critical thinking 3

Answer

1. Critical Thinking

    

   Question 1. Patient Scenario

   Brandon, a 68-year-old war veteran who served both in Iraq and Afghanistan and with bipolar disorder, presented to the mental health institution with his brother and wife. According to the family members, Brandon had been experiencing nightmares and sleep-walking while narrating his experience on the battlefield. His wife also said that Brandon had tried committing suicide and had recently been heard narrating that he felt guilty for killing so many people in the name of occupational duties. According to the family members, Brandon was under Topiramate, anti-epileptic medications to contain his situation, but the issue persisted. Considering that the medicine has detrimental side effects, it would be effective if Brandon is given Selective Serotonin Reuptake Inhibitors, but this would also be ineffective considering he has bipolar disorder. Respectively, Brandon could be set for psychotherapy to help him understand, accept, and control his condition. Both interventions will help reduce the nightmares and suicidal thoughts.

     PICO Question about Effectiveness

   P

   Who or what is at the center of the issue?

   Brandon, a 68-year-old war veteran with bipolar disorder and has Post Traumatic Disorder (PTSD).

    

   I	What is the intervention at issue?	Antipsychotic drugs
   C	Is there an alternative intervention (there may not be any)?	Psychotherapy
   O	What outcome would be beneficial or harmful?	Reduction of suicidal thoughts and nightmares.

    

   PICO Question

   In patients with PTSD, does Selective Serotonin Reuptake Inhibitors or psychotherapy work effectively in reducing suicidal thoughts and nightmares?

   Question 2

   	Element	Definition	Examples
   P	Population	Who is experiencing the phenomenon?	Brandon, a 68-year-old war veteran with bipolar disorder and has Post Traumatic Disorder (PTSD).
   I	Phenomenon of interest	What is the experience that you want to understand?	Did the PTSD medication previously administered to Brandon affect his general wellbeing?
   Co	Context	What is the context that will shape the experience?	Brandon has been subjected to the effectiveness of type of medications before coming to the mental health institution and those that the current physician will suggest.

    

    

    

    

   PICO Question

   How can a patient with PTSD and bipolar disorder who has previously been administered anti-epileptic medications respond to a new class of drugs (Selective Serotonin Reuptake Inhibitors) in relation to his recovery from nightmares and suicidal thoughts?

   Challenge of Formulating a PICO Question

   The hardest part when writing the PICO questions was formulating the outcomes. In most cases, a clear choice for one’s patients will merely have a single objective or desired outcome, and it is surely effective when this is the case of a practitioner’s question. In reality, physicians often want to explore several distinct outcomes for themselves, their clients, and their patients (Hopp, Rittenmeyer & Ebrary, 2012). For instance, health care professionals may wish for easy, effective, safe to use, and economic interventions. Many PICO questions may address various outcomes, analyzing both efficacy and negative results and costs. This will compel medical practitioners to look into multiple studies to obtain the data. One method is to redefine the outcome to be a compound statement that reflects one’s overall objective for the proposed case.

   Importance of Questions

   In the medical field, questions play a vital role in establishing effective problem-solving options.  For instance, questions encourage curiosity that helps medical practitioners to gain a deeper understanding of the apparent issue (Hopp, Rittenmeyer & Ebrary, 2012). Similarly, questions enhance creative thinking whereby physicians ponder on the most appropriate health care interventions for patients.  Also, questions reinforce one’s problem-solving abilities. Nurses who think critically are always instinctual problem-solvers.