Disease Screenings
Disease Screenings
In the field of public health, I have had the opportunity to learn about the importance of disease screenings and the challenges associated with encouraging individuals to get screened for various conditions. Through my coursework and practical experiences, I have gained valuable insights into how to address the apprehensions that many patients may have regarding disease screenings. Disease screenings are crucial for early detection and timely intervention, which can significantly improve treatment outcomes and reduce the burden of various illnesses (Yokota et al., 2021). Nevertheless, some people may be afraid of getting screened for different reasons, for instance, the procedure itself, the anxiety that they may have about the results, or the lack of knowledge about the importance of screening.
Most of the time, the patients have the worry that the screening procedure will be painful. Some may be concerned about the possible discomfort or even the pain that is associated with some of the tests, like the mammograms or colonoscopies. In these situations, it is necessary to give the correct information about the screening process, stressing that the discomfort is usually slight and will go away (Severin et al., 2020). Besides, the development of the new screening techniques which have made the procedures less invasive and more comfortable can be used as an argument to reduce these worries. A major apprehension that patients may have is the fear of the positive result. The prospect of being diagnosed with a serious illness can be overwhelming, and some individuals may prefer to remain unaware rather than confront the possibility of a diagnosis (Hurtado-de-Mendoza et al., 2021). In these situations, it is crucial to approach the conversation with empathy and understanding. Acknowledging the emotional weight of the situation and providing support resources, such as counseling services or support groups, can help patients feel more comfortable and prepared to face the potential outcome.
Furthermore, some individuals may be hesitant about disease screenings due to a lack of awareness or understanding of the importance of early detection. In such cases, education and awareness campaigns can play a vital role in addressing these concerns. Providing clear and accessible information about the benefits of regular screenings, the potential risks of delaying or avoiding screenings, and the available treatment options can empower individuals to make informed decisions about their health.
When addressing patients’ apprehensions about disease screenings, it is essential to tailor the approach to their specific concerns and cultural backgrounds. The construction of trust and the establishment of a good relationship with patients is very important, because it enables the doctors to have a free and open conversation with the patients about their fear and reservations. The act of listening to patients actively and providing a secure, free environment for them to vent their worries can be very helpful in making them feel understood and supported. Besides, giving patients a chance to participate in the decision-making process and to respect their autonomy can be a way to reduce the worries (Cheng et al., 2020). The reasons for and against various screening options can be discussed, and the patients can be allowed to make their own decisions, which in turn will make them feel that they are in control of their health.
Conclusively, I have learned that to deal with the patients’ fears about disease screening, I need to use the multifaceted approach. This consists of giving the proper information, offering emotional support, spreading knowledge and awareness, customizing the method to the needs of each person, creating trust, and involving the patients in the decisions. By addressing these concerns with empathy, respect, and a commitment to patient-centered care, we can encourage more individuals to participate in potentially life-saving disease screenings.
Disease Screening
Eileen Santiago
St. Thomas University
NUR 509-ADVD FNP ADULTS
Janice Baptista
May 16, 2024
Disease Screening
A health screening test is a medical test or procedure performed on members of an asymptomatic population or population subgroup to assess their likelihood of having a particular disease. Screening tests for early diagnosis include Pap smears for cervical cancer or colonoscopy for colon cancer, thyroid-stimulating hormone for congenital hypothyroidism in newborns, cholesterol level for heart disease, urine drug screen for illicit drug use, or blood pressure for hypertension. The function of health screening is to assess the likelihood that an asymptomatic individual has a particular disease, with the goal of preventing illness or death from that disease (Givler & Givler, 2023).
Patient Apprehensions
The student scholar has specialized in Adult and Pediatric Oncology for over a decade and understands the significance of routine screening for disease prevention. The student scholar remembers the day that she was assigned to 19-year-old female newly diagnosed with breast cancer. The student scholar was curious about how the diagnosis was discovered. After building a trusting rapport with the patient, the patient explained that she was not aware that she was at high risk due to a genetic mutation and family history. The young woman had this misconception that women her age were too young to have to perform breast self-examinations or have clinical breast examinations and mammograms. Her mother was diagnosed at the age of 35 with triple negative breast cancer. Therefore, she figured if she were to get breast cancer then it would have occurred around the age that her mother was diagnosed so she ignored the lump in her right breast for 3 months before revealing the discovery to her parents. She was apprehensive about screening because she did not deem it necessary at her age and avoided medical attention because she could not fathom the diagnosis and was afraid of the outcome. The student scholar sat with the patient throughout the duration of the visit and listened attentively and showed empathy while acknowledging her feelings about early screening and the diagnosis she received. In the article published by Heena et al. (2019), participants shared similar attitudes regarding breast cancer. The following responses were used: If I examine my breast myself, I cannot detect abnormalities in my breast. There is no reason to examine my breasts. If I knew the benefit of breast self-examination, I would have done it by now. The article exposes the lack of knowledge and misconceptions society has about early detection and screening.
