Describe Your Clinical Experience This Week At A Fami 812004
Describe Your Clinical Experience For This Week At A Family Health Cli
Describe your clinical experience for this week at a family health clinic as a student nurse practitioner caring for geriatric 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 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
This week’s clinical experience at the family health clinic provided valuable insights into geriatric patient care, highlighting both challenges and successes in a real-world setting. As a student nurse practitioner, caring for older adults requires a comprehensive approach that considers the unique physiological, psychological, and social aspects of aging. This reflection discusses a particular patient assessment, the challenges encountered, lessons learned, and the implications for future advanced practice nursing.
During the clinical session, I cared for an 82-year-old male patient presenting with complaints of fatigue, shortness of breath, and occasional dizziness. The patient’s vital signs were noteworthy: blood pressure of 150/90 mmHg, heart rate of 88 bpm, respiratory rate of 18 breaths per minute, and oxygen saturation of 94% on room air. Physical examination revealed pale conjunctiva and bilateral basal crackles on auscultation, suggesting possible cardiovascular or respiratory pathology. The patient’s history included hypertension, hyperlipidemia, and a prior myocardial infarction five years ago, managed with medications.
The assessment focused on thoroughly reviewing the patient’s history, conducting a physical examination, and procuring appropriate diagnostic tests. The signs and symptoms—the fatigue, dizziness, and crackles—indicated potential heart failure or pulmonary issues. The initial plan involved ordering a chest X-ray, echocardiogram, and blood work (including BNP, complete blood count, renal function tests). While awaiting results, I initiated supportive care by advising the patient on sodium restriction and adherence to medication, emphasizing the importance of medication compliance, and recommending lifestyle modifications like weight management and exercise within tolerance.
Based on preliminary findings, possible differential diagnoses included congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and anemia. CHF was prioritized given the signs of fluid overload and history of cardiac issues, supported by bilateral crackles and fatigue (Yancy et al., 2017). COPD was also considered due to the patient's age and symptomatology, but the absence of significant respiratory distress or cough made it less likely. Anemia was another consideration, given the fatigue and pallor, which could be confirmed through blood tests. Rationales for these differential diagnoses were based on the physical findings, medical history, and presenting symptoms.
The health promotion intervention focused on patient education about controlling risk factors for cardiovascular disease, including dietary modifications, medication adherence, and regular exercise. Additionally, smoking cessation was discussed, despite the patient being a former smoker, to prevent further respiratory and cardiovascular decline. Social support systems and community resources were also reviewed to promote mental and emotional well-being, which are crucial components of holistic geriatric care.
From this clinical experience, I learned the importance of comprehensive assessment and personalized care planning. Geriatric patients often present with atypical symptoms, making it vital to conduct detailed history-taking and physical examination. Furthermore, I recognized the significance of evidence-based practice in guiding diagnosis and management. According to the American Heart Association (2017), integrating current research guidelines into clinical decision-making enhances patient outcomes, especially in complex cases involving multiple comorbidities.
As an aspiring advanced practice nurse, developing strong communication skills and cultural competence remains critical for fostering trust and improving adherence among geriatric patients. The experience reinforced that individualized care plans, supported by current research, can effectively address the complexities associated with aging and chronic disease management. Continuing education and staying updated with evolving guidelines are necessary to provide high-quality, evidence-based care.
In conclusion, this week’s clinical experience strengthened my clinical reasoning, emphasized the importance of holistic and patient-centered care, and underscored the value of integrating current peer-reviewed research into practice. These skills and insights are essential as I advance toward becoming a competent and compassionate nurse practitioner dedicated to enhancing geriatric health outcomes.
References
American Heart Association. (2017). 2017 ACC/AHA Guideline for the Management of Heart Failure. Journal of Cardiac Failure, 23(8), e1-e67. https://doi.org/10.1016/j.cardfail.2017.04.001
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