Weekly Clinical Experience 7 Pediatrics

Sample Answer

This week’s clinical experience has offered a great learning experience through the pediatric patient encounters. However, I faced a challenge assessing autistic children due to their hypo-reactivity, hyper-reactivity, and sensory-seeking behavior. Besides, autistic children are often triggered by enclosed places, bright lights, strange tastes, and strange smells, which affect health assessment as they heighten their anxiety.

Nonetheless, I have successfully performed physical examinations of pediatric patients and learned how the exam of a child differs from that of an adult.

I encountered a 6-year-old girl who reported being embarrassed and shied about her frequent bowel movement accidents. She experienced a bowel movement accident during a recent bus ride on a field trip, resulting in her peers mocking and ridiculing her. She experienced significant distress and subsequently abstained from attending school for two weeks. She also presented with a chronic history of constipation.

The priority differential diagnosis was Encopresis Disorder owing to the patient’s history of involuntary discharge of feces (Timmerman et al., 2021). The second differential was chronic constipation, given the patient’s chronic history of constipation. The third differential was Imperforate anus owing to the patient’s fetal incontinence (Timmerman et al., 2021).

The plan of care for the Encopresis Disorder was routine laxative therapy and Toilet training. Health promotion for this patient will include explaining to the child and caregiver that constipation often leads to a vicious circle that results in stool withholding, fecal retention, and eventually fecal incontinence.

Thus, they must understand that fecal incontinence is caused by rectal impaction and is beyond the child’s control (Aymerich et al., 2020). Besides, the child and caregiver will be informed that recovery is possible with adequate, often protracted treatment.

This week, I learned about family-centered care (FCC), which is a core philosophical view of health care that recognizes the family as the principal focus of every intervention in a sick child. FCC’s philosophical standpoint states that the family is constant in a child’s life, and a child’s injury or illness affects every family member. It emphasizes the partnership between the family and the health provider at all levels of a child’s care.

Knowledge of FCC will be valuable to my APN practice since I understand the importance of allowing a child’s family to be present during the patient’s rounds and inviting the caregivers to be present during medical procedures. I will implement FCC by sharing medical information with the child and family in a useful and encouraging manner.

References

• Aymerich, C., Pedruzo, B., Pacho, M., Herrero, J., Laborda, M., Bordenave, M., Salazar de Pablo, G., Sesma, E., Fernández-Rivas, A., Catalan, A., & González-Torres, M. Á. (2023). Relationship between elimination disorders and internalizing-externalizing problems in children A systematic review and meta-analysis. JCPP Advances, 3(3), e12185. https //doi.org/10.1002/jcv2.12185
• Timmerman, M. E. W., Trzpis, M., & Broens, P. M. A. (2021). Prevalence of Defecation Disorders and their Symptoms is Comparable in Children and Young Adults Cross-Sectional Study. Pediatric Gastroenterology, Hepatology & Nutrition, 24(1), 45–53. https //doi.org/10.5223/pghn.2021.24.1.45