Describe your clinical experience for this week at a health clinic caring for geriatric patients as a student nurse practitioner student.
- Did you face any challenges, any success? If so, what were they?
- 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.
- Mention the health promotion intervention for this patient.
- 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:
- Post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Title: Clinical Experience as a Student Nurse Practitioner in a Geriatric Health Clinic
Introduction:
This week, I had the opportunity to gain valuable clinical experience at a health clinic specializing in geriatric care as a student nurse practitioner. Working with older adults has its unique challenges and rewards, and I have learned a great deal during this week’s rotations. The clinical setting focused on providing comprehensive healthcare to geriatric patients, managing chronic conditions, and promoting health and wellness among this vulnerable population.
Challenges and Successes:
Throughout the week, I faced some challenges in communicating effectively with older patients, especially those with hearing impairments or cognitive decline. However, by adapting my communication style, actively listening, and being patient, I was able to establish rapport and ensure that their concerns were addressed properly.
One notable success was conducting a comprehensive health assessment on an 80-year-old female patient, Mrs. Smith. The patient presented with several signs and symptoms that required thorough evaluation and careful planning of her care.
Assessment of Patient – Mrs. Smith:
Signs and Symptoms (S&S):
- Fatigue and weakness
- Frequent urination and increased thirst
- Unintentional weight loss
- Dry mouth and blurred vision
Assessment:
Physical examination revealed an elevated blood pressure of 160/90 mmHg, and laboratory investigations showed increased blood glucose levels (fasting glucose: 200 mg/dL). The patient’s medical history included hypertension and a family history of diabetes mellitus. Based on the assessment, I formulated the following possible differential diagnoses:
- Type 2 Diabetes Mellitus (DM) – Considering the patient’s elevated fasting glucose, frequent urination, increased thirst, and unintentional weight loss, diabetes is a likely possibility. Older adults are more susceptible to developing diabetes, and the symptoms align with this diagnosis.
- Hypertension – The patient’s elevated blood pressure suggests poorly controlled hypertension, which is a common condition in the geriatric population. Hypertension can exacerbate diabetes and vice versa, necessitating prompt management.
- Sjögren’s Syndrome – The presence of dry mouth and blurred vision raises the possibility of Sjögren’s syndrome, an autoimmune disorder that commonly affects older adults. This condition can lead to complications like dental caries and eye problems.
Plan of Care:
To provide optimal care for Mrs. Smith, the following plan was devised:
- Diabetes Management: Initiate lifestyle modifications, including dietary changes and regular exercise. Prescribe oral antidiabetic medication or insulin therapy as needed to achieve glycemic control.
- Hypertension Management: Implement lifestyle changes, such as salt restriction and physical activity promotion. Initiate antihypertensive medication to achieve blood pressure goals.
- Sjögren’s Syndrome Management: Recommend artificial tears for dry eyes and promote good oral hygiene to prevent dental complications. Referral to a rheumatologist may be necessary for further evaluation and treatment.
Health Promotion Intervention:
To promote health and prevent complications in Mrs. Smith, I emphasized the importance of self-care and regular follow-up appointments. I educated her about diabetes management, including self-monitoring of blood glucose levels and foot care. Additionally, I provided resources on hypertension control and encouraged her to maintain a well-balanced diet and exercise routine.
Learnings and Evidence-Based Practice:
Through this week’s clinical experience, I realized the significance of tailoring care plans to meet the specific needs of geriatric patients. Older adults often have multiple comorbidities and require comprehensive, patient-centered care.
As an advanced practice nurse, staying updated with current research and guidelines is crucial. For this patient, my plan of care was based on evidence from peer-reviewed research studies and clinical practice guidelines from reputable sources like the American Diabetes Association (ADA) and the American Heart Association (AHA). These organizations offer evidence-based recommendations for managing diabetes and hypertension, ensuring the most effective and safe treatment options.
Conclusion:
This week’s clinical experience in a geriatric health clinic provided me with invaluable insights into caring for older adults and managing complex health issues. Through effective communication, thorough assessments, evidence-based practice, and health promotion interventions, I was able to develop a comprehensive plan of care for my patient, Mrs. Smith. As I progress in my journey as an advanced practice nurse, I will carry these experiences and lessons with me, ensuring that I can provide the best possible care to the diverse population I will serve.