Weekly Clinical Experience 2 Gerontology

Sample Answer

During my clinical experience in gerontology, I have successfully conducted comprehensive patient exams of geriatric patients. I have been in the outpatient setting, where I have been tasked with assessing patients, ordering and interpreting diagnostic tests, developing treatment plans, prescribing medication or medical devices, and providing health education to patients and their families. Furthermore, I have successfully identified the physical, psychological, emotional, and social needs of geriatric patients and the measures to meet these needs.

During the practicum, I encountered an 82-year-old female who reported a history of frequent falls. She reported experiencing tremors at rest, taking longer to complete most activities, and difficulties initiating movement, like rising from a sitting position or turning in bed. On assessment, the patient had a poor gait and balance, jerky movements, decreased muscle mass, reduced muscle strength, and muscle rigidity.

The differential diagnoses were Parkinson’s disease (PD), Chorea, and Dementia with Lewy bodies (DLB). PD was the presumptive diagnosis since the patient presented with the three cardinal signs, including tremor, rigidity, and bradykinesia, or abnormally slow movements (Prajjwal et al., 2023).

Chorea manifests with excessive, spontaneous movements and was a differential based on the patient’s tremors and jerky movements. DLB is characterized by Parkinsonian motor features like tremors, stiffness, and slow movements, making it a differential (Prajjwal et al., 2023). The plan of care was to prescribe Levodopa/carbidopa, which is the gold standard symptomatic treatment for PD.

Health promotion for this patient included educating her about measures to improve mobility. She was advised to engage in exercises like walking, swimming, and gardening to help maintain joint mobility. She was also educated on stretching (stretch–hold–relax) and range-of-motion exercises to promote joint flexibility (Milne-Ives et al., 2022). Besides, she was advised to have warm baths and massage in addition to passive and active exercises to help relax muscles and relieve painful muscle spasms accompanying rigidity.

During this week’s experience, I learned that the FNP has roles in acute and critical care management, disease prevention, health promotion, restoring patients’ maximum health, and providing palliative care. The FNP should demonstrate competencies in health promotion, disease prevention, health protection, and treatment. Thus, in my future practice, I will empower individuals to make better health choices and implement lifestyle changes that help prevent infectious and chronic diseases.

When providing care to patients with acute, chronic, and critical conditions, I will be tasked with educating them on the interventions they can implement to prevent the recurrence of the disease and promote their health.

References

• Milne-Ives, M., Carroll, C., & Meinert, E. (2022). Self-management Interventions for People With Parkinson Disease Scoping Review. Journal of Medical Internet Research, 24(8), e40181. https //doi.org/10.2196/40181
• Prajjwal, P., Flores Sanga, H. S., Acharya, K., Tango, T., John, J., Rodriguez, R. S. C., Dheyaa Marsool Marsool, M., Sulaimanov, M., Ahmed, A., & Hussin, O. A. (2023). Parkinson’s disease updates Addressing the pathophysiology, risk factors, genetics, diagnosis, along with the medical and surgical treatment. Annals of Medicine and Surgery (2012), 85(10), 4887–4902. https //doi.org/10.1097/MS9.0000000000001142