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3 pages/β‰ˆ825 words
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3 Sources
Style:
APA
Subject:
Health, Medicine, Nursing
Type:
Essay
Language:
English (U.S.)
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MS Word
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Topic:

Ace Inhibitor Monotherapy vs Combined Ace Inhibitor and Non-pharmacological Interventions

Essay Instructions:

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-reviewed research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.
Use the "Literature Evaluation Table" to complete this assignment.
Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
The PICOT question will provide a framework for your capstone project.
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.

Essay Sample Content Preview:
Literature Evaluation Table
Student Name:
Summary of Clinical Issue (200-250 words):
Nursing Practice Problem
Patient Population
Chronic kidney disease (CKD) is defined by an estimated glomerular filtration rate (eGFR) of <60mL/min/1.73m2 or evidence of kidney damage, such as proteinuria, for ≥3 months. It affects approximately 10% to 15% of the world population (Pugh et al., 2019; Teo et al., 2021). This disease results in multiple diseases as it is one of the most significant comorbidities resulting in mortality. One condition that develops with CKD is hypertension, secondary to the renin-angiotensin-aldosterone system and endothelial dysfunction (Pugh et al., 2019). In this case, patients without hypertension are at risk of developing this condition secondary to CKD. Conversely, patients who have already developed hypertension secondary to CKD should be managed appropriately to avoid the progression of the disease.
Clinical Problem
The clinical problem should focus on the effectiveness of pharmacological and non-pharmacological management in managing hypertension in patients with CKD. The proposed pharmacological treatments include angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARBs), beta-adrenergic blockers, and loop diuretics. Conversely, nonpharmacologic management focuses on a salt-restricted diet (Sinha & Agarwal, 2019). The potential barriers and other factors that affect the treatment should also be evaluated to ensure adequate disease management. These include poor knowledge about the disease, lack of access to health facilities and medications, poor co-management strategies among specialized physicians, and poor patient compliance to the prescribed management (Jafar et al., 2020; Greer et al., 2019; Lissanu et al., 2019).
PICOT Question: “In adult patients with chronic kidney disease (P), how effective is ACE inhibitor monotherapy (I) versus combined ACE inhibitor and non-pharmacological interventions (C) in the management of hypertension (O) when used in six months (T)?”
Criteria

Article 1

Article 2

Article 3

APA-Formatted Article Citation with Permalink

Greer, R. C., Liu, Y., Cavanaugh, K., Diamantidis, C. J., Estrella, M. M., Sperati, C. J., ... & Choi, M. J. (2019). Primary care physicians’ perceived barriers to nephrology referral and co-management of patients with CKD: a qualitative study. Journal of general internal medicine, 34(7), 1228-1235. https://doi.org/10.1007/s11606-019-04975-y

Jafar, T. H., Ramakrishnan, C., John, O., Tewari, A., Cobb, B., Legido-Quigley, H., ... & Jha, V. (2020). Access to CKD Care in Rural Communities of India: a qualitative study exploring the barriers and potential facilitators. BMC nephrology, 21(1), 1-12. https://doi.org/10.1186/s12882-020-1702-6

Lissanu, L., Lopez, F., King, A., Robinson, E., Almazan, E., Metoyer, G., ... & R Saunders, M. (2019). “I try not to even think about my health going bad”: a qualitative study of chronic kidney disease knowledge and coping among a group of urban African-American patients with CKD. Journal of racial and ethnic health disparities, 6(3), 625-634. https://doi.org/10.1007/s40615-019-...
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