Discussion Post-Clinical Experience paper
Discussion Post-Clinical Experience paper
My Clinical Experience
Entering a clinical rotation was full of mixed feelings; fear, anxiety, and excitement. One week before the end of the rotation, I had learnt a lot from other advanced nurse practitioners and the consultant physician. My communication skills, interpersonal skills, and decision making skills improved. Clerking patients, physical assessments, and prescribing medicine was easy at this point. Discussion Post-Clinical Experience paper
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My Personal Challenges And Successes
Towards the end of the rotation, I still had a challenge of time management getting to work late and preparing medical reports. The work was becoming overwhelming due to long shifts, many patients, and inadequate staffing. An advanced nurse practitioner should keep time by prior planning of the daily events to ensure smooth sessions at the clinic. My personal successes one week before the end of the rotation were improved communication skills and mustered healthy practice habits. I was friendly to the patients the staff. Good communication skills improved my confidence in clerking the patients and doing reports. Healthy clinical practices helped in reducing the rate of hospital-acquired infections. Good communication skills create rapport with the patients. Healthy clinical practices such as hand washing before and after examining patients reduces the spread of communicable diseases.
Describe The Assessment For This Patient
Ms. M.L is a 27years old female who complaints of a bad sore throat and difficulties in swallowing. The pain is of acute onset and is worse when swallowing. The sore throat is associated with a fever. The patient denies a history of tonsillitis and other chronic illnesses. She denies undergoing surgical procedures. Currently, she is on Tylenol for pain. She has no known food or drug allergy. Her blood pressure is 119/68, RR at 15, the temperature at 99.7, and spo2 at 98%. The possible differential diagnoses for the patient are acute tonsillitis, pharyngitis, and rhinitis with post nasal drip. Discussion Post-Clinical Experience paper
Differential Diagnoses
Acute tonsillitis is the inflammation of the pharynx producing pharyngeal exudate. It is caused by group A streptococcus pyogens (Sanmark, et al, 2020). Its signs and symptoms are fever, sore throat, painful swallowing, and tender cervical lymph nodes. Pharyngitis is the irritation of the pharynx commonly caused by group A. streptococcus. Its signs and symptoms are fever, throat pain, postnasal drip, and anterior cervical lymphadenopathy (Oliver, et al, 2018). Rhinitis with post nasal drip is an allergy associated with cold (Patel, C., & Ponda, P. 2019). It presents with a running nose and a mild sore throat. The actual diagnosis for the patient is tonsillitis. The patient presents with symptoms of tonsillitis (fever, sore throat, and painful swallowing).
This Week’s Clinical Lesson
This week’s clinical experience taught me the importance of thorough clerking and physical examination of a patient to make the correct diagnosis. Often, patients assume serious medical problems and leave them out, only to find them when reviewing the systems. A physical examination can help a nurse practitioner make a diagnosis without performing diagnostic investigations. For example, in the above patient case scenario, after doing the patient’s vitals, I noticed she had a fever which she had not complained of.
Plan of care
I will start with diagnostic investigations. I will do a throat swab for culture and sensitivity to isolate the organisms present. I will do a complete blood count to rule out the cause of the infection. I will treat the patient with amoxicillin 500mg three times a day for ten days the prednisolone 5mg once a day, and the patient to continue with paracetamol 1g three times a day for three days.
Describe your clinical experience for this week. • Describe your clinical experience for this week? Discuss 1 personal challenge and 2 personal successes faced by you as an Advanced Practice Nurse one week before the end of your clinical rotation in a clinic setting. What were they? Describe the assessment of Ms. ML, a 27 years old female who came to the clinic with chief complaint, “I am having a bad sore throat for the past few days, I cannot swallow.” • Describe the assessment of this patient, detailing the signs and symptoms (S&S), assessment, plan of care, and possible differential diagnosis. • 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: • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 3 academic sources no older than 5 years (2016-2021). Subjective Data-You can fill out the rest of the information. Chief Complaint (CC): “I am having a bad sore throat for the past few days, I cannot swallow.” History of Present Illness PMH: PSH: Drug Hx: Allergies: BP 119/68 HR 67 sitting, RR 15, Temp 99.7, and O2 sat 98% Discussion Post-Clinical Experience paper
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This is supposed to be in a doctor’s office at an Advanced Nurse Practitioner level. They do not administer medications. They work as a doctor, and they see one (1) patient at a time. The questions are: Describe your clinical experience for this week as an Advanced Practice Nurse one week before the end of your clinical rotation in a clinic setting or Doctor’s office. Discuss 1 personal challenge and 2 personal successes faced this week as an Advanced Nurse Practitioner? What were they? What did you learn from this week clinical experience that can be beneficial for you as an Advanced Nurse Practitioner? The rest of it is okay. Just focus on the questions above. Please do it as soon as possible. I have until 3:00PM to turn it in. I am losing points.
References
Oliver, J., Malliya Wadu, E., Pierse, N., Moreland, N. J., Williamson, D. A., & Baker, M. G. (2018). Group A Streptococcus pharyngitis and pharyngeal carriage: a meta-analysis. PLoS neglected tropical diseases, 12(3), e0006335. Discussion Post-Clinical Experience paper
Patel, C., & Ponda, P. (2019). Perennial Rhinitis and Post Nasal Drip. In Pediatric Allergy (pp. 33-36). Springer, Cham.
Sanmark, E., Wikstén, J., Välimaa, H., Aaltonen, L. M., Ilmarinen, T., & Blomgren, K. (2020). Peritonsillar abscess may not always be a complication of acute tonsillitis: A prospective cohort study. Plos one, 15(4), e0228122. Discussion Post-Clinical Experience paper
