ANSWER
Reflection on the Clinical Experience: Week Synopsis
Managing patients with a variety of ailments was the main emphasis of this week’s clinical experience, which included a middle-aged woman who had a urinary tract infection (UTI). The interaction provided a chance to navigate clinical problems while utilising evidence-based assessment and management techniques.
Obstacles and Achievements
Because the patient was anxious about her symptoms, getting a thorough patient history was one of the main obstacles. It was essential to build trust and create a welcoming atmosphere. The key to success was employing therapeutic communication skills, which put the patient at ease and enabled me to collect comprehensive information for precise diagnosis and treatment.
Evaluation of the Patient: Signs and Symptoms of a UTI (S&S):
The patient’s symptoms were suprapubic soreness, increased frequency and urgency of urination, and dysuria. She denied having a temperature or experiencing flank pain, but she did describe having turbid, foul-smelling pee. It was thought that the infection was limited to the lower urinary tract because there were no systemic symptoms, such as fever or chills.
Results of the assessment:
Vital Signs: temperature: 98.7°F; heart rate: 80 bpm; blood pressure: 120/80 mmHg.
Physical Exam: Palpation reveals mild pain in the suprapubic area. There was no evidence of costovertebral angle (CVA) soreness.
Diagnostics: A urinalysis revealed pyuria, nitrites, and leukocyte esterase, all of which were indicative of a UTI.
Care Plan:
Drugs:
prescribed 100 mg of nitrofurantoin twice a day for five days, as advised for adult women with simple UTIs (Gupta et al., 2019).
Over-the-counter phenazopyridine was suggested as a short-term remedy for dysuria.
Interventions for Health Promotion:
taught the patient how to eliminate bacteria from the urinary tract by increasing their fluid intake to at least two to three litres each day.
promoted frequent urination and discouraged postponing voiding in order to reduce the growth of microorganisms.
To lower the chance of recurrence, good perineal cleanliness is advised.
Follow-up:
A follow-up appointment has been set for one week from now to review possible test culture results and reevaluate symptoms.
Differential Diagnosis:
Given the urinalysis results and the symptoms of suprapubic discomfort, urgency, and dysuria, bacterial cystitis is the most likely diagnosis.
Since there was no fever, flank discomfort, or CVA soreness, pyelonephritis was ruled out.
Considered because of similar urinary symptoms, vaginitis is ruled out because there is no vaginal discharge or itching.
Intervention for Health Promotion
The main goal of health promotion was to inform the patient about lifestyle modifications and ways to lower the likelihood of recurrence. Advising on hydration, appropriate voiding habits, and cleanliness practices were important treatments. Dietary guidelines also advised staying away from irritants like alcohol and caffeine, which can make bladder symptoms worse.
Reflection on Learning
The clinical experience this week highlighted the value of a comprehensive evaluation and evidence-based treatment. I discovered that in addition to evaluating clinical findings, identifying a UTI necessitates ruling out other possible explanations of same symptoms, such as pelvic inflammatory disease or sexually transmitted diseases. Accurate diagnosis and successful treatment were guaranteed by following evidence-based recommendations, such as those issued by the Infectious Diseases Society of America (IDSA).
The significance of patient education in promoting compliance and averting recurrence was another lesson learned. Patients are more equipped to manage their health when they are taught to identify the early signs of UTIs and take preventative measures. The advanced practice nurse’s dual roles as a clinician and an educator are in line with this strategy.
Support Based on Research
Because of its effectiveness and low resistance profile, nitrofurantoin is currently recommended by the IDSA as a first-line treatment for uncomplicated UTIs (Gupta et al., 2019). In order to prevent recurrence, these guidelines also highlight health promotion strategies like proper cleanliness and water. I made sure the care plan was in line with the greatest available evidence by following these principles.
In conclusion
My knowledge of managing UTIs has increased as a result of this professional experience, which also made me realise how crucial patient education and evidence-based practice are. Using these tactics as an advanced practice nurse will improve patient outcomes and foster a relationship of trust between the practitioner and the patient.
Citations
Grigoryan, L., Gupta, K., and Trautner, B. W. (2019). infection in the urinary tract. 167(7), ITC49–ITC64, Annals of Internal Medicine. https://doi.org/10.7326/AITC201810020
Fineout-Overholt, E., and B. M. Melnyk (2018). Evidence-based nursing and healthcare practice: A best practice guide (4th ed.). Kluwer Wolters.
QUESTION
Describe your clinical experience for this week.
· 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.
· Patient has a UTI
· 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:
· Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.