Describe Your Clinical Experience For The Final Week As A St ✓ Solved

Describe Your Clinical Experience For The Final Week As A Student Nurs

Describe your clinical experience for the final week as a student nurse practitioner at a family health clinic caring for older adult patients. 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 diagnosis with rationales. Mention the health promotion intervention for this patient.

What did you learn from this week's clinical experience that can 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.

Sample Paper For Above instruction

During my final week as a student nurse practitioner at a family health clinic, I had the valuable opportunity to care for older adult patients, which greatly enhanced my clinical skills and understanding of geriatric healthcare. My clinical experience was marked by both challenges and successes, providing insightful lessons applicable to my future practice as an advanced practice nurse.

Clinical Experience Overview

During this week, I primarily focused on conducting comprehensive assessments of older adult patients, managing prevalent chronic conditions such as hypertension, diabetes, and arthritis. I encountered challenges related to managing multiple comorbidities and polypharmacy, which required meticulous attention to medication reconciliation and patient education. Success was achieved in establishing trust with patients, allowing for more open discussions about lifestyle modifications and medication adherence.

Patient Assessment: Case Example

One notable case involved Mrs. A, a 75-year-old woman presenting with complaints of fatigue, dizziness, and occasional shortness of breath. On assessment, she exhibited a blood pressure of 160/90 mmHg, a pulse of 88 beats per minute, and mild bilateral edema in her lower extremities. Her physical exam revealed clear lung sounds but evident jugular venous distension indicating possible heart failure. Laboratory tests showed elevated BNP levels. The signs and symptoms suggested a possible diagnosis of congestive heart failure (CHF), necessitating further evaluation.

Plan of Care and Differential Diagnoses

The plan of care for Mrs. A included medication adjustments, including initiating an ACE inhibitor, further diagnostic testing such as echocardiography, and lifestyle counseling on sodium intake and weight monitoring. The interventions aimed to optimize cardiac function, manage symptoms, and prevent hospital readmission.

Three possible differential diagnoses considered were:

1. Chronic obstructive pulmonary disease (COPD): Symptoms of shortness of breath and fatigue could also indicate COPD, especially given her age and history of smoking, requiring spirometry for confirmation.
2. Anemia: Fatigue and dizziness may be due to anemia, which would be confirmed via complete blood count (CBC) testing.
3. Anxiety or depression: Psychosocial factors might contribute to her fatigue; screening tools would help in diagnosis and management.

Rationales for these differentials emphasized the importance of distinguishing among primary cardiac, pulmonary, hematologic, and psychological contributors to her symptoms.

Health Promotion Intervention

Health promotion for Mrs. A included educational counseling on smoking cessation, dietary modifications to reduce salt intake, encouragement of regular physical activity tailored to her abilities, and medication adherence strategies. Emphasizing the importance of routine follow-up and symptom monitoring was also part of her plan.

Lessons Learned and Implications for Advanced Practice Nursing

This clinical experience underscored the importance of comprehensive assessment skills, interdisciplinary collaboration, and patient-centered communication. I learned that effective management of older adults requires a holistic approach, considering physical, psychological, and social factors. I also recognized the value of current evidence-based guidelines, such as those from the American Heart Association, in informing clinical decisions and optimizing patient outcomes (Yancy et al., 2017).

As an advanced practice nurse, applying these lessons will enhance my ability to deliver quality care, foster strong therapeutic relationships, and implement interventions grounded in current research. Moreover, tailoring health promotion strategies to individual patient needs can significantly improve health outcomes and quality of life among older adults.

References

1. Yancy, C. W., Jessup, M., Bozkurt, B., et al. (2017). 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure. Circulation, 136(6), e137–e161. https://doi.org/10.1161/CIR.0000000000000509
2. Gheorghiade, M., & Pang, P. S. (2009). Acute heart failure syndromes. The Journal of the American College of Cardiology, 53(7), 557–573.
3. American Diabetes Association. (2022). Standards of Medical Care in Diabetes—2022. Diabetes Care, 45(Supplement 1), S1–S232.
4. National Institute on Aging. (2021). Fighting elder abuse. https://www.nia.nih.gov/news/fighting-elder-abuse
5. Fried, L. P., Tangen, C. M., Walston, J., et al. (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(3), M146–M157.
6. FitzGerald, J. M., & Weisel, R. (2020). Multimorbidity management in older adults: An evidence-based practice. Journal of Geriatric Cardiology, 17(4), 224–231.
7. WHO. (2015). World report on aging and health. World Health Organization.
8. Chodosh, J., et al. (2010). Geriatrics at Your Fingertips. American Geriatrics Society.
9. Hirsch, C. R., et al. (2018). Geriatric syndromes and their impact on health-related quality of life among older adults. Journal of Aging and Health, 30(7), 1144–1165.
10. American College of Physicians. (2016). ACP clinical guidelines and standards. https://www.acponline.org/clinical-information/guidelines