NPM2 D225 Emerging Professional Practice
FIELD EXPERIENCE PASSED FIRST ATTEMPT
Western Governors University
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D225 FIELD EXPERIENCE PASSED FIRST ATTEMPT.
INSTRUCTOR …. DR CAMI J
WESTERN GOVERNOR UNIVERSITY
My field experience/clinical hour is at Center for Neuro Skills, this is a big, gated community that have
Assisted living section, Outpatient section, and Rehabilitation section.
Today I shadowed my preceptor Grace Nzuki BSN, RN at the Assisted living section. I observed her
attend to a total of 11 patients. The patients were between the ages of 55 years to 80 years who had
chronic diseases ranging from Chronic Kidney Disease, Multiple Sclerosis, Stroke, Parkinsons Disease,
Diabetes, and Osteoporosis.
We started with patient is Patient A. with Chronic Kidney Disease. (CKD) is a progressive illness with a
variety of causes that results in structural and functional abnormalities to the kidney. CKD is described
as a decline in renal function. I observed, my preceptor perform a focused assessment on this patient,
the patient had elevated blood pressure, but denied chest pain and no changes to baseline level of
consciousness. Patient reported not taking his blood pressure medication. I observed my preceptor fill
the patient medication box for the week and administered his blood pressure medication. The
preceptor instructed the patient that the first step to protect the kidney is to control the blood pressure,
eat healthy diet, and reduce diet high in sodium which can easily affect/elevate his blood pressure.
Education was provided on medication administration and compliance. I observed my preceptor
go through the patient’s available lab results and notified the physician of the patient’s current GFR
of 37Ml/Min, BUN, and Creatinine levels were also reported.
Patient B has Multiple Sclerosis. I observed my preceptor perform focused assessment on the patient.
During the assessment, I observed the patient report of pain to the back, neck, and joints. The patient
reported current pain management not being effective, the patient also reported new dif 케 culty
swallowing. I observed my preceptor encourage the patient to drink approximately 30 CC of water, to
identify the swallowing dif 케 culty reported, immediately after drinking, the patient had coughing spell
which was not severe and was continuously trying to clear the airway. My preceptor notified the
physician of the patients concern of the current pain management not being effective. A new order was
given for Tramadol and Robaxin which was called in to the pharmacy by my preceptor. The speech
therapist was also notified of the patient swallowing concerns, an appointment was scheduled, the
speech therapist requested that the patient be on mechanical soft diet and nectar thick liquid until the
appointment day. I observed my preceptor inform the patient of the discussion with both the Physician
and the speech therapist and all the new orders.
Patient C is a Stroke patient. The patient has a new diagnosis of CVA, which affected the left upper
extremity. The patient has secondary diagnosis of Hypertension. I observed my preceptor perform head
to toe assessment on the patient. The patient reported pain which well controlled with the current
medication regimen. The patient had no further complain nor concerns but during the assessment, we
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