STU Developing a Comprehensive Care Plan Discussion Replies

150 words with one peer review article:

Hany

In my clinical experience this week, I encountered a diverse range of patients and situations that contributed to my growth as an advanced practice nurse. I faced different challenges and successes, which will be instrumental in my career as an advanced nurse practitioner. For instance, I faced both ethical and emotional challenges. Dealing with patients in deep pain due to life-threatening issues and experiencing emotional stress was emotionally challenging for me. Additionally, a challenging aspect was communicating with patients from diverse cultural backgrounds with different cultures, languages, and socioeconomic statuses. It required cultural competence to ensure adequate care. Lastly, there were also issues with pressure and stress due to the fast-paced nature of the healthcare facility.

However, there were also successes from this clinical experience. For instance, one of the notable successes was effectively managing a patient with respiratory problems. Through a multidisciplinary approach, we were able to manage the symptoms effectively, elevate his distress, and hence enhance his well-being. Another success was a collaborative effort to address medication reconciliation discrepancies, ensuring patient safety and preventing potential adverse events.

Assessment of a patient

Patient Scenario

A 50-year-old male came to the healthcare facility with chief complaints of chest distress, shortness of breath, and tiredness.

Signs and Symptoms

The patient complained of experiencing the following signs and symptoms. Chest Pain, which he described as a sharp and squeezing sensation. It radiated to the left arm and was associated with sweating, as evidenced by (Bhatt et al., 2022). Shortness of Breath, where he reported a sudden onset of difficulty breathing, with a feeling of heaviness in the chest, and lastly, fatigue, where he reported feeling extremely tired and weak.

Assessment

Upon initial assessment, I discovered the following. The patient had hypertension (160/90 mm Hg). His heart frequency was also rapid (110 beats per minute), and he had an increased respiratory rate (24 breaths per minute). His skin was cool and clammy, and he appeared anxious and distressed. I also reviewed the patient’s therapeutic history and ordered relevant diagnostic tests to determine his problem.

The patient’s Plan of Care

The patient’s plan of care encompassed several essential stages. In the initial stage, several immediate actions were undertaken to stabilize the patient’s situation. According to Freund et al., 2022), these activities incorporate regulating supplemental oxygen to preserve oxygen saturation, putting the patient on a cardiac screen to survey for any arrhythmias, setting up intravenous access for medications and liquid resuscitation, and performing an electrocardiogram (ECG) to assess for signs of myocardial ischemia or dead tissue. Of course, referring the patient to the emergency room.

Medications

Several medicines were also administered to the patient, such as sublingual nitroglycerine, which helps relieve chest pain and diminish cardiac workload, aspirin to avoid platelet aggregation and intravenous morphine for pain alleviation and anxiety decrease.

Further Diagnostic Evaluation

In order to establish the specific patient issue and hence diagnose the problem, further diagnostic evaluation was necessary. Several diagnostic tests were conducted, for instance, a complete blood count (CBC) and an inclusive metabolic panel (CMP), whose main aim was assessing for any electrolyte imbalances, as shown by (Bhatt et al., 2022). Serial cardiac enzyme (troponin) measurements were also conducted to evaluate for myocardial damage, while a chest X-ray helped rule out other causes of chest pain and shortness of breath. Lastly, echocardiography helped assess cardiac function and rule out structural abnormalities.

Possible Differential Diagnoses

After further diagnostic evaluation, several possible diagnoses were arrived. They included Acute Coronary Syndrome (ACS) since the patient’s chest pain, burning to the left arm, and related symptoms are suggestive of myocardial ischemia (Bhatt et al., 2022). The diagnosis was further confirmed by the elevated cardiac enzymes and ECG changes experienced by the patient. Another solid conclusion is that the patient may be suffering from Aspiratory Embolism (PE), which is characterized by shortness of breath and tachycardia. A chest X-ray may show an anomaly, whereas a CT pulmonary angiography is regularly utilized for definitive diagnosis.

Health Promotion Intervention for the Patient

The patient’s health promotion intervention involves educating the patient about cardiovascular risk factors and lifestyle modifications to prevent future cardiac events. It involves several measures, such as advising the patient to quit smoking and providing him with resources or referrals to smoking cessation programs. Also, recommend a heart-healthy diet such as one with low sodium and fat quantities and abundant fruits, vegetables, and whole grains, as evidenced by (Freund et al., 2022). It is additionally imperative to encourage standard physical activity and give rules for exercise suitable to the patient’s condition. It is also essential to emphasize adherence to prescribed medications to manage risk factors, such as antiplatelet agents, beta-blockers, and lipid-lowering drugs. Finally, the importance of standard follow-up arrangements with healthcare providers to screen their cardiovascular health and make essential alterations to their care plan should be stressed.

