Discussion: Week 5 Clinical Experience

Did you face any challenges, any success? If so, what were they?

This week's clinical experience was very different and provided more opportunities to learn and grow my skills in every setting. During the week, the significant group of patients was elderly, who presented unique health conditions. In the focus to promote effective care, more attention was required, and we repeated ourselves to them to promote better understanding. As a result, more time was taken with the elderly patient, and additional time was spent checking and assessing other patients. Hence, this week's clinical experience was successful through effective support from other health care professionals and cooperation from the patients. I was assigned care aid responsibilities which included perineal care, bed baths, bowel care, using lifts, and incorporating various assessments such as head-to-toe assessments. The clinical experience was so good, and I developed numerous memories with other health care providers and patients. In addition, we recorded the highest number of patients with specific conditions, which increased my opportunity to learn assessment and medication processes on the specific conditions.

Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and possible differential diagnosis.

During the week, I had an encounter with Mr. JF, a 75 years old male who had a complaint of occasional headaches and some lightheadedness when getting up too quickly over the past four weeks.  Mr. JF agrees to minimal physical exercise and states that he does not add salt to his food. He also confirms that his last visit to PCP was nine months ago. The patients agree on excessive use of alcohol smoking occasionally when going out. Upon examination, the patient represented the following outcomes BP 162/90, heart rate, and respiratory rate 16 weight 190. The patient's past medical history includes hypertension, Type 2diabetes, and chronic obstructive pulmonary disease (COPD). The significant signs and symptoms from the patient include frequent wheezing and coughing, trouble taking a breath, severe headaches, chest pain, confusion, fatigue, irregular heartbeat, increased thirst, and hunger, recurrent urination, and weight loss. The current medications that Mr. JF takes include Hydrochlorothiazide 25 mg daily; Insulin glargine 20U daily; Metformin 1000 mg BID, tiotropium (Spiriva) 1 capsule inhaled daily.

Upon examination, hypertension contributed to the patient's chief complaints. The differential diagnoses for hypertension include heart failure, stroke, anxiety disorders, Amphetamine Toxicity, Myocardial Infarction, and many more. The medication plan for the infection consists of administering antihypertensive medications. The medication helps in reducing the risks of heart failure, stroke, and myocardial infarction. The other step to enhance medicine is getting the blood pressure checked (Mostafavi et al., 2018). It is also essential to observe a healthy diet, hygiene, and effective living environment in physical exercise. Other medication drugs include diuretics, inhibitors, beta-blockers, and calcium channel blockers, and angiotensin-converting enzymes. The patient was also booked for regular follow-up clinics after every two weeks (Crittenden et al., 2017).

What did you learn from this week's clinical experience that can beneficial for you as an advanced practice nurse?

The imports skills that I learned from this clinical experience include that elderly patients can successfully share their feelings, express their wishes and cope with the mediational changes. The clinical experience also helped improve communication skills and listening skills, which are essential in listening and communicating to fellow health care providers and patients. The clinical experience also provided more opportunities that helped me learn assessment and medication processes on the specific conditions.