Practicum Imperfections
Today it was another busy day. For the first 2 hours of the shift, we had walk ins. I saw altogether 7 patient independently. It is hard to believe that I have only 2 more week left to finish my practicum hours. I started as a naïve nurse practitioner student and now I find myself more confident in collecting history, doing physical exam, ordering diagnostic testing, differential diagnosis and creating plan. It has been wonderful learning opportunity for me with a great preceptor and working environment. The reason for the visits were hives, possible sinus infection, HTN and hyperlipidemia follow up, swollen foot, lower leg pain, lower back pain, stomach pain and crohn’s disease. Patient with hives was given prednisone for 6 days at urgent
care. At first hives resolved and then it started to come back after completing her prednisone dose. Patient was educated on avoiding use of new soap and starting on Zyrtec and Zantac. Patient with possible sinusitis was given antibiotics because her symptoms had started 10 days ago and worsening. She was educated to use OTC decongestant and increase fluid intake. For the patient with hypertension and hyperlipidemia follow up, I inquired if the patient had any side effect associated with the medications and, ordered CBC and lipid panels. Patient with left lower leg swelling had history of venous insufficiency. Patient was advised to elevate her leg and use compression stocking. For the patient with stomach pain, I ordered X ray of the abdomen with CBC and Urinalysis. Patient with crohns disease presented with abdominal pain. She had not seen GI specialists for last 3 years. I educated her on diet and importance of visiting GI specialists.
I was not able to accomplish my goal of last week because no patient needed Pap smear today. My goal for next 2 weeks would be to conduct history, physical, diagnosis and plan of 6 patient independently.
care. At first hives resolved and then it started to come back after completing her prednisone dose. Patient was educated on avoiding use of new soap and starting on Zyrtec and Zantac. Patient with possible sinusitis was given antibiotics because her symptoms had started 10 days ago and worsening. She was educated to use OTC decongestant and increase fluid intake. For the patient with hypertension and hyperlipidemia follow up, I inquired if the patient had any side effect associated with the medications and, ordered CBC and lipid panels. Patient with left lower leg swelling had history of venous insufficiency. Patient was advised to elevate her leg and use compression stocking. For the patient with stomach pain, I ordered X ray of the abdomen with CBC and Urinalysis. Patient with crohns disease presented with abdominal pain. She had not seen GI specialists for last 3 years. I educated her on diet and importance of visiting GI specialists.
I was not able to accomplish my goal of last week because no patient needed Pap smear today. My goal for next 2 weeks would be to conduct history, physical, diagnosis and plan of 6 patient independently.