Lessons from this week’s Clinical Experience as an Advanced Practice Nurse

As an advanced practice nurse, clinical experiences are essential for professional development. From this patient scenario, I have learned several key lessons and takeaways. First, I have learned the importance of quickly and accurately assessing a patient’s condition in acute situations. Timely intervention can save lives. The ability to consider a range of potential diagnoses based on clinical presentation is a critical skill, too, I have learned. It enables one to rule out life-threatening conditions while considering other possibilities. I have also learned that effective patient education is essential for promoting better health outcomes. It entails providing clear, concise information about risk factors and preventive measures to the patient. Finally, it is additionally imperative to create strong critical thinking abilities to empower the making of sound clinical choices, particularly in high-stress circumstances

Tetyana

The third week of my clinical practice as a student in the FNP program has been a rewarding and challenging experience. Throughout the week, I had the opportunity to interact with patients across various age groups and witness a wide range of medical conditions, including flu, headaches, arthritis, and hypertension. Working alongside an experienced doctor and having the chance to assess patients independently has provided me with valuable insights into the real-world application of medical knowledge and skills. During this week, I encountered several challenges, such as managing the high volume of patients and balancing the demands of clinical practice. However, these challenges were accompanied by numerous successes, including accurate diagnosis and effective communication with patients. One notable success was my ability to collaborate with the healthcare team efficiently, leading to comprehensive patient care.

Assessment of a Patient and Plan of Care

One of the patients I assessed this week presented with severe headaches, dizziness, and visual disturbances. After a thorough assessment, the signs and symptoms included pulsating headaches, sensitivity to light, and blurred vision. Based on these findings, the possible differential diagnoses considered were migraines, tension headaches, and increased intracranial pressure.

Migraines were prioritized as the primary differential diagnosis based on the patient’s symptoms, including pulsating headaches, sensitivity to light, and blurred vision. Migraines are a common neurological disorder characterized by recurrent headaches and can be accompanied by various symptoms, including visual disturbances, nausea, and photophobia (Baraness, L., & Baker, 2023). The patient’s description of the headaches aligns with the typical characteristics of migraines, making it a likely diagnosis.

Tension headaches are another prevalent type of primary headache disorder characterized by a dull, aching pain and pressure around the head (Baraness, L., & Baker, 2023). Unlike migraines, tension headaches typically do not cause pulsating pain or significant sensitivity to light and sound. However, they can cause mild sensitivity to light, which might overlap with migraine symptoms. Tension headaches are often triggered by stress, anxiety, or muscle tension (Baraness, L., & Baker, 2023). Considering the patient’s symptoms, tension headaches were considered in the differential diagnosis, but the presence of pulsating headaches and pronounced photophobia made this diagnosis less likely compared to migraines.

Increased intracranial pressure refers to elevated pressure within the skull and can result from various conditions, including brain tumors, intracranial hemorrhage, or meningitis (Baraness, L., & Baker, 2023). Symptoms of increased ICP can include severe headaches, visual disturbances, dizziness, and nausea (Baraness, L., & Baker, 2023). While some symptoms overlap with migraines, the distinguishing factor is the underlying cause. In cases of increased ICP, the symptoms are often progressive and accompanied by neurological signs such as changes in consciousness, seizures, or focal neurological deficits (Baraness, L., & Baker, 2023). The absence of these additional neurological signs in the patient, coupled with the recurrent nature of the headaches and the presence of specific migraine symptoms like photophobia, led to the conclusion that increased intracranial pressure was less likely in this case.

The plan of care for the patient included pain management, lifestyle modifications, and stress reduction techniques (Jenkins, 2020). I referred the patient to a neurologist for further evaluation and prescribed medication for immediate relief. Health promotion interventions involved educating the patient about pain triggers, promoting regular exercise, and emphasizing the importance of stress management techniques (Jenkins, 2020).

Beneficial Learning and Research Support

From this week’s clinical experience, I learned the significance of a holistic approach to patient care, considering not only the physical symptoms but also the psychological and social factors influencing health. Additionally, I gained insights into effective communication, interdisciplinary collaboration, and the importance of evidence-based practice. These skills are crucial for my future role as an advanced practice nurse.

To support my care plan, I referenced current peer-reviewed research guidelines on migraine management. These guidelines emphasized the importance of individualized treatment plans, incorporating pharmacological and non-pharmacological approaches. The evidence-based practice reinforced my implemented interventions, providing a solid foundation for my decision-making process.