PICOT Paper Does tele monitoring blood pressure (I) in African Americans with hypertension (P) improve blood pressure control (O) within the six months of initiation of the medication (T)? Population – urban African Americans – I am not sure you need urban here. This is something that you can refine based on what the population is in the research studies that you find. Intervention – tele-monitoring of BP – this is good! Comparison – routine care – this you might need to define better – by routine care do you mean medication management? This can also be assisted by the research studies that you find. What did they use for a comparison? Outcome – improved blood pressure control – this is great! We want to decrease the blood pressure. Time – 6 months – this you can leave off unless all of the research studies that you find have a time frame of 6 months. Introduction (10 points possible) _____History/Evolution of Topic (5 points) _____Clinical Concern/Problem (5 points) Body (65 points possible) _____Clinical Question in PICO(T) Format (5 points) _____Evidenced Based Literature – Presentation of source, study, findings, & conclusion of each source (48 points) -At least 6 sources: APA citation within paper & reference page included -Must be Evidence-Based Practice Nursing Resources or Nursing Research Resources -Must be from within the last 5 years _____Make Recommendations/Suggestions for Clinical Impact and Identify/Discuss Steps to Create Suggested Changes (12 points) Conclusion (10 points possible) _____Brief Summary/Key Points of Paper (5 points) _____Strong Closing Statement (5 points) Paper Format (15 points possible) ____ _____APA Format (15 points) -Including cover page, double spaced, & reference page -Citation within paper -Professional writing – no spelling or grammatical errors -A minimum of 5 pages, not counting cover page & reference page

Read the following case study and submit a 1- to 2-page essay in a Microsoft Word document using APA 6th edition in response to the questions.
Case Study:
Ann is a seventy-seven-year-old grandmother. She has one daughter and three grandchildren. Two years ago, she was diagnosed with moderately advanced Alzheimer’s disease, which causes her to have periods of confusion, frustration, anger, and obsessive thinking. When speaking, she is uncertain and her speech patterns are choppy. Before her mental deterioration, Ann was a woman of love, intelligence, and patience. Realizing they were getting older, she and her husband, Frank, discussed their wishes should anything happen to them. She told Frank that if there was no chance of survival, she would not want to be hooked to a breathing machine. They never got around to filling any papers.
Frank is a sweet and sensitive man. His wife’s state frightens him. Ann’s love for him has been the focus of his life for sixty years. His urgent desire for the best care for Ann shows his devotion and love. Their daughter, Sarah, is a businesswoman. She is a hard worker and a good mother. She is forty-five, successful, and intelligent. Although she loves her parents dearly, she lives ten hours away. She regrets not seeing much of them, especially recently. Frank feels his role is to take care of Ann. He has spent the past year with her, watching after her, cooking for her, cleaning the home, and witnessing her deterioration. Finally, Ann is unable to walk alone safely and he finds he must have her admitted to a long-term care facility. He calls Sarah to come and help with the arrangements. After having Ann admitted to a local nursing home, both Frank and Sarah remember the pleading look in Ann’s eyes as they walk away.
After three weeks in the nursing home, Ann starts to cough and run a fever. She is seen by doctors and diagnosed as having pneumonia. She is transferred to a local hospital, where she is given intravenous antibiotics. Although the progress of her pneumonia is halted by the antibiotics, she stops talking and refuses to eat. The physician calls Frank to insert a feeding tube. Frank calls Sarah to ask what to do. They wonder, Is a feeding tube equivalent to a breathing machine? Would it be possible to allow Ann to lie there and die of starvation? Is that murder? What would she want? What is the right thing to do? (Burkhardt & Nathaniel, 2008).
Respond to the following:
• Discuss the ethical decisions you would make.
• Discuss the legal decisions you would make.
• Explain, as a nurse, what advice would you give to Frank and Sarah. Support your responses with examples