The Clinical Experience : Adherence, Congestive Heart Failure, Cardiomyopathy, And Coronary Artery Disease

759 Words Nov 12th, 2016 4 Pages
One of the concepts that I was able to reflect on for the last clinical experience was adherence. The patient that I was able to spend time with had a long list of comorbidities, some of which include, type 2 diabetes mellitus, congestive heart failure, cardiomyopathy, and coronary artery disease. However, the patient had very poor adherence to the treatment recommendations for these diagnoses. Once diagnosed with heart issues, the patient did not attend any appointments at the hearts doctors and eventually presented back to the emergency department for heart complications. The patient also has very uncontrolled diabetes and has not had a Hgb A1C under 10 upon any hospital admissions. Prior to this clinical experience I realized that a lot of people in the population have poor adherence to treatment regimens, however, this patient’s situation was one of the most unfortunate I have seen yet. This is because the doctors believe eventually he will be in need of an LVAD, but it is unlikely they will perform this due to the patient’s poor adherence.
Another concept I was able to reflect on this last clinical was infection. We noticed that the patient had an elevated temperature during the clinical. Therefore, we decided to administer acetaminophen to help bring the temperature down but the doctor was concerned about the cause. He decided that he wanted to have the patients PICC line removed and a new one placed incase this was the cause. This allowed me to look at the big…

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