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Adult Clinical Discussion

Summarize your clinical experience this past week. Did you encounter any challenges or successes?

The prior week’s clinical experience went smoothly. The clinical setting was friendly and helpful for learning. While I was struggling, my clinical mentors were terrific supporters. I also got to speak with many kind pediatric patients (Versalle et al., 2022). I significantly impacted how some young kids with serious illnesses were assessed and given treatment programs. This week I learned a lot, which made me more adept at taking histories, performing physicals, and documenting and interpreting test results.

The patient’s examination covers the signs and symptoms (S&S), evaluation, treatment plan, and three alternate, logical diagnoses. Give details of the patient’s strategy for enhancing their health.

A Caucasian man in his 20s lamented, having red eyes. When he woke up in the morning, he claimed his left eye was slightly red and scratchy. The patient had not utilized eye drops or any other drugs. He denied having double vision, tears, or discharge but admitted that his eyes hurt when he woke up and had more morning “eye crusties” than usual. He denied having upper respiratory problems, light sensitivity, or eyeglasses. His family and medical background had previously been typical (Versalle et al., 2022). His exposed accoratient’s pupils were uniform, rounded, and receptive to light, and his eyes were hot and erythematous on both sides, with crusting across his lower lid. Typical papillary responses were also seen.

The results of the ophthalmoscopic examination showed no vascular hemorrhage and normal reflexes and discs in the eye. There was no vascular injection, despite the hyperemic conjunctivae on both sides. The patient’s cornea and lens were clear and appeared normal to everyone. The remainder of the medical examination proceeded smoothly. After evaluating the patient, it was found that bacterial conjunctivitis was the most likely diagnosis based on his medical history and physical exam findings (Versalle et al., 2022). The most common type of conjunctivitis seen in primary care is acute bacterial conjunctivitis, also called pink eye. A few signs are Pruritus, minor pain, purulent discharge, and frequently bilaterally irritated eyes. Patients with bacterial conjunctivitis frequently describe the crusts on their eyes, itching, and purulent discharge as more noticeable when they wake up. Hemophilic influenza is one of the most typical causes of bacterial conjunctivitis in kids.

The patient could be diagnosed with blepharitis, viral conjunctivitis, or allergic conjunctivitis. There were red, itchy eyes, which suggested that viral conjunctivitis might be present. The virus that causes the illness is very contagious (Versalle et al., 2022). Due to the absence of preauricular lymphadenopathy and a history of upper respiratory conditions such as a cough, stuffy nose, and rhinorrhea, it was ruled out.

Conjunctivitis from allergies was a possibility because of the itching and red eyes. It is linked to atopic conditions such as allergic rhinitis, asthma, and eczema. Due to the absence of bilateral tearing and a history of atopic disease, two of the syndrome’s most recognizable signs, the condition was ruled out.

The signs of blepharitis included erythematous eyes with crusty eyelid margins, red, itchy eyes, and swollen eyelids (Black & Ford, 2020). The absence of light sensitivity, photophobia, loss of eyelashes, and corneal involvement ruled out the condition, characterized by acute or chronic eyelids and conjunctival inflammation.

The patient took azithromycin ophthalmic (1%) twice daily for two days, followed by one dose for five days, as part of their therapy regimen. A broad-spectrum topical antibiotic is indicated for patients with bacterial conjunctivitis. The symptoms of infections and their recovery are hastened by antibiotics (Black & Ford, 2020). Wide-spectrum antibiotics are advised because they are effective against gram-negative and gram-positive bacteria. The patient was informed about the importance of excellent hand and eye cleanliness for preventing infections. He was instructed to switch out his pillowcase every night until the infection cleared.

What can I use the lessons I acquired from this week’s clinical experience as an advanced practice nurse?

The clinical experience I had this past week has given me more outstanding knowledge and valuable clinical practice abilities. By individually getting to know pediatric patients, recording subjective and objective data, and developing treatment plans, I could gain experience from the pertinent course (Black & Ford, 2020). I increased my knowledge and expertise in recording the results of patient evaluations, which promoted the dissemination of crucial information that would guide my future work as an advanced practice nurse. I also grasped the significance of involving parents and professionals in the assessment and development of care plans to ensure pediatric patients have the assistance they require to achieve better results. The group projects I took part in also let me understand how crucial collaboration is to developing into a capable nurse.

References

Black, C. J., & Ford, A. C. (2020). Global burden of irritable bowel syndrome: trends, predictions, and risk factors. Nature Reviews Gastroenterology & hepatology17(8), 473–486.

Versalle, D., Qi, J., Noyes, S. L., Moriarity, A., George, A., Cher, M. L., … & Collaborative, M. U. S. I. (2022). Practice-Level Variation in the Decision to Biopsy Prostate Imaging-Reporting and Data System 3 Lesions in Favorable-Risk Prostate Cancer Patients. Urology164, 191–196.

 

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