NR 501 Week 2 Discussion: Ways of Knowing

NR 501 Week 2 Discussion: Ways of Knowing Ways of Knowing Reflective Essay NR 501: Theoretical Basis for Advanced Nursing Practice Clinical Situation While working in the emergency room one day, I encountered a family that was not comfortable taking their mother home. I reviewed the patient’s chart and noticed that the patient presented to the emergency department with a sudden onset of shortness of breath and minor chest pain that was deemed noncardiac by the physician. The emergency department physician simply dismissed the patient’s symptoms and diagnosed her with an upper respiratory infection, gave her a dose of IV antibiotic and a prescription for oral antibiotic to take home. When I assessed the patient, she was not in any acute distress, however, I auscultated expiratory and inspiratory wheezes in her right lung and diminished breath sounds in her left lung. The patient did have a history of CHF and newly diagnosed COPD. The family reported to me during my assessment that the patient had visited ED at an early date as well for similar complaints but that this episode had been much worse than the first. I reviewed the patient’s earlier visit and noted that the chest x-ray showed minor infiltrates in the left and right lung that was secondary to her COPD and that her lab work was overall unremarkable accept for a BNP level that was 100 pg/mL. I took this information to the physician and reported to him that the patient’s symptoms were worse and that she had dimini