EvidenceBased Practice in Health Care:

Significantadvances in medicine have improved our knowledge and skills withregard to interventions employed to prevent heart attacks. Heartattack remains one of the leading killers in developed countries. Inthe United States, more than half a million adults die each year dueto heart attack (Facchiano &amp Snyder, 2012). In this paper, I willcritically appraise research evidence on potential risks of heartattack with regard to individuals with obesity. I will employevidence-based practice process in exploring the nursing problem.

Mostimportant nursing problem to be addressed

Themost important nursing problem to be addressed in the case study ismanaging heart attack. I have chosen this problem because of thegrave impact it portends to patient if not well managed. From thecase study, David complains of chest tightness and sweating during afamily trip. Following his wife’s suggestion, David visits thefamily’s general practitioner for an examination. His wife isconcerned about the symptoms he exhibited, given that David’sfather had died of heart attack complications. Upon examination bythe general practitioner, David is advised to avoid stressfulsituations as well as strenuous activities. On account of his age andobesity, David is at risk of heart attack and other heart relatedailments.

Accordingto Offredy and Vickers (2010), patients with obesity, high bloodsugar and high blood pressure are at a high risk for heart attack.Apparently, David is reported to have obesity a proven risk factorfor a heart attack. A number of interventions against heart attacksinclude a wide range of activities such as clinical therapies, socialactivities and lifestyle changes. Crabtree et al. (2016) argues thatit is easier and effective to take control of major risk factors thatcan lead to heart attack rather than seek clinical interventions. Inaddition, individuals can avoid behaviors such as smoking, alcoholabuse and unhealthy eating habits in order to reduce the risk ofheart attack. Given that obesity is considered as one of the riskfactors for heart attack, individuals can manage their weight throughexercising, dieting as well as avoiding stressful situations. Gardneret al. (2016) points out that individual from families with historyof heart disease are also susceptible to heart attacks. Thus, thereis need to raise awareness among individuals from families withhistory of heart attack about relevant preventive measures.

Developingan answerable question

Indeveloping the answerable question, I have used a specializedframework referred to as PICO. The acronym PICO stands forPatientpopulation/problem,Intervention,Comparison/Controland Outcome.

Thepopulation/patient (p) is “adult people with obesity” for theintervention (I) is “avoiding stressful conditions and strenuousphysical activities” outcome (O) is “reducing the risk of heart”and control (C) is “is there evidence?”

Theanswerable question directing the search for evidence to help thenurse support David is “Isthere evidence to suggest that avoiding stressful conditions andstrenuous physical activities is effective in reducing the risk ofheart attack in adult individuals with obesity?”


Asaforementioned, heart attack is a condition that can be preventedthrough various ways. The most important aspect is to recognize therisk factors and how they can be avoided. For individuals withobesity, they can reduce the risk of heart attack by avoidingstrenuous physical activities and stress.


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