Conclusion
The student scholar educated the patient and family members on the importance of screening for that disease, the prevalence of the disease, modifiable and non-modifiable risk factors using appropriate health literacy. The student scholar supplied educational materials and resources available to the family like peer support groups. Research shows that incorporating family members in the educational process of health promotion can provide support and reassurance for patients. Including the patient and family members in the decision-making is another key component to ensure adherence. Promoting screening and surveillance in any population involves a system-based and holistic approach, and would require a rigorous health policy that is put in place to encourage adherence. This would involve educating and engaging the public, having a system in place to track patients who are overdue for screening, sending reminders to participants and simplifying access of care to reduce provider-related barriers (Kew & Koh, 2020).
Clinical Experience: Week 1
Jisel Llerena
St. Thomas University
NUR509: Advd FNP Clinical III
Dr. Erica Ochoa
May 16th, 2024
Did you face any challenges, any success? If so, what were they?
When attending my first clinical as a FNP student, a few challenges were encountered. For one, the clinical setting was very different from one I am used to. Working in a hospital as a bedside registered nurse is completely different from being an FNP in a primary care clinic. Getting used to the environment was the first challenge. The second challenge was overcoming the anxiety of not knowing what I was going to go into. Being my first clinical with a new role is something difficult to adjust to. As a few patients were seen, I was able to feel more comfortable and get a routine going with how this clinic works. In regards to success, I was nervous about correctly filling out the log book for patients seen in a day and I was able to overcome this and successfully chart each patient seen as the day proceeded.
Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
One of the first patients seen that day had a chief complaint of pain exacerbation related to gout. Gout is an inflammatory arthritis that causes swelling in joints. Gout is caused by a high level of uric acid build up in the body (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023). This causes inflammation and can lead to pain in the joints. With the patient who came this day, he mentioned how he had pain in his right hand and shoulder. These were both swollen on inspection. He also mentioned how his right hand was limited when opening and closing, which was also observed as the patient attempted to open and close. The patient was alert and oriented and didn’t seem to have any difficulty with getting around. The patients’ vitals were within defined limits, including blood pressure. Heart was clear with no murmurs and lungs were clear and symmetrical. Three possible diagnoses include acute pain, impaired physical mobility, and deficient knowledge. The patient clearly had pain in his right shoulder and hand related to gout. Upon observation, it was also clear he had impaired mobility in the upper extremities. Lastly, the patient had been two years without taking his gout medications and is clearly deficient in the knowledge he needs to maintain his disease. The plan of care included lab work to be done to see the patient’s current uric acid level and his previous medication was prescribed, Allopurinol. Also, a follow up appointment was scheduled for two weeks.
Mention the health promotion intervention for this patient.
Education on how Anti-inflammatory medications such as colchicine and nonsteroidal anti-inflammatory medicines (NSAIDs) like acetaminophen or ibuprofen are used to treat flare-ups (Centers for Disease Control and Prevention, 2023). Also, injectable, or oral corticosteroids are further options. Educating the patient on how future attacks may be avoided by making dietary and lifestyle adjustments, such as cutting back on alcohol, lowering weight, and avoiding foods high in purines (such as organ meat or red meat, which can trigger flare-ups of gout). Lastly, letting them know that stopping their medication should not happen unless advised by provider.
What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?
From this week’s clinical experience, I learned the routine that the FNP uses to treat each and every patient. The order of which they interview the patient, create rapport, and complete assessment. I also observed on how the patient was assessed depending on what the patient is in for. If it is a new patient, a full assessment is done. If it is a regular patient and came in for cough, then a focused assessment on their respiratory system is assessed. This will all help in the future as an advanced practice nurse.
