FSU Clinical Experience and Learning Discussion Reply

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Please respond to discussion below using current APA edition and 2 scholarly references. Must be 150 words. 

Challenges/Success

           Challenges this week include continuing to adjust from adult health to women’s health. Successes this week include learning so much information from my preceptor and assisting him in doing a pelvic examination for the first time. Other successes that I had this week included getting to know the office staff and effectively communicating with the patients and allowing them to feel safe and comfortable.

Assessment of the patient, signs/symptoms, and plan of care

This week I had a patient who came in complaining of irritation and itchiness in her vagina. She stated that she noticed abnormal discharge that occurred within the past week with a slight odor. Upon vaginal examination, signs and symptoms included thick white discharge with redness, swelling, and inflammation around the vagina. A slight odor was also noted. Although she reported that it wasn’t painful, she stated that she was experiencing discomfort. We swabbed the area to test for yeast, bacterial vaginosis, and other infections.

Differential Diagnosis 

Differential diagnosis includes bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis. Bacterial vaginosis can be associated with abnormal discharge, itchiness and odor that can be grayish white in color. Trichomoniasis can also be foul smelling with genital itching, painful urination, and overall discomfort. Vulvovaginal candidiasis or yeast infection is one of the most common causes of vaginitis and is associated with a thick, white cottage cheese-like discharge (Bitew & Abebaw, 2018).

Health promotion

Health promotion interventions for this patient include education on avoiding tight fitting clothes and irritants such as products with perfumes and soap gels. Vaginal douching is to be avoided as it can further irritate the area and cause more infections. Women who are high risk for sexually transmitted infections should be offered STI screening regardless of the organism identified. Patients should also be educated on the importance of informing sexual partners and all partners should be treated and screened. Medication ordered by the provider should be taken as prescribed and patients must take the full course of treatment even if they feel better. For those being treated for STIs, sexual intercourse should be avoided for at least a week after treatment and until all partners have been treated and followed up with their providers. Patients should also be encouraged to limit sexual partners and use condoms (Sim et al., 2020).

Clinical Experience

This week I learned how to swab and culture patients for infections. I also learned how to perform a pelvic examination and perform ultrasounds. I learned that by using the ultrasound machine we can determine the number of weeks that the mother is due to measuring the parietal bones of the fetus which I was also shown how to do. This rotation has taught me the importance of checking the fetal heart rate by the doppler and keeping up with not just the mother’s health but the baby’s health as well. As providers, it is important for us to do thorough check ups and address all patient concerns to ensure that we do not miss any pertinent information. The information that I learned this week is beneficial to me as an advanced practice nurse because I will most likely encounter many female patients which will require me to conduct pelvic examinations.