FSU Clinical Experience Challenges and Successes Discussion Reply

Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words.  

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

           This week was exciting and nerve wrecking at the same time. This was my first full week observing and interacting with patients in this field. The challenge I had with this week is familiarizing myself with equipment and the pathophysiology of the different diseases. I also had some success and that is that I learned so much already and had different chief complaints to learn from.

Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.

           One of the patient’s I had this week was a 30-year-old female who came for her yearly pap smear and had complaints of vaginal odor. The patient complained of some pruritus, accompanied with vaginal odor. Patient has also experienced thick vaginal discharge but states “she thought it was normal”.

           The assessment for this patient started with having her in a lithotomy position and letting her know what we were going to do prior to doing it. My preceptor went ahead and examined her vagina and inspected for any abnormality. There was in fact some odor along with thick cottage cheese discharge. The preceptor took a sample of it and sent it to the lab for further confirmation of diagnosis. My preceptor then finished her pap smear.

           The plan of care for this patient is antibiotics such as oral fluconazole of 150mg as a one-time dose and re-evaluate in a week.

           Three differential diagnoses for these signs and symptoms would be yeast infection, bacterial vaginosis, and urinary tract infection. A yeast infection is also called candidiasis. It is a fungal infection that is cause by candida. This can happen from having moist underwear and not changing it often. This would make sense for this patient as the signs and symptoms she presents are the characteristics of this infection. Bacterial vaginosis is bacteria overgrowth in the vagina. Bacterial vaginosis has similar signs and symptoms as a yeast infection including a fishy odor and vaginal discharge. The patient has not had sexual intercourse and is not experiencing burning sensation while urinating. Lastly, urinary tract infection is an infection in the part of the urinary system which includes burning sensation while urinating, fever, itching, and may cause pelvic pain. The patient does not present with the burning sensation while urinating, fever, or pelvic pain so this would not be the best diagnosis for this patient.

Mention the health promotion intervention for this patient.

           The health promotion intervention for this patient is sanitation and hygiene. The patient was educated on vaginal hygiene and prevention tips from a yeast infection. The patient should be aware that after going into a pool she must change her under pants into something dry. If the patient is going to the gym, she must change her underwear to a dry one after and shower. The patient must try to avoid hot tubs as they are brewing in bacteria.

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

           This week I learned the difference between similar diagnosis and how to distinguish between them. My preceptor helped me understand women’s health better and made me feel more comfortable talking to patients. I also learned how to make a patient feel comfortable and not embarrassed about their signs and symptoms. This will be beneficial for me as an advanced practice nurse to make connections with the patient and gain their trust. This will result in treating the patient to my highest ability.