fever is attributed to the inflammatory response, while pain results from myocardial ischemia and necrosis. Providing comprehensive explanations to patients like Mr. W.G. is essential for understanding their condition and facilitating optimal management and recovery.

References

Arnette, D. K., Blumental, R. S., Buroker, M. A., & Goldberger, A. D. (2020). Correction to: 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 141(4), 177–182. https://doi.org/10.1161/cir.0000000000000755Links to an external site.

Chen, S.-H., Chang, H.-C., Chiu, P.-W., Hong, M.-Y., Lin, I.-C., Yang, C.-C., Hsu, C.-T., Ling, C.-W., Chang, Y.-H., Cheng, Y.-Y., & Lin, C.-H. (2023, August 4). Triage body temperature and its influence on patients with acute myocardial infarction – BMC cardiovascular disorders. BioMed Central. https://bmccardiovascdisord.biomedcentral.com/arti…

Thygesen, K., Jaffe, J. S., Chaitman, A. S., Bax, B. R., & Morrow, J. J. (2018). Universal definition of myocardial infarction. European heart journal. https://pubmed.ncbi.nlm.nih.gov/179512Links to an external site.

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