STU Wk 7 Healthcare Givers to Separate Their Personal & Personal Life Response

Respond to your peers 

• Roodelyne Petit. 

                                                       Syncope

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

My clinical this week was very interesting, it was my last week and I had some mix feelings. I took a deep breath knowing that at last I pull through even though I am facing a lot of very difficult challenges in my personal life and at times, really thought that I would have to give up. The challenges I faced mostly throughout this process was knowing how to separate my personal problems from my professional life. I had to learn to be in the present and give it my all regardless of anything else because the patients rely on my professionalism and knowledge.

Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and possible differential diagnosis.

I cared for a 66 year-old-male presenting initially to the emergency room after an episode of dizziness that made him sit on the floor of his house and call 911. He has a past medical history significant for hypertension, hyperlipidemia, and previous laparoscopic cholecystectomy. He was admitted to the hospital for three days and he was here today for a post hospital admission follow up visit.

During physical exam, nystagmus noted to the right eye as it moved to the lateral aspect of his ocular field for a total of 8 beats with associated reported dizziness and “I just don’t feel right.”

Past Surgical History:  Laparoscopic Cholecystectomy

Socioeconomic History

Marital status: married with 3 children

Tobacco Use

Smoking status: never smoker

Smokeless tobacco: Never Used

Substance and Sexual Activity

Alcohol use: not currently but occasional

Drug use: No

Meds:

• Scheduled Medications:

? Atorvastatin 20mg nightly for hyperlipidemia

? Lisinopril 20mg daily for hypertension

• ? Metoprolol Succinate 150mg BID for hypertension
• The patient was diagnosed and treated for syncope in the hospital and my preceptor agree with the diagnosis. However, these are some differential diagnosis that we also considered due to the patient’s history and presented symptoms: Vertigo, Orthostatic Hypotension, and  Dizziness.

What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?

We have been learning a lot about differential diagnosis and how it assists in helping the patient by looking a bigger picture. I learn that differential diagnosis is extremely important and may validate a primary diagnosis and even target the problem better. I learn that it is extremely important to view the patient as whole and not focus on one particular diagnosis because all our major organs and systems and connected and when one is not working properly it affects several other. Therefore, it is paramount as an advanced practice nurse that we must always treat the person and not the primary diagnosis.

• References
• Colombo, G., Frattini, E., Ceriani, E., Zilocchi, M., Del Bo, R., DI Fonzo, A., & Solbiati, M.
  (2019). Syncope and autonomic failure in a middle-aged man. Internal & Emergency
  Medicine, 14(2), 271-274. DOI: 10.1007/s11739-018-1871-5

Pfieffer, M. L. D. C. F. -B. C., Anthamatten, A. D. F. -B., & Glassford, M. D. F. -C. (2019).
Assessment and treatment of dizziness and vertigo. Nurse Practitioner, 44(10), 29-36.
DOI: 10.1097/01.NPR.0000579744.73514.4b