Introduction
During this week’s clinical experience, as an advanced practice nurse, I encountered diverse challenges and celebrated notable successes in patient care. One significant patient assessment involved a middle-aged female presenting with specific signs and symptoms. This case required a thorough assessment, differential diagnosis, and development of a comprehensive plan of care. The health promotion intervention for the patient was an essential component of the care plan, aiming to enhance overall well-being and prevent potential health issues. Through this clinical experience, I gained valuable insights that will positively impact my practice as an advanced practice nurse.
Patient Assessment
The patient, a 45-year-old female, complained of persistent fatigue, unexplained weight loss, and increased thirst and urination. The assessment revealed signs of dehydration, elevated heart rate, and elevated blood glucose levels. The patient’s medical history indicated a family history of diabetes and recent episodes of frequent urinary tract infections.
Differential Diagnosis
Type 2 Diabetes Mellitus: Given the patient’s symptoms of excessive thirst, frequent urination, unexplained weight loss, and family history, Type 2 diabetes mellitus is a probable diagnosis. The increased blood glucose levels further support this diagnosis (American Diabetes Association, 2020).
Hyperthyroidism: Fatigue, unexplained weight loss, and tachycardia are consistent with hyperthyroidism. The patient’s symptoms and history necessitate consideration of this condition (Garber et al., 2020).
Chronic Kidney Disease: Elevated heart rate, dehydration, and frequent urinary tract infections may indicate underlying kidney dysfunction, requiring evaluation and further investigation (Levey et al., 2021).
Plan of Care
The patient’s care plan involves comprehensive management to address the identified health issues. Initiating a blood glucose monitoring schedule, administering insulin therapy, and implementing a carbohydrate-controlled diet will be essential in managing Type 2 diabetes (American Diabetes Association, 2020). Additionally, a thyroid function test and a complete blood count will be performed to rule out hyperthyroidism. In the case of chronic kidney disease, further evaluation, including kidney function tests and urinalysis, will be conducted. The patient will receive appropriate medical treatment based on the confirmed diagnosis.
Health Promotion Intervention
As part of the health promotion intervention, the patient will be educated on diabetes self-management, including glucose monitoring, insulin administration, and dietary modifications. Encouraging regular exercise and adopting a healthy lifestyle will be vital to manage diabetes effectively (American Diabetes Association, 2020). Furthermore, the patient will be educated about the importance of regular health check-ups and early detection of potential health issues to prevent complications.
Insights as an Advanced Practice Nurse
Through this clinical experience, I recognized the significance of a holistic approach to patient care. Conducting a comprehensive assessment, considering the patient’s medical history, and performing differential diagnoses are essential in providing accurate and effective treatment. Additionally, health promotion interventions play a crucial role in preventing future health complications, promoting patient education, and enhancing overall well-being.
Research-Guided Plan of Care
The American Diabetes Association’s (ADA) guidelines on the management of diabetes provide evidence-based recommendations for care. The ADA’s guidelines emphasize the importance of individualized treatment plans, regular blood glucose monitoring, and patient education for diabetes management (American Diabetes Association, 2020). These guidelines supported the development of the patient’s care plan in this clinical experience.
Conclusion
This week’s clinical experience highlighted the importance of a comprehensive assessment, differential diagnosis, and evidence-based care in advanced practice nursing. The patient’s case emphasized the significance of addressing health issues promptly and promoting preventive measures for optimal patient outcomes. As an advanced practice nurse, incorporating a holistic approach to patient care and staying updated with current guidelines will enhance my ability to provide effective and patient-centered care.
References
American Diabetes Association. (2020). Standards of Medical Care in Diabetes—2020. Diabetes Care, 43(Supplement 1), S1-S212.
Garber, J. R., Cobin, R. H., Gharib, H., Hennessey, J. V., Klein, I., Mechanick, J. I., … & Woeber, K. A. (2020). Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice, 26(1), 1-203.
Levey, A. S., Gansevoort, R. T., Coresh, J., Inker, L. A., Heerspink, H. L., Grams, M. E., … & Kasiske, B. L. (2021). KDIGO clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Supplements, 11(1), S1-S71.
