Matilda Mullen

Wednesday Clincial
UVA Healthsouth
Annan
Journal 3
I definitely feel like I went out with a bang after my last clinical
this week. I feel like I finally reached an entirely new level of
confidence in my assessment. I also felt more comfortable spending
time with my patients. It was easy and I didn't have to think about it or
stress about what my patient was thinking. Everything came naturally
because I have become so used to it. I think I have come a long way
since our first day at UVA Healthsouth. I also had a patient who was
very enthusiastic and friendly. He was very supportive of me and put a
lot of effort into helping me learn. I got to administer medication and
give two injections, and the whole way through he gave me advice on
how to administer his medication. Instead of questioning the fact that a
student was giving him his medication, he was open and willing to help
me learn.
Having the chance to give medications connects easily to my
pathophysiology/pharmacology course. Sure enough, many of the
medications my patient was on happened to be ones that I am
currently studying. For example, heparin was one of the anticoagulants
on my test today (lenhe, 726). Atorvastatin is a cholesterol lowering
drug on my exam and aspirin was an antiplatelet that I have had on
many exams Also, all 3 of my patients insulins (insulin regular, insulin

glargine, and insulin lispro) were medications from my last test. I also
learned about docusate, a stool softener, I clinical applications. It was
interesting to transition from learning about these medications in my
text book, to having to reflect on the therapeutic effects that I learned
and determine which one pertained to my patient.
My patient had many diagnoses, and he was not admitted for
diabetes for this one but it jumped out at me. He has serious type 2
diabetes and because of this, he has began to develop diabetic
neuropathy in his feet. Before this semester, I had no idea how serious
of a disorder diabetes really is. I understood that it altered blood sugar
levels and involved careful monitoring but I did not realize it had so
many serious effects. It frequently leads to complications like
decreased blood flow, which leads to loss of feeling (neuropathy). This
can result in ulcers due to reduced sensation. In fact diabetic
neuropath occurs in nearly 50 percent of patients with diabetes
(Airing, Falko, Jones).Thereareseveraltypesofneuropathyandamyriadof
complicationsthatcanresultfromit.Othercomplicationsofdiabetesincluderenal
dysfunctionandvisionproblems. Who knew altered blood sugar levels
could have such adverse effects. Now I understand why Strict
glycemic control and good daily foot care are key to preventing
complications of diabetic neuropathy (Airing, Falko, Jones).
Aring, A., Falko, J., & Jones, D. (2005). Evaluation and Prevention of
Diabetic Neuropathy. Retrieved November 20, 2015, from
http://www.aafp.org/afp/2005/0601/p2123.html

Lehne, Richard A. Pharmacology for Nursing Care. St. Louis, Mo:

Saunders, 2004. Print.