identify two sources of primary evidence that can be used to help answer the group PICOT question.
The sources should be in the form of single, primary quantitative, or qualitative research studies (primary source). Systematic reviews (meta-analyses or meta-syntheses), scoping reviews, literature reviews, narrative reviews, integrative reviews, etc.) are unacceptable.
The evidence should not be a clinical (quality improvement article, evidence-based program article) or opinion article. Though some authors identify literature reviews as systematic reviews, the work does not represent the criteria required for a systematic review. For this assignment, only true systematic reviews can be used.
The sources of the evidence need to be a peer-reviewed journal or a database such as the Cochrane Review and be current within the last five years.
submitting the bibliography of the articles and the PDF copy of the articles
Adverse side effects of Digoxin Versus Betablockers in the Elderly
Digoxin is one of the main drugs used to treat heart failure in the elderly (Parikh et al., 2022). This drug, however, has had negative side effects, such as impaired mental status, gastrointestinal issues, exacerbated cardiac issues and visual changes (Alfaqeeh et al., 2023). It is imperative, therefore, that when treating the elderly, it is important to note the narrow therapeutic range and monitor patients closely (Alfaqeeh et al., 2023). Beta blockers have been shown to have more positive therapeutic outcomes and side effects than digoxin (Poposka, 2019). Elderly patients are more susceptible to the adverse side effects of digoxin due to changes in their digestive and renal systems especially when compared younger individuals (Alfaqeeh et al., 2023). For this paper the elderly will be defined as anyone age 65 and over.
Nursing Situation
I had my first clinical rotation at Westside Regional Hospital on the Medical Surgical Unit. My professor assigned me to a nurse, and I was expected to shadow her for the day. As I assisted my nurse in assessing patients, we eventually met a 65-year-old African American male who was admitted for congestive heart failure (CHF). The patient had defecated all over himself and his bed. My nurse and I immediately attempted to assist the patient, but he seemed annoyed and upset that we were in his room, although we explained that our intent was to provide care and ensure that he was safe and clean. The patient refused profusely and stated that he would take care of himself. The patient, however, appeared lethargic and confused, so it was evident that he would not be able to effectively provide proper care to himself. Additionally, the patient refused all medications. Further perusal of the patient’s medical record revealed that he was prescribed 0.3 mg of digoxin per day. It was eventually determined that the patient was experiencing digoxin toxicity. Subsequently, it was important that the nurse utilize empathy to provide care to this patient.
PICOT Question
For patients 65 years and older diagnosed with CHF and prescribed digoxin, how does the use of digoxin compared with the use of beta blockers influence the risk of developing adverse side effects within one (1) year?
In my PICOT question:
Population is individuals aged 65 years and older diagnosed with CHF, Intervention is how the use of digoxin is compared to the use of beta blockers (Comparison) and Outcome influences the risk of developing adverse side effects within one (1) year (Time). My PICOT question is a prognosis/prediction type of PICOT question.
I incorporated the professor’s feedback by adding a timeframe into my PICOT question. In order to ascertain side effects, it is important to identify a timeframe. My research question is aimed at identifying risks of developing adverse side effects of digoxin, versus individuals 65 and older who were prescribed beta blockers within a one-year period.