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Being a reflective practitioner enables NPs to identify weaknesses and target professional development in order to address these weaknesses. In turn, this increases the NPs’ ability to provide the best care to patients and their families. Reflection also affords the NP time to consider communication and their efforts toward creating a culture of mutual support with colleagues, a characteristic that is essential to successful NP practice (Somerville & Keeling, 2004).Each week you will complete a Journal Entry and Time Log that prompts you to reflect on your Practicum Experiences and how they relate to your Professional Goals and Self-Assessment of Clinical Skills. This week you will begin documenting your Practicum Experiences in your Practicum Journal.
Patient:18 year old female. She presents with UTI symptoms.
Diagnosis: Acute cystitis and Treatment with Macrobid.I will upload my paper to correlate improvement with
An 18-year-old patient presented at the healthcare facility with recurrent UTI. The female patient had a two-year history of the said infection. She has had 10 negative cultures and 2 positive ones. The patient has had some relief on several occasions following antibiotic courses. Sometimes the drugs have not had the desired effect.
She presented for a continuous episode that had lasted a fortnight with incidences of urine frequency every half hour to one hour, continuous urge to urinate, voiding at least four times before sleeping and at night time she reports waking up thrice. She experiences bladder fullness, suprapubic pain, and significant dysuria. The patient did not report any episodes of incontinence. She described the infection as a flare and as had similar symptoms but of lesser intensity, daily, within the last two years.
Additionally, the patient said she has had a sexual partner for the last two years though she admits that sexual activity is an uncomfortable occurrence for her. The patient is also a heavy smoker (half a pack a day). The patient did not report any remarkable medical history or chronic condition. The physical examination revealed an anterior vaginal wall and an SP region that was tender. The urinalysis under the high power field showed 5-10 white blood cells and 1-3 red blood cells.
The patient was diagnosed with cystitis. Of paramount importance was smoking cessation and the patient was advised on the importance of smoking cessation (Kullmann, 2017). I gave the patient reading material on the health risks of smoking, where to get help and some of the immediate actions that can be taken in seeking cessation. I also educated the patient on painful bladder syndrome and its treatment. In this situation, the patient’s level of knowledge and awareness play an important role in recovery. I advised the patient to take additional measures such as stress reduction, regular exercise, modification of diet, and avoiding irritants including douches, diaphragm use and condom use by her partner (Kavuma, 2017). Also, I advised the patient to seek alternative contraceptive methods.
Additionally, I asked the patient to book an appointment with the physiotherapist for pelvic floor exercises (Kavuma, 2017). A pelvic examination and local cystoscopy showed that the bladder was normal. The patient was put on an extended course of antibiotics specifically, nitrofurantoin (Macrobid) and pyridium (phenazoyridine) for 2-3 weeks as a way of ruling out an infectious etiology because of the recurrent UTI (Daniel, Schulten, & Herndon, 2018).
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