NURS 6551 Practicum Journal Template Assignment Paper
Week 10 journal Reflect patients with a cardiovascular, neurological,respiratory, GI disorder during your a practicum experience describe personal and medical history drug therapy and treatment and follow-up care and explain how that might have impacted or influenced her care…
Assignment: Practicum Experience Journal Entry
As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your Practicum Experience. By applying the concepts that you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment such as Journal Entries and SOAP Notes that prompts you to reflect on your Practicum Experiences and relate them to the material presented in the classroom. This week, you begin documenting your Practicum
Experiences in your Practicum Journal.
- Select and describe a nursing theory to guide your practice.
- Develop goals and objectives for your Practicum Experience in this course. When developing your goals and objectives, be sure to keep the seven domains of practice in mind.
- Create a timeline of practicum activities based on your practicum requirements.
Nurse Practitioner Program
A practicum is a distinctly defined supervised on-site experience in which students develop applied skills and integrate professional knowledge in the provision of advanced practice nursing care.
All nurse practitioner students must complete four practicum courses, with a minimum of 576 hours of supervised clinical experience (144 hours in each course). The didactic (classroom) and clinical components of the courses are integrated. The courses vary by specialization:
NURS 6551 Practicum Experience Assignment
As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your Practicum Experience. By applying the concepts you study in the classroom to clinical settings, you enhance your professional competency. Each week you complete an Assignment such as Journal Entries or SOAP Notes that prompts you to reflect on your Practicum Experiences and relate them to the material presented in the classroom. This week you begin documenting your Practicum Experiences in your Practicum Journal.
To prepare for this course’s Practicum Experience, address the following in your Practicum Journal:
- Select and explain a nursing theory or feminist perspective to guide your clinical practice.
- Develop goals and objectives for the Practicum Experience in this course. When developing your goals and objectives, be sure to keep women’s health guidelines and best practices in mind.
Create a timeline of practicum activities based on your practicum requirements.
By Day 7 of Week 3
Assignment 1: Practicum – Journal Entry
Reflect on a patient who presented with a vaginal discharge during your Practicum Experience. Describe key signs and symptoms that were consistent with a sexually transmitted infection (STI) versus a non-STI related infection. If you diagnosed the patient with an STI, describe your experience in telling the patient that she had an STI, as well as the patient’s reaction to the diagnosis. Explain how the diagnosis might impact the patient’s life short-term and long-term.
Include an explanation of the patient’s medical history, drug therapy and treatments, and follow-up care. If you did not have an opportunity to evaluate a patient with this background during the last four weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.
Assignment 1: Practicum – Journal Entry
Reflect on a patient who presented with endometriosis, ovarian cysts, or amenorrhea during your Practicum Experience. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. Then, explain how treatment modalities differ for endometriosis, ovarian cysts, and amenorrhea, as well as the implications of these differences when diagnosing and treating patients.
If you did not have an opportunity to evaluate a patient with this background during the last five weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.
Assignment: Practicum – Journal Entry
Reflect on a patient who presented with a breast condition during your Practicum Experience. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. Then, explain your patient education strategies for patients with or at risk of breast conditions. Include a description of how you might teach patients to perform breast self-examinations.
If you did not have an opportunity to evaluate a patient with this background during the last six weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.
Assignment 1: Practicum – Focused SOAP Note and Time Log
Select a patient whom you examined during the last three weeks. With this patient in mind, address the following in a Focused SOAP Note:
- Subjective: What details did the patient provide regarding her personal and medical history?
- Objective: What observations did you make during the physical assessment?
- Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?
- Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
- Reflection notes: What would you do differently in a similar patient evaluation?
A common presentation seen by practitioners is a bacterial discharge with a foul-odor. Oftentimes practitioners are able to determine a diagnosis based on the patient’s history and their presenting symptoms. Before prescribing antibiotics, practitioners should perform a thorough assessment and perform a physical examination, including vaginal exam, prior to determining a diagnosis and prescribing medications.
This week a patient presented to the office with complaints of a white-green, foul smelling vaginal discharge with some itching. The patient is a 29-year-old G1P1 patient who is also single currently. The patient reports that she has noticed the discharge for a few days and states it is a medium amount and has not seen any blood associated with it. She states that she has felt moderate, constant suprapubic pain that has not radiated anywhere.
Patient attempted taking Motrin for the pain, but states she felt no relief and the pain intensified when she had bowel movements and had to bear down. Patients denied fever, dysuria, urinary frequency, or other pain. Patient had Mirena IUD placed 2 years ago after she delivered her baby and reports an irregular period occurring every 50-60 days that is very light with spotting. She reported this last happening 5 weeks ago. She also is due for her routine PAP smear.
Currently, the patient reports she has an active sex life and has recently had a new partner. She reports that during intercourse, the condom broke roughly one month ago. She is concerned that she may have a sexually transmitted infection (STI) and worries about potty training on the toilet and transmitting it to her daughter.
The patient stated she was “not ready” for a genital examination at this visit, she would rather be diagnosed based on symptoms and given medications to “cure” her. After being explained the importance of the examination, she agreed to have it done, admitting she was embarrassed. On examination, her vital signs were stable and were febrile. She had bowel sounds present in all four quadrants, it was soft, non-distended, and non-tender except for the suprapubic area but had no guarding. The pelvic examination showed that the uterus was a normal size with no masses.
During the vaginal examination, the unopened cervix was visualized and there was greenish, malodorous discharge coming from the os. The IUD strings were also visible from the os once the discharge was cleared. There was also a foreign body identified in the vaginal canal that appeared to be a piece of a tampon after it was removed with forceps.
Treatment will be dependent on the examination findings and diagnosis. The cervix was swabbed and samples were sent to the lab. The cervical os was cleaned with a chlorhexidine sponge. The patient was given a pregnancy test as the condom broke, despite the presence of the IUD, which was negative. The patient believes in holistic treatment options and would prefer to try essential oils and herbs to cure the infection before she puts any medication, even antibiotics, into her body. She stated that if in 3 days she is still having these symptoms, she will call back to have the prescription sent to a pharmacy she prefers.
The patient was educated on the importance of being treated as soon as possible and the risk of toxic shock syndrome and sepsis. Education on signs and symptoms of both toxic shock syndrome and sepsis were provided. The provider called in the prescription to the pharmacy and told the patient to pick it up that way, should her symptoms get worse, she has it available.
Impact of Diagnosis
The patient was mortified that there was a tampon found in her vaginal cavity. She was confused on how it could have gotten there, and why she would not have known that it was still there, especially since she has had sexual intercourse since she had last inserted a tampon. The patient stated that she uses natural cotton tampons and that there is no string attached to the tampon, so at times it can be difficult to remove, but she tries her best to ensure she has taken the entire tampon out.
The provider called the patient to see if she wanted to make another appointment and to see if she picked up the prescription. The patient did not answer the phone, nor did she call back this week. The practitioner stated that she calls in prescriptions and other medications after educating the patient, even if the patient refuses, just in case they change their mind at a later time and decide to take the medications, it is readily available to them. I feel this is smart as it not only covers the patient, but also the provider.
Ahmed,N.M.(2019). Effect of Nursing Intervention on Knowledge about Genital Hygienic Practices Regarding Vaginal Infection among Intrauterine Device Users and Non-Users. International Journal of Nursing Didactics,09(01), 01-11.doi:10.15520/ijtld.v9i01.2398