Description
Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words.
Challenges/Success
During this week, I encountered different challenges which contributed immensely to the knowledge I gained and the success of the whole week’s activities. The most valuable lesson I learned in this week is how to take care of patients well through collaborating with different healthcare workers to promote the outcomes of patients. I gained management skills and good communication skills with patients and other healthcare workers. I experienced a high workload due to a high patient turnout. Collaboration with other nurses and healthcare providers made the work easier and helped significantly in reducing the workload (Sharma et al., 2023). I also faced anxiety while working on patients in critical condition and those with contagious diseases. However, the facility provided adequate protective equipment that promoted the safety of all healthcare providers.
Patient Assessment
During this week, I encountered different patient cases. A 36-year-old female patient was presented to the clinic with cough, wheezing sound, and shortness of breath. The patient states that six months ago she experienced similar symptoms and was diagnosed with acute bronchitis which was treated using empiric antibiotics and bronchodilators. However, her condition continued to worsen even after treatment. For the last six months, the patient has lost almost 20 pounds. The patient denied sick contacts, night sweats, chest pain, vomiting, diarrhea, abdominal pain, bleeding or bruising, palpitations, and fever (Sharma et al., 2023). However, the patient has been a smoker for the last 20 years and states that she quit smoking 6 months ago. The patient is hypertensive and has never had allergies.
Differential Diagnosis & Plan of Care
A complete blood count test indicated mild transaminase elevation, a high number of platelet count, and low hemoglobin of 8.3g. A chest X-ray exam revealed mild interstitial pneumonitis. The differential diagnosis for the patient was; histoplasmosis, pneumococcal infection, or viral or bacterial pneumonia (Hanson & Haddad, 2022). A bronchoscopy exam was conducted and the findings helped in diagnosing acute pulmonary histoplasmosis. The plan of care for the patient is the administration of itraconazole for a period of 6 to 12 weeks. The condition of the patient should be continually monitored throughout the treatment period by performing a chest X-ray exam. It is also important to continue monitoring the patient for years after diagnosis for any cases of disease recurrence.
Health Promotion
Pulmonary histoplasmosis can be a self-clearing infection. However, advanced stages of the disease require treatment using systemic antifungal medications such as itraconazole (Hanson & Haddad, 2022). The patient should adhere to the medication as prescribed. Moderate or severe infections are contraindicated, the patient should be closely monitored for recurrence of the infections in the following years after diagnosis. The patient should also manage their hypertension by taking antihypertensive medication and completely quitting smoking.
Lessons
This week was an insightful week essential for me as an advanced nurse practitioner. During the week, I learned and encountered differential diagnosis cases which improved my clinical knowledge on coming up with correct and accurate diagnoses (Cornine, 2020). The clinical experience this week contributed to enriching my competence ability and levels in clinical practice. I learned on how to take care of patients while promoting their overall outcome with the help of other nurses and healthcare providers. I also learned good communication skills that are essential in clinical practice.
