Advanced Nursing Clinical research paper. Patient dealing with CHF/ Afib

The Patient with CHF/AFib

You are the primary care nurse practitioner in a busy family practice. The patient is a 72-year-old female with a CHA2DS2 VASc score of 6. She was recently hospitalized for CHF and was found to be in rapid AFib. She was diuresed while inpatient and placed on Lasix (furosemide) 20 mg once a day, Coumadin 5 mg once a day, and Toprol XL (metoprolol extended release) 50 mg once a day in addition to her Metformin (glucophage) 500 mg once a day, Zestril (lisinopril) 2.5 mg once a day, and Women’s Multivitamin once a day. She is in your office today, five days after discharge. Her last INR was two days ago, and it was 2.7. Her PT and PTT were in range. Her weight is 153 pounds.

She reports to you that she no longer drives and has difficulty obtaining rides to get to the lab. She wants to know if you could change her to one of the novel anticoagulants that her friend is on.

· How do you respond?

· Please provide patient education about the new medication and any side effects of which she should be aware.

Important Instruction about the Assignment 

1. The paper should always have an introduction statement that explains what the paper will entails.

3. For this paper, you must provide 5-7 pages well written evidence-based research paper according to the rubric guidelines, follow the APA format formatting for references and support your paper with at least 5 nursing or medical evidence-based research articles not older than 7 yrs.

4. Please take time to read and review it, if the paper is not up a master’s degree level standard, I will not accept the work. I just want to be clear about that before I assigned it to anyone. This is an advanced degree work that requires a very strong writer with the background and experience in Nursing and Medical field and a very well-developed English and written expertise.