I went twice this week to my practicum site. The reasons for the visits were physical, pink eye, well women visit, ER follow up for cough, bronchitis, thyroid follow up, hospital follow up for cough, diabetes follow up, back pain, medications refill, stomach pain and well child. I saw 8 patients each day independently. I learned that working in the primary care is a team work. If in doubt, it is beneficial to get an opinion from another provider.
For the patient with well women exam, the patient was uptodate with the pap, so I did not do any pap. However, I ordered flu vaccine, refilled OCP, discussed safe sex practices, encouraged drinking water, exercising regularly and healthy diet. For the patient with pink eye, the patient had purulent discharge from both eyes and it was itchy and crusty in the morning. I ordered tobramycin for 1 week for his both eyes and encouraged to wash hand frequently. For the patient with thyroid follow up, her TSH was elevated, so I increased dose of her levothyroxine. Also, her BMI was >30, I educated on daily exercise and healthy diet, and referred to the dietitian. For the patient with ER follow up with cough, the patient was sent home with albuterol inhaler as needed. He was using it every 4 hours for last 4 days. He was still having cough and bronchospasm. I ordered him oraphred for 5 days, drink water with honey, mucinex prn and Zyrtec daily for his pollen allergy. For the patient with hospital follow up with cough, she was sent home couple of days ago without any medications and her symptoms were getting worst. I ordered z-pak, mucinex prn and encouraged to drink plenty of water. For the patient with diabetes, her hemoglobin A1C was 9. As I was
…show more content…
One of my goal for the next week would be to focus on non-pharmacological interventions. My other goal would be to consider whether labs are necessary and whether I need to order them. I use UpToDate, Medscape and Dynamed as my