WE STERN MINDANAO STATE UNIVERSITY

COLLEGE OF NURSING
ZAMBOANGA CITY

Name : Achmed Neil A. Juksin Date: September 22, 2020

TRY THIS !

Activity No. 3 Applying Evidence

Based Process

Instruction: Read the given case scenarios below,

1. Formulate clinical questions using PICOT format.

2. Acquire evidence based practice using applicable resources.
3. Formulate one appropriate nursing care plan from the problems presented in any of the given
scenarios.

CASE SCENARIOS PICOT

Case Scenario 1 P-School age children with gum and
dental problems
Most school age children suffers gum and dental problems as a result I- Periodontal toothpaste
of frequent eating of sweets and candies. These children often uses C- Saline Gargle
saline gargle as dental hygiene regimen because it’s readily available O- reduces gum swelling and cure
while others emphasizes the use of periodontal toothpaste as it does not other dental problems
only reduces gum swelling but also cure other dental problems when T- when constantly use for 6 months
constantly use for 6 months. However, the use of periodontal toothpaste
is costly and most mothers wants to find out if it is really worth to use.
Clinical Question:
In P- School age children with gum
and dental problems, what is the
effect of I- Periodontal toothpaste on
O- reducing gum swelling and cure
other dental problems compared with
C- Saline Gargle within T- 6 months
of constant usage?
Case Scenario 2 P-Middle-aged patients with
suspected myocardial infarction
Most middle- aged  patients who comes to cardiac unit presents with I- 12 lead ECG
central or epigastric chest pain radiating to the arms, shoulders, neck, C- One ECG reading
or jaw. The pain is described as substernal pressure, squeezing, aching, O- can help diagnosing MI
burning, or even sharp pain. With this findings, you suspect the patient T- N/A
to suffer from myocardial infarction and that a series of 12 lead ECG is
done to help diagnosing MI than a one ECG reading. Clinical Question:
Is a I- 12 lead ECG done on P-
middle -aged patients with suspected
myocardial infarction more accurate
in O- diagnosing myocardial
infarction compared with C- One
ECG reading?

Case Scenario 3 P- 30 year old pregnant woman

 I- Periodontitis
C- N/A
A 30 year old female visited your clinic complaining of bleeding gums O- risk for miscarriage
for 3days and has been taking oral prophylaxis. A week after she found T- within 3rd trimester
out that she is pregnant and been taking prenatal vitamins. On your
assessment reveals that she has periodontitis. The patient verbalized to Clinical question:
you that she is worried that her periodontitis made her more at risk for Does I- Periodontitis influence O-
miscarriage within the third trimester. risk of miscarriage in P- a 30 year
old pregnant woman T- within 3rd
trimester?

Prepared by:

NERISSA C. MARIGA, MAN, RN

BSN 3-D Instructor

Evidence-based practice acquired:

CASE #1:

“Toothpaste can be used as a vehicle for substances to improve the oral health of individuals and
populations. Therefore, it should be recommended based on the best scientific evidence available, and not
on the opinion of authorities or specialists. Fluoride is the most important therapeutic substance used in
toothpastes, adding to the effect of mechanical toothbrushing on dental caries control.”

Reference: Cury, Jaime Aparecido, & Tenuta, Livia Maria Andaló. (2014). Evidence-based recommendation on toothpaste
use . Brazilian Oral Research, Retrieved January 24, 2014 from https://dx.doi.org/10.1590/S1806-83242014.50000001

CASE #2:

“The 12-lead electrocardiogram (ECG) remains the most immediately accessible and widely used initial
diagnostic tool for guiding management in patients with suspected myocardial infarction (MI). Although
the development of high-sensitivity cardiac troponin assays has improved the rule-in and rule-out and risk
stratification of acute MI without ST elevation, the immediate management of the subset of acute MI with
acute coronary occlusion depends on integrating clinical presentation and ECG finding”

Reference: Miranda, D., Lobo, A., Walsh, B., Sandoval, Y., & Smith, S. (2017, November 29). New
Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the
Emergency Department. Retrieved September 21, 2020, from
https://www.sciencedirect.com/science/article/abs/pii/S0828282X1731173X

CASE #3

“Multiple factors are associated with the incidence of APO, and periodontal disorders are an independent
risk factor, according to epidemiological and experimental studies. Periodontal bacteria, especially P.
gingivalis, and their components can injure the trophoblast morphologically and functionally.”
Reference: Komine‐Aizawa, S., Aizawa, S., & Hayakawa, S. (2018, August 09). OBGYN.
Retrieved September 21, 2020, from
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/jog.13782
 ASSESSMENT NURSING DIAGNOSIS NURSING INTERVENTION RATIONALE

SUBJECTIVE CUES: Impaired dentition related to -Assess the patient’s oral hygiene Oral hygiene information provides direction on
“Masakit talaga ang ngipin ko” toothache as evidenced by practices. possible etiological factors and guidance for
as verbalized by the patient tooth enamel discoloration subsequent education.

OBJECTIVE CUES: -Assess the patient’s nutritional status. Poor food choices contribute to dentition problems.
-Halistosis Poor dentition can affect food consumption with
-Tooth Enamel Discoloration people with loss of teeth consuming fewer foods rich
and erosion in fiber such as fruits and vegetables.
-Used pain scale to the patient
and graded it 8/10 -Encourage to avoid high-sugar foods. High sugar foods may cause tooth decay and promotes
good oral health and healing.

-Educate patient about the importance of Right knowledge helps prevent possible dental
oral hygiene. problems.

-Administer antibiotics and analgesics of to treat oral or gum infection and dental pain.
topical analgesics

Reference:

Wayne, G., By, -, Wayne, G., & Gil Wayne graduated in 2008 with a bachelor of science in nursing and during the same year. (2020, September 07). Impaired
Dentition: Nursing Diagnosis Guide. Retrieved September 22, 2020, from https://nurseslabs.com/impaired-dentition/
Arandid, A. (n.d.). IMPAIRED DENTITION Nursing Care Plan. Retrieved September 22, 2020, from http://www.ncpmania.com/2012/07/impaired-dentition-
nursing-care-plan.html?m=1