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Types of Research in Healthcare
Contribute a minimum of (number) pages. It should include at least (number) academic sources, formatted and cited in APA. Select a rubric that matches the requirements of the assignment if the default does not fit. Be sure to review the academic expectations for your submission. Assignment Instructions Using APA 7th edition format, write a short paper (2–3 pages, excluding title and references) that includes the following sections: Overview of Major Research Types Explain in your own words: • Quantitative research • Qualitative research • Mixed-methods research • Basic vs. applied research • Experimental vs. non-experimental research Include definitions and typical examples in healthcare. Study Design Comparison Table Create a table that compares at least five quantitative study designs: Study Design Purpose Example in Nursing Strength Limitation (e.g., RCT, cohort, case-control, cross-sectional, quasi-experimental) Levels of Evidence Briefly describe how research design influences the strength of clinical evidence. Include a pyramid of evidence (pasted image or created by student). Application to DNP Practice Choose one clinical problem related to your DNP project. Describe which type of research design would be most appropriate and justify why, including: • Population/context • Feasibility • Intended outcomes
Sample Answer
This assignment requires an analysis of a client scenario in the context of an assigned disease process, which, based on the provided instructions, is Heart Failure.
1. Application of Course Knowledge: Heart Failure
Discuss the underlying pathophysiological mechanisms of your assigned disease process. Which clinical manifestations observed in Janessa’s case could be explained by the pathophysiological mechanisms?
Heart failure (HF) is a complex clinical syndrome resulting from any structural or functional impairment of ventricular filling or ejection of blood (Mebazaa et al., 2021). The underlying pathophysiology involves a decrease in the heart's ability to supply adequate blood flow to meet the body's metabolic demands, leading to low cardiac output and subsequent activation of compensatory mechanisms:
Decreased Cardiac Output: The primary mechanism is the heart's inability to pump efficiently. When the left ventricle (LV) fails, blood backs up into the lungs (congestive heart failure), causing pulmonary edema. When the right ventricle (RV) fails, blood backs up into the systemic circulation, causing peripheral edema (Braunwald, 2023).
Activation of the Renin-Angiotensin-Aldosterone System (RAAS): Due to low cardiac output, the kidneys perceive low perfusion and activate RAAS. This leads to vasoconstriction (to increase blood pressure) and retention of sodium and water (to increase blood volume). While initially compensatory, chronic activation leads to increased workload on the heart and detrimental cardiac remodeling (Yancy et al., 2021).
Activation of the Sympathetic Nervous System (SNS): Decreased cardiac output also triggers the SNS to release norepinephrine, increasing heart rate and contractility. This provides short-term benefit but eventually increases oxygen demand, leading to cardiac ischemia and further damage.
The observed clinical manifestations in Janessa's case that could be explained by these mechanisms are:
Shortness of Breath (SOB): This is the hallmark of left-sided heart failure. Pulmonary venous congestion and the resulting pulmonary edema (fluid in the alveoli) impair gas exchange, leading to dyspnea (shortness of breath) (Yancy et al., 2021).
Weakness and Dizziness: These symptoms are directly attributable to low cardiac output. Insufficient blood and oxygen delivery to the skeletal muscles cause weakness, while inadequate perfusion to the brain causes dizziness (Yancy et al., 2021).
Analyze Janessa’s clinical manifestations in the context of your assigned disease process. Do these findings support a diagnosis of your assigned disease process? Why or why not?
Janessa's clinical manifestations may support a diagnosis of heart failure, but they are not definitive and suggest a need for further investigation.
Clinical Manifestation
Relevance to Heart Failure (HF)
Support for HF Diagnosis?
Shortness of Breath (SOB)
Highly relevant; cardinal symptom of left-sided HF due to pulmonary congestion.
Strong Support: SOB is the primary reason patients seek care for HF.
Weakness and Dizziness
Relevant; consistent with low cardiac output and poor systemic perfusion.
Moderate Support: Common non-specific symptoms of systemic failure.
Lungs Clear to Auscultation
Less common for acute decompensated HF. While chronic HF may not always have crackles, the absence of crackles/rales makes classic pulmonary edema less likely.
Weak/Contradictory Support: Challenges the diagnosis of acute, severe pulmonary congestion.
Pale Mucous Membranes
Less direct correlation with HF. While severe systemic congestion can cause a grayish pallor, pale membranes are a stronger indicator of anemia (low red blood cells or hemoglobin).
Weak/Contradictory Support: Pallor often suggests an alternative or coexisting condition (like anemia).
History of Endometriosis
Relevant due to chronic blood loss. Endometriosis can cause significant chronic or acute blood loss leading to iron-deficiency anemia, which itself can mimic and even precipitate heart failure (known as high-output HF).
Moderate Support: History suggests a risk for high-output HF secondary to chronic anemia.