Weekly Clinical Experience 1 Assignment: Gerontology

Weekly Clinical Experience 1 Assignment: Gerontology

Weekly Clinical Experience 1 Assignment: Gerontology

Clinical Experience
Elderly patients have unique care needs that nurse practitioners should be aware of and can address in their practice. Nurse practitioners utilize their knowledge and skills to develop patient-centered plans that minimize the risk of harm when caring for geriatric patients. Therefore, this paper reflects my experiences with gerontology practicum experience.

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Challenges and or Success
I started the gerontology practicum experience this week. I have encountered some challenges, which I believe I can manage with time. Firstly, I experienced challenges in collaborating with elderly patients. Factors such as cognitive decline among some patients make it difficult to collaborate with them when developing their care plans. I also experienced some difficulties determining the care needs of elderly patients. Gerontology patients often present to the facility with comorbid conditions, which makes it difficult to determine an appropriate approach to care. The risk of polypharmacy among them is also high (Pazan & Wehling, 2021). Therefore, I intend to explore strategies to enhance my ability to function optimally in this new setting.
Patient Assessment
I assessed an elderly patient who was admitted to the facility for further management. The patient came with complaints, which included painful urination, urinary incontinence, confusion, two fall episodes, and lack of appetite. The assessment findings included passage of foul-smelling urine, hematuria, urinary urgency and frequency, lower abdominal pain, altered mental status, fatigue, hypotension, and tachycardia. The patient was diagnosed with a urinary tract infection. The plan of care included admitting the patient for treatment and stabilization because of an increased risk of self-injury. The patient was prescribed intravenous fluids, antibiotics, and close monitoring for falls.
One of the differential diagnoses that were considered for the patient is acute pyelonephritis. Acute pyelonephritis is a kidney infection due to ascending bacteria that causes urinary tract infections. Patients usually experience symptoms such as nausea, vomiting, flank pain, urgency, frequency, dysuria, hematuria, fatigue, and fevers. The other differential diagnosis considered for the patient is bladder pain syndrome. Blabber pain syndrome is characterized by bladder inflammation, urgency, and frequency. The absence of leucocytes and nitrites in urinalysis rules out bladder pain syndrome. The last differential considered was renal calculi. Patients with renal calculi experience symptoms such as sharp flank pain, dysuria, and hematuria. These symptoms are similar to those seen in urinary tract infections (Soria & Khoujah, 2021). Diagnostic investigations such as urinalysis help rule out renal calculi in patients with urinary tract infections.
Health Promotion Interventions
Health promotion interventions are crucial to prevent recurrent of urinary tract infections in elderly patients. The patient was educated on the importance of maintaining adequate body hydration. This included ensuring that he increases water intake to help flush the bacteria causing the infections. The patient was also educated on the importance of treatment adherence. Treatment adherence would prevent the recurrence of urinary tract infections. The patient was also educated on the significance of avoiding self-medicating or using over-the-counter medications. This was essential to lower the risk of drug interactions and polypharmacy. The patient was also educated on good hygiene practices (Godbole et al., 2020). This included wiping from front to back and avoiding irritants that could predispose him to urinary tract infections.
Lessons Learnt
I learned from this week’s experience the importance of comprehensive patient assessment. Geriatric patients are at risk of adverse events due to comorbidities and polypharmacy. A comprehensive patient assessment would help develop accurate diagnoses and treatment plans that minimize safety risks. I also learned the importance of interprofessional collaboration. The complexities experienced when caring for geriatric conditions require interprofessional collaboration to optimize patient outcomes.
Overall, I experienced some challenges in the first week of my gerontology practicum experience. I assessed a patient diagnosed with a urinary tract infection. I educated him on health promotion interventions to prevent the recurrence of urinary tract infections. I will use the lessons learned from the experience to improve my practice.
Godbole, G. P., Cerruto, N., & Chavada, R. (2020). Principles of assessment and management of urinary tract infections in older adults. Journal of Pharmacy Practice and Research, 50(3), 276–283. https://doi.org/10.1002/jppr.1650
Pazan, F., & Wehling, M. (2021). Polypharmacy in older adults: A narrative review of definitions, epidemiology and consequences. European Geriatric Medicine, 12(3), 443–452. https://doi.org/10.1007/s41999-021-00479-3
Soria, N., & Khoujah, D. (2021). Genitourinary Emergencies in Older Adults. Emergency Medicine Clinics, 39(2), 361–378. https://doi.org/10.1016/j.emc.2021.01.003

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Weekly Clinical Experience 1

Describe your clinical experience for this week.

Did you face any challenges, any success? If so, what were they? First clinical week for gerontology

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:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources

Please discuss a gerontological primary care case

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