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Weekly Clinical Experience 3
This week I was unable to complete clinical hours, due to the preceptor’s availability at the clinic. I will discuss how I was feeling finishing up the clinical week, last week. I worked to perfect and improve my charting and my SOAP notes. As the day went on, I saw more and more patients and that truly helped me and my comfort level with charting. The more practice, the more proficient I got. It took longer than I thought, but I feel that I am getting the hang of it. I feel like this was a great success for me.
A patient that presented to the clinic last week, presented with a generalized rash all over her body. She stated it started the night prior after eating a new brand of potstickers. She presented to the clinic 24 hours later and still had an itchy rash all over her body. The rash presented on her back, bilateral flanks, abdomen, bilateral upper and lower extremities, ears, and the back of her head. She explained her symptoms as an intense itching sensation. She took a benadryl the night before and applied calamine lotion, with some relief. She was prescribed a Medrol dose pack and an Epipen for any further episodes and was instructed to use if she felt her throat closing, any difficulty breathing, or swelling of the tongue, and to immediately call 911. She was instructed to take warm oatmeal baths and apply calamine lotion to relive the itching sensation. She was given the diagnosis of allergic reaction, urticaria and unspecified rash.
More than 50 million Americans have an allergy of some kind. You probably know one of those people or are one yourself. Food allergies are estimated to affect 4% – 6% of children and 4% of adults, according to the Centers for Disease Control and Prevention. Symptoms of a food allergy can range from mild to severe. Just because an initial reaction causes few problems doesn’t mean that all reactions will be similar; a food that triggered only mild symptoms on one occasion may cause more severe symptoms at another time. Symptoms of an allergic reaction may involve the skin, the gastrointestinal tract, the cardiovascular system and the respiratory tract. Most food-related symptoms occur within two hours of ingestion; often they start within minutes. In some very rare cases, the reaction may be delayed by four to six hours or even longer. Delayed reactions are most typically seen in children who develop eczema as a symptom of food allergy and in people with a rare allergy to red meat caused by the bite of a lone star tick (American College of Allergy, Asthma & Immunology, 2020).
I continued to learn that practice and experience will truly help and make me feel more comfortable. As the day went on, the more patients that I saw and examined, and the more things I was able to see, the more comfortable I got. I also learned the importance of making sure to complete a full health assessment and interview with the patient to truly get the most information, to make sure that nothing is missed. Medical professionals consider a medical history of greater diagnostic value than the physical exam or laboratory results/investigations. Patient interviews are the most common evaluation tool in clinical medicine with medical professionals performing hundreds of thousands during a career and are critical in discovering pertinent information leading to a correct diagnosis. The interview also grants therapeutic power; it is used to establish a relationship with the patient and afford empathy and reassurance. Depending on the purpose of the interview, the goals of the patient and the medical professional may be very different. Patients tend to be interested in airing their problems in front of a respected professional, and interviewers are looking for causes and/or potential solutions for the patient (Slade & Sergent, 2021).
American College of Allergy, Asthma & Immunology. (2020). Food allergy. American College of Allergy, Asthma & Immunology. https://acaai.org/allergies/types/food-allergy.
Slade, S., & Sergent, S. (2021). Interview techniques. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK526083/.