Health Medical Homework Help

• You should respond to your peers by extending, refuting/correcting, or adding additional nuance to their posts.
• All replies must be constructive and use literature where possible.

Katia Gedeon

St Thomas University

ADVD FNP Adults NUR-509CL-AP1

Dr. Jean Tashara Readding

09/2/2021

Discussion Clinical Experience Week 2

During the clinical week, Oliver Jefferson, a 62-year-old male, comes to the office complaining of hoarseness.

Did you face any challenges, any success? If so, what were they?

The clinical experience I had for this week was generally a success. The learning was made easier by the proper clinical environment. At the clinic, my colleagues and mentor were willing to provide any help when required. I interacted with many patients during the time and we were able to discuss their illnesses and how they could get better. Therefore, I was able to take up the process of learning and treating the patients seriously. I was able to improve on my confidence in the clinical field through the patient interactions that I had. I believe that this experience has helped me gain clinical skills and experiences that will help in practice. Moreover, the attitude I have towards helping patients also grew at the time. I did not experience many challenges during my time at the clinic with effective communication being part of this.

Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and possible differential diagnosis.

Patient assessment is to determine the cause of the hoarseness. Laryngeal cancer could be a possible diagnosis. Past illnesses include the flu a month ago being the past illness in the upper respiratory part of the body. The hoarseness started gradually three months ago but has been getting worse. Fatigue and mild fever are associated with the condition. The patient also had a lump in his throat, has heartburn all the time, and has high cholesterol. Laryngeal cancer based on the worsening of the hoarseness for the past three months, cervical lymphadenopathy, decreased appetite, weight loss, advanced age, and a history of alcohol use and cigarette smoking means that it is the most likely diagnosis (Elicin & Giger, 2020).

The treatment plan is also part of the assessment. Chemoradiation therapy and the start of induction therapy considering that the disease seems to be locally advanced (Elicin & Giger, 2020). Surgery can be recommended but under further examinations and referrals. Healthy nutrition was an important part and the patient needs to be educated on the importance of nutrition. The patient needs to be educated on the importance of stopping smoking and avoiding alcohol to aid in the treatment of disease and allow for effective care (Elicin & Giger, 2020). The patient also needs to be educated on the importance of adherence to treatment and follow-ups as part of the treatment process.

Possible differential diagnoses include Laryngitis based on the flu history, low-grade fever, history of smoking cigarettes, high temperature, and GERD (Liu et al., 2020). Hypothyroidism is another differential diagnosis associated with hoarseness with some complaints including fatigue and loss of appetite. This however does not explain all the other symptoms.

What did you learn from this week’s clinical experience that can benefit you as a healthcare practitioner?

During the week, I have improved on my communication skills as I was able to communicate better with patients and had a more positive attitude towards treating the patients. Effective communication is an important part of healthcare and will help me in providing safe and quality care (Szalados, 2021). Moreover, I improved on teamwork as I worked with nurses, doctors, pharmacists, and other professionals such as social workers in helping patients. For example in this case we worked with different groups as I even referred the patient to the psychologist to recommend the need for support groups that can aid in recovery and stopping smoking and alcohol use. Healthcare being a collaborative system (Szalados, 2021), the teamwork I encountered would be important for me.

References

Elicin, O. & Giger, R. (2020). Comparison of Current Surgical and Non-Surgical Treatment Strategies for Early and Locally Advanced Stage Glottic Laryngeal Cancer and Their Outcome. Cancers, 12(3), 732; https://doi.org/10.3390/cancers12030732

Liu, David Gerold Besser, Matthias Leonhard, Tina Josefin Bartosik, Thomas Parzefall, Faris F. Brkic, Christian Albert Mueller & Dominik Riss. (2020). Seasonal Variations in Public Inquiries into Laryngitis: An Infodemiology Study. Journal of Voice, https://doi.org/10.1016/j.jvoice.2020.04.018

Szalados, J. E. (2021). The medical-legal aspects of acute care medicine: A resource for clinicians, administrators, and risk managers. Cham: Springer.