NUR-507cL D4 (Peds)
McCance Burns, C. E., Dunn, M. A., Brady, A. M., Starr, B. N., Blosser, G. C., & Garzon, L. D. (2017). Pediatric Primary Care. (6th ed). Elsevier.
Module 4 Discussion
Weekly Clinical Experience 4
Describe your clinical experience for this week.
• Did you face any challenges, any success? If so, what were they?
• 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.
• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
Your assignment will be graded according to the grading rubric.
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts Distinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts. Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts. Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts. Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts. 5 points
Use of Citations, Writing Mechanics and APA Formatting Guidelines Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors. Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors. Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail. Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention. 3 points
For this week’s clinical experience, I worked with a 4-year-old female patient who presented with a chief complaint of fever and cough. The patient’s mother reported that the fever started two days ago and was accompanied by a dry cough, sore throat, and decreased appetite. The patient’s medical history was unremarkable, and there was no family history of respiratory illnesses or allergies.
Upon examination, the patient had a temperature of 101.2°F, a respiratory rate of 20 breaths per minute, and an oxygen saturation of 98% on room air. Lung auscultation revealed mild bilateral wheezing and scattered crackles. The throat was erythematous, and there were no tonsillar exudates or cervical lymphadenopathy. The rest of the physical examination was within normal limits.
Based on the patient’s history and examination findings, the differential diagnoses include:
Viral upper respiratory infection (URTI) – The patient’s symptoms are consistent with a URTI, which is a common viral illness in children. The presence of wheezing may suggest reactive airway disease.
Atypical pneumonia – This is a possibility given the patient’s persistent fever and cough, and the presence of crackles on lung auscultation.
Allergic rhinitis – The patient’s symptoms may also be due to allergies, which can present with nasal congestion, cough, and sore throat.
The plan of care for this patient includes symptomatic management, which may include acetaminophen for fever and a bronchodilator or corticosteroid inhaler for wheezing. A throat culture or rapid strep test may also be ordered to rule out a bacterial infection. The patient will be advised to rest, drink fluids, and avoid contact with others to prevent the spread of infection.
As a health promotion intervention, the patient’s mother will be advised on proper hand hygiene and respiratory etiquette to prevent the spread of infection to others. The mother will also be educated on the signs and symptoms of worsening respiratory distress and advised to seek medical attention if the patient’s symptoms worsen or do not improve after 3-5 days.
Research studies have shown that symptomatic management with acetaminophen and bronchodilators is effective in managing symptoms of URTIs and reactive airway disease in children. Additionally, education on hand hygiene and respiratory etiquette has been shown to be effective in preventing the spread of infection in both community and healthcare settings (Wang et al., 2019; Aiello et al., 2010).
This week’s clinical experience has highlighted the importance of proper assessment, diagnosis, and management of respiratory illnesses in pediatric patients. It has also emphasized the role of health promotion and education in preventing the spread of infection and improving patient outcomes.