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Clinical Experience Weekly 3

Katia Gedeon

• MK a 26-year-old female patient presents to the clinic with a couple of years of history of cramps abdominal pain and diarrhea alternating with constipation.  MK recently established that she is one month pregnant. MK denies any weight loss, fever, bloody stools, or heartburn. Her family’s medical history and other aspects of her medical history are remarkable and clear of any issues. The pelvic and abdominal examination was required as part of the physical experience.

The clinical week I had at the antenatal care, was a positive and successful experience. I faced success and challenges during the week. The antenatal clinical environment was effective for learning and mentors at the clinic were readily available to offer any help. Therefore, the weekly experience was generally a success. Additionally, I was able to interact with many patients that we communicated well and were willing to inform me of their past medical journeys. I was able to understand many illnesses faced by women. One challenge was associated with the physical examination especially the pelvic and abdominal examinations that usually requires consent from the patient. Some patients failed to provide consent and thus it was a challenge to physically examine them. Generally, my confidence in the clinical field increased through a proper attitude to provide care.

Patient assessment was essential for one of the cases described earlier to understand why the patient faced cramps abdominal pain and diarrhea alternating with constipation as the signs and symptoms. For this case, a possible diagnosis due to her illness history is irritable bowel syndrome. The disease mainly presents with abdominal problems such as diarrhea, constipation, and gas (Chaban, 2016). However, further examination is required on a stool, bowel habits, family history, stress levels, and any allergies such as the use of antacids and laxatives that may lead to constipation (Chaba, 2016). Further, assessment of the diet she is taking is also an essential part of the diagnosis. A pregnancy test is also required to confirm if the woman is pregnant.

The plan of care required for the patient is to ensure that she manages her condition. The treatment for the patient is simple since her constipation could be dealt with by ensuring that the patient takes in more fluids and especially water. Since stress is also an important part of irritable bowel movement, the patient is educated on effective and natural ways through which her stress can be managed. The crampy abdominal pains can be managed through the prescription of painkillers including Paracetamol or Ibuprofen (Chaban, 2016). A differential diagnosis, in this case, would be the signs and symptoms of early pregnancy which includes the signs and symptoms she is facing including abdominal pain and constipation as her body adjusts to the hormonal changes (Ayasi et al., 2014).

During the week at the antenatal care, I was able to gain skills and knowledge that would be highly beneficial as a healthcare practitioner. I improved on my attitude towards the provision of care to the patients as I realized the critical role the nurse plays in the care process. Moreover, I gained skills and knowledge on physical examination of patients which always requires that the patient feels comfortable during the process. My teamwork and communication skills were greatly improved during the week since the care in the clinic was a collaborative process that included gynecologists, nurses, pharmacists, and other physicians (Cronie et al., 2019). I would ensure that what was learned is applied in future caring of patients.

References

Ayiasi, R. M., Criel, B., Orach, C. G., Nabiwemba, E., & Kolsteren, P. (2014). Primary healthcare worker knowledge related to prenatal and immediate newborn care: a cross-sectional study in Masindi, Uganda. BMC Health Services Research, 14(1), 65.     doi:10.1186/1472-6963-14-65.

Chaban, V. (2016). Irritable Bowel Syndrome: Novel Concepts for Research and Treatment.          Books on Demand.

Cronie D, Rijnders M, Jans S, Verhoeven CJ, & de Vries R. (2019). How good is a collaboration between maternity service providers in the Netherlands? J Multidiscip Healthc. 12,21-30
https://doi.org/10.2147/JMDH.S179811