Clinical experience Week 1
Tania Supreme
St. Thomas University
NUR509: Advanced FNP Clinical III
Dr. Erica Ochoa
May 16th, 2024
Did you face any challenges and success? If so, what were they?
The first week of clinical was challenging because it was a new environment and setting of activities. However, the preceptor was very friendly and worked with professionalism. One of the most difficult situations I faced was using E-medical practice software to look up patient information, such as SOAP HIP and ROS. On day two, I became more familiar with the observation process, and the preceptor taught me how to do it. My success in the first week of clinical, especially on Tuesday, was that I could finally read and search the patient’s medical history and lab results in the charts.
Describe the assessment of a patient, detailing the signs and symptoms, examination, plan of care, and at least three possible differential diagnoses with rationale.
On Tuesday morning, I observed a 45-year-old Black African American Male with a past medical history of high blood pressure, diabetes, and prostate enlargement. He has a family medical history of prostate cancer and high blood pressure. The patient visited the clinic for a follow-up on his blood test results from the previous visit eight weeks ago. On the subjective assessment, the Patient-reported headaches associated with high blood pressure and also reported difficulty urinating. He denied any pain with urination. On objective assessment, the patient has a blood pressure of 159/94, Blood Sugar of 189, HR 84, temperature of 98.1, and saturation of 100. The patient’s heart and lung sounds were clear on osculation and the abdomen, with no abnormal findings on abdominal palpitation.
The lab results showed the Patient’s AIC level was 7.3%, and the PSA level was 6.7 ng/ml. All other lab results were negative. The care plan for that patient is to educate him regarding his diet and compliance with diabetic medication, encourage him to drink more water, and practice exercise. Teach the patient to monitor his blood pressure daily while taking his medication as recommended. Assess if the patient needs a medication refill for the blood sugar and blood pressure. A urologist consult is required for further evaluation because the PSA level is elevated based on the patient’s medical history and lab results; there are three possible differential diagnoses, such as diabetic type 2 non-controlled because the AIC level of 7.3% is an indicator that the patient is not balanced with medication (Duderstadt & Kaplan, 2021). The AIC test measures the percentage of hemoglobin in the blood coated with glucose, reflecting the average blood sugar levels over the past three months. The average AIC level is below 5.7%. The second diagnostic is high blood pressure because the patient record shows him on hydrochlorothiazide 12, 5 mg daily, and hydralazine 25 mg daily. The patient reports that he has been taking medication as prescribed (DeNisco et al., 2019).
Patients must follow their blood pressure closely and adjust their diet and daily exercise associated with stress level management. The third diagnosis is BPH, which is benign prostatic Hyperplasia because the patient has previous ultrasounds that show prostate enlargement and a family medical history of prostate cancer. The patient has a new PSA result of 6. 7 ng/ml, above the normal range. PSA stands for prostate-specific antigen, and a PSA test measures the level of PSA in the blood. For example, the PSA level range for men aged 40 to 50 is 06 ng/ml to 0.7 ng/ml, and a PSA score greater than 2.5 ng/ml is considered abnormal. Therefore, the patient should follow up with his urologist immediately (Collins-Bride et al.,2021).
3- Mention the health promotion intervention for this patient
As a nurse practitioner, besides the assessments, diagnostic medication prescription, and referral to a urologist that has been made. I have to implement a patient plan education for effective health promotion. The specific health promotion for that patient is to assist him by educating him in the process of health improvement and gaining more control over his health condition. In the teaching plan, these topics must be addressed, including medication compliance, diet adjustment, and physical exercise. It is essential to emphasize the teaching activities regarding blood pressure, Blood sugar, and early detection of prostate cancer complications (Dains & Sheilebel, 2021).
What did you learn from this week’s clinical experience that can benefit you as an advanced practice nurse?
Clinical experience is the key to the application of knowledge that the student got from the book. In that first week, I learned to apply active listening while communicating with each patient during an assessment process. I also learned that each patient is different regarding culture, education levels, and religious beliefs.
Support your plan of care with the current peer-reviewed research guidelines.
The current peer-reviewed research guideline ensures accurate, practical, and timely information that can reinforce skills and abilities to build clinical judgment while contributing to advanced nurse practitioner competency in the practice setting. It is important to note that the care plan was based on intervention bias related to the methods used for clinical approaches, such as subjective assessment, objective assessment, physical examination, differential diagnosis, and referral requirements (Haag-Heitman & George, 2019).
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