Reflection On The Practicum Journal

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Journal: Week 7

The practicum journal allows for the joining of knowledge, practice and reflection. In week five, the subject matter was atypical presentation. In week six, the subject was the impact of dementia, delirium and depression on the elderly. The purpose of this paper is to reflect on my practicum from weeks five and six while covering atypical presentation and dementia.

Week Five: Atypical Presentation

Patient is a 68-year-old WF who was admitted for extended recovery from sepsis secondary to perforated diverticulum post exploratory laparoscopic with colonoscopy. Wound was left open with wound vac covering. Patients relevant history includes COPD on 4L at home, obesity, herpes, e.coli, pseudomonas and MRSA, along with the
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Patient was being treated for respiratory distress to no avail. Patient had atypical presentation of the infection in the peritoneum, possibly intestinal tract or gall bladder (Hauser, 2014). Symptoms included, fever, heat at site, nausea, pain, ecchymosis, necrotic looking dots and long history of cesspool of bacteria and viruses. Atypical presentation of infection in GI/abdominal area can include difficulty breathing, tachypnea and tachycardia (Hauser, 2014). CBC had elevated white count. Started Clindamycin 300 mg po QID x 2 weeks and consulted surgeon to ensure wound not tunneling or necrotic tissue inside.

Week Six: Delirium Impact

Depression, dementia and delirium are the trifecta of geriatric ailments (Downing, Caprio, & Lyness, 2013). Depression is the most likely to get diagnosed and the risk of getting it increases with age (Downing, Caprio, & Lyness, 2013). It affects nearly a quarter of the elderly population in facilities (Downing, Caprio, & Lyness, 2013). Dementia is a cognitive decline that affects a significant portion of older adults (Morandi et al., 2017). It is associated with both depression and delirium (Downing, Caprio, & Lyness, 2013). Treatment is challenging because medication do not really work and the best solutions tend to be environmental (Morandi et al., 2017). Delirium is the most difficult as it is the hardest to diagnose and pharmacological treatment is questionable (Morandi et al., 2017). It is acute in
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