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Reflect on a patient who presented with postpartum depression during your Practicum Experience.

Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. Then, explain the implications of the patient’s postpartum depression, including how this might impact the entire family unit. If you did not have an opportunity to evaluate a patient with this background during the last nine weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences

Week 10 Assignment 2: Practicum – Journal Entry

Reflect on a patient who presented with a cardiovascular, neurologic, respiratory, or gastrointestinal disorder during your Practicum Experience.

Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. Then, explain how the patient’s gender might have impacted or influenced her care. If you did not have an opportunity to evaluate a patient with this background during the last 10 weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

Discussion: Nonadherence to Lifestyle Changes During Pregnancy

After identifying potential health risks for pregnant patients, providers often recommend behavior changes in lifestyle choices such as drug use, alcohol consumption, dietary habits, and environmental exposures. Even with provider recommendations and patient education programs, some patients still struggle to adhere to recommended lifestyle changes during pregnancy, posing health risks for both the mother and child. In your role as the provider, you must be able to recognize signs of non adherence to recommended lifestyle changes because not all patients will be forthcoming with the struggles they may be experiencing. Management plans are only successful if patients’ individual needs are recognized and met, so provider-patient collaboration is essential for mitigating non adherence issues. For this Discussion, consider implications of non adherence to recommended lifestyle changes and potential management strategies for pregnant patients.

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To prepare:

Review the “During Pregnancy” article in this week’s Learning Resources. https://www.cdc.gov/pregnancy/during.html

Think about the health promotion topic which was Smoking
With the topic you selected in mind, consider early signs and symptoms that might indicate a patient’s non-adherence to recommended lifestyle changes during pregnancy. Think about the impact of non-adherence on the fetus and the patient.
Reflect on treatment and management strategies for patients presenting with signs and symptoms of non-adherence to recommended lifestyle changes.

Smoking was the topic of choice

Post an explanation of signs and symptoms that might indicate a pregnant patient’s non adherence to recommended lifestyle changes related to the topic you selected. Explain the impact of non-adherence to these lifestyle recommendations on the fetus and the patient. Then, explain treatment and management strategies for patients presenting with signs and symptoms resulting from their non adherence.

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.

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.

See example

Amenorrhea

So far, I have had an opportunity to care for a female that has presented with endometriosis, ovarian cysts, or amenorrhea during this practicum experience. Out of the three disorders listed above, I will discuss amenorrhea. Amenorrhea simply means the absence of menses. It is categorized as either primary or secondary (Schuiling & Likis, 2013). Primary amenorrhea, which by definition is failure to reach menarche, is often the result of chromosomal irregularities leading to primary ovarian insufficiency (e.g., Turner syndrome) or anatomic abnormalities (e.g. Mullerian agenesis). Secondary amenorrhea is defined as the cessation of regular menses for three months or the cessation of irregular menses for six months. Most cases of secondary amenorrhea can be attributed to polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia, or primary ovarian insufficiency (Klein & merrily, 2013)

There many different causes of amenorrhea. With that being said, each cause has a different treatment and management strategy. For example, a structural cause can be treated with a hysteroscopy (Klein & Merrily, 2013). Also, hormonal deficiency can be treated with hormone replacement. Again, treatment is based on the cause.

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.

See example below:

TRICHOMONIAS

A 21-year-old pregnant female presented with her boyfriend to the clinic for her routine prenatal visit. She is currently 36 weeks pregnant. She complained of having discharge that well not go away. Upon examination, a greenish discharge was noted. My preceptor suspected trichomoniasis so he tested her for Trichomoniasis, chlamydia, HIV, syphilis and gonorrhea. She was instructed to come back in a week for results.

Key signs and symptoms that are consistent with a sexually transmitted infection (STI) versus a non-STI are discharge, odor, labial pain and irritation, and lower abdominal pain. W
it trichomoniasis, some infected men have symptoms of urethritis, epididymitis, or prostatitis, and some infected women have vaginal discharge that may be diffuse, malodorous, or yellow-green with or without vulvar irritation, (CDC,2014)

A week later, the 21-year-old returned with her boyfriend, I did not tell her the result, but my preceptor did. She was asked was it okay for her boyfriend to be in the room, and she consented to him staying while the results were read, My preceptor informed her that she was positive for trichomoniasis, but all her other test were negative, she was shocked and immediately began to deny having sex with anyone else except her boyfriend. Her boyfriend was angry and denied having sex with anyone else.

She was treated with Flagyl 2gm PO X 1 dose and instructed to return for follow up in 1 week. If a single-dose of Flagyl fail and reinfection is excluded, Flagyl 500mg PO Bid for 7 days should be prescribed. If infection persists, consider Flagyl or tinidazole 2gm po for 5 days. If infection persists, consultation with specialist is warranted (Schuiling & Likis, 2013).