PRACTICUM EXPERIENCE

 In my practicum experience, I encountered a 64 year old who presented to the primary care clinic complaining of dyspnea on exertion and productive cough for the past seven months. My immediate suspicion was COPD Since the patient admitted that he has been smoking for the past forty years. He was admitted and treated with albuterol 2.5 mg through the nebulizer that was given after every four hours. He was also given the prednisone 30 mg orally taken once daily, an ipratropium 0.5 mg through nebulizer after each eight hours and 500 mg of cefuroxime axetil taken orally twice daily. He was also given 2L/min O₂ via nasal cannulae (Institute of Medicine, 2015).

Past medical history revealed that he had myocardial infarction at the age of 40 years. Other is appendectomy and hypertension. His father died of myocardial infarction at the age of 70 years. He has healthy siblings, mother is alive and healthy. For the past several hours before coming to clinic, the wife had noticed his inability to speak full sentences. He had productive cough. I could hear wheezing and had mild chest tightness. Nails had tar stains and clubbing. Chest x-ray showed pneumonia on the right lower lobe and hyperinflation. I informed the wife that the patient had to be hospitalized and informed the need to decrease exacerbation that could lead to death. I also informed her that the patient needed ventilator support and the need to decrease respiratory acidosis (Buppert, 2015). I taught the patient self care and gave instructions for self management. Also taught his wife, and children on how top note early signs and symptoms and also complication that required them to seek immediate medical care. Through this practice experience I was able to fulfill one of my long term goals of sharing my knowledge in improving the health of community members.

References

 Buppert, C. (2015). Risk Management. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (285 – 302). Burlington, MA: Jones & Bartlett.

Institute of Medicine. (2015). Assessing Progress on the Implementation of the Recommendations of The Future of Nursing.

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