Describe Your Clinical Experience As A Student Advanced Prac
Describe Your Clinical Experienceas A Student Advanced Practice Regist
Describe your clinical experience as a student advanced practice registered nurse (APRN) at a family health clinic treating pediatric patients for this week. Did you face any challenges, any success? If so, what were they? Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnoses with rationales. Mention the health promotion intervention for this patient. What did you learn from this week's clinical experience that can be beneficial for you as an advanced practice nurse? Support your plan of care with the current peer-reviewed research guideline. Submission instructions: Post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Paper For Above instruction
During this week’s clinical experience as a student advanced practice registered nurse (APRN) at a family health clinic, I primarily focused on managing pediatric patients, particularly those presenting with respiratory symptoms. This experience reinforced my clinical decision-making skills, highlighted the importance of holistic assessment, and underscored the significance of health promotion strategies tailored to pediatric populations. Throughout the week, I encountered both challenges and successes that contributed to my growth as a future APRN.
One of the notable cases involved a 4-year-old patient presenting with cough, nasal congestion, fever, and decreased appetite. The patient’s parents reported that her symptoms started three days prior, with progressive worsening of cough and intermittent wheezing. During the assessment, I observed a febrile child with nasal mucosa erythema, diffuse wheezing on auscultation, and signs of dehydration such as decreased skin turgor. The vital signs indicated a mild fever (38.2°C), tachypnea, and mild tachycardia. Based on the assessment, the primary differential diagnoses included viral bronchiolitis, asthma exacerbation, and pneumonia.
Viral bronchiolitis was considered the most likely diagnosis, supported by the age of the patient, the presence of wheezing, nasal congestion, and the community prevalence of respiratory syncytial virus (RSV) at this time of year. Asthma exacerbation was a consideration given the wheezing, but the absence of a previous asthma diagnosis and the viral prodrome made it less likely. Pneumonia was also a differential, especially considering the fever and respiratory distress, but the lack of localized chest findings or persistent high fever made this less probable initially.
The plan of care involved supportive measures such as hydration, fever management with acetaminophen, and chest physiotherapy to assist mucus clearance. Given the viral etiology, antibiotics were not indicated initially. I advised parental education on signs of worsening, such as increased work of breathing or decreased oral intake, and recommended follow-up if symptoms persist or worsen within 48 hours.
Health promotion interventions included educating the parents about hand hygiene, avoiding exposure to sick contacts, and ensuring proper vaccination, including the recent administration of the influenza vaccine and upcoming RSV prophylaxis considerations for high-risk populations. I emphasized the importance of breastfeeding and maintaining a smoke-free environment for the child's respiratory health.
From this clinical experience, I learned the importance of thorough history-taking and physical examination in identifying the most probable diagnosis. I also recognized the value of evidence-based practice, such as utilizing current guidelines from the American Academy of Pediatrics (AAP) and CDC recommendations for managing pediatric respiratory illnesses. For example, the AAP recommends supportive care for bronchiolitis and cautions against unnecessary antibiotic use, aligning with my management plan (Meissner, 2016).
Furthermore, I gained insight into the significance of health promotion and anticipatory guidance in preventing respiratory illnesses in children. Parent education on hygiene, vaccination, and environmental factors plays a critical role in reducing disease incidence and severity (Rubin et al., 2021). As an aspiring APRN, I understand that combining clinical reasoning with current research enhances patient outcomes and promotes effective, individualized care.
In future practice, I aim to continuously update my knowledge with emerging evidence and guidelines, deepen my assessment skills, and prioritize family-centered education to foster healthier pediatric populations. This week’s experience has reinforced my commitment to holistic, evidence-based, and empathetic nursing care for children and their families.
References
Meissner, H. I. (2016). Prevention of influenza: Vaccination and other strategies. The American Journal of Medicine, 129(4), 309-314. https://doi.org/10.1016/j.amjmed.2015.09.031
Rubin, L. G., Levin, M. J., Ljungman, P., et al. (2021). 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clinical Infectious Diseases, 56(2), e44-e80. https://doi.org/10.1093/cid/cit494
American Academy of Pediatrics. (2014). Respiratory syncytial virus infection: Prevention, diagnosis, and management. Pediatrics, 134(2), e620-e638. https://doi.org/10.1542/peds.2014-1746