Describe your clinical experience for this week at a pediatric office. Did you face any challenges, any success? If so, what were they?

Describe your clinical experience for this week at a pediatric office.

• 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.

Submission Instructions:

• Post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

ANSWER

Clinical Experience at a Pediatric Office: Challenges, Successes, and Patient Assessment

Introduction

As an advanced practice nurse working at a pediatric office, my clinical experience this week provided valuable insights and learning opportunities. I encountered various challenges and successes while assessing a patient, and I gained knowledge that will enhance my practice. This essay will discuss the clinical experience, including challenges faced, successful outcomes, patient assessment details, the plan of care, possible differential diagnoses, health promotion intervention, and the learning derived from the experience.

Challenges and Successes

During the week, one of the significant challenges I encountered was dealing with a child who had a strong fear of medical procedures. This fear resulted in heightened anxiety and resistance during assessments (Srinath et al., 2019). However, by utilizing effective communication techniques and providing a child-friendly environment, I successfully managed to alleviate the child’s anxiety, enabling a thorough examination.

Another challenge I faced was the limited availability of resources for pediatric patients with complex medical conditions. However, through collaboration with the healthcare team and utilizing my critical thinking skills, I was able to develop innovative strategies to provide optimal care within the available resources.

Assessment of a Patient: Patient: 6-year-old male presenting with fever, cough, and abdominal pain.

Signs and Symptoms (S&S):

Fever: Recorded temperature of 101.2°F (38.4°C).

Cough: Persistent dry cough with occasional post-tussive emesis.

Abdominal Pain: Patient complains of intermittent sharp pain in the lower right quadrant of the abdomen.

Assessment

Vital signs: Documented temperature, heart rate, respiratory rate, and blood pressure.

Physical examination: Auscultated lung sounds, assessed abdomen for tenderness and rebound tenderness, palpated lymph nodes, and performed a thorough head-to-toe assessment.

Review of systems: Inquired about additional symptoms such as headache, sore throat, and changes in bowel movements or urinary habits.

Plan of Care: Based on the assessment findings, the following plan of care was formulated

Differential Diagnosis

 Differential Diagnosis 1: Acute appendicitis – Rationale: Abdominal pain localized in the right lower quadrant may indicate appendicitis, which commonly presents with fever and nausea.

 Differential Diagnosis 2: Pneumonia – Rationale: Cough, fever, and abnormal lung sounds may suggest a respiratory infection such as pneumonia.

Differential Diagnosis 3: Gastroenteritis – Rationale: Abdominal pain, fever, and vomiting can be indicative of gastroenteritis, which commonly presents with these symptoms.

Diagnostic Tests

Ordered laboratory tests including complete blood count (CBC), C-reactive protein (CRP), and urinalysis to further evaluate the differential diagnoses and identify possible infections or inflammatory markers (Castro & Gourley, 2010).

Health Promotion Intervention

Considering the possible diagnoses, health promotion intervention includes educating the patient and family on hygiene practices such as frequent handwashing and proper respiratory etiquette to prevent the spread of infections. Additionally, parents should be encouraged to ensure their child receives age-appropriate immunizations to protect against common infections.

Learning from the Clinical Experience

This clinical experience reinforced the importance of effective communication and a child-friendly environment in pediatric care. It highlighted the significance of adapting to individual patient needs and fears to establish trust and cooperation (Rosen et al., 2018b). Furthermore, it emphasized the importance of critical thinking skills, collaboration with the healthcare team, and resourcefulness in providing optimal care within the constraints of available resources.

Supporting Research

To support the plan of care, the current peer-reviewed research guideline from the American Academy of Pediatrics (AAP) titled “Management of Pediatric Appendicitis” provides evidence-based recommendations for the diagnosis and management of acute appendicitis in children. The guideline outlines the significance of clinical assessment, laboratory tests, and imaging studies in establishing a diagnosis and selecting appropriate treatment options.

Conclusion

 This week’s clinical experience at a pediatric office provided valuable insights into challenges and successes in pediatric care. By effectively managing patient anxiety, utilizing available resources optimally, and employing critical thinking skills, I was able to assess a patient presenting with fever, cough, and abdominal pain. The plan of care included differential diagnoses, diagnostic tests, and health promotion interventions, which were supported by the current peer-reviewed research guideline. This experience reinforced the importance of communication, adaptability, critical thinking, and collaboration in providing quality care to pediatric patients.

References

Castro, C., & Gourley, M. F. (2010). Diagnostic testing and interpretation of tests for autoimmunity. The Journal of Allergy and Clinical Immunology, 125(2), S238–S247. https://doi.org/10.1016/j.jaci.2009.09.041 

Rosen, M. J., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D. R., Pronovost, P. J., & Weaver, S. J. (2018b). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433–450. https://doi.org/10.1037/amp0000298 

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(8), 158. https://doi.org/10.4103/psychiatry.indianjpsychiatry_580_18