Site Evaluation

For my site evaluation, I met with my preceptor to discuss interesting cases that I had seen during my rotation. One of the patients that I presented was a 20 y/o G1P0 female at 27w5d that presented with shortness of breath and chest pain. The patient did not have any significant history of this happening before and denied any known pulmonary disease. Due to the increased risk of thromboembolisms amongst the pregnant population, despite the patient’s low risk of PE and DVT the providers decided to proceed with a CT. The patients history and physical were all unremarkable. Imaging did not reveal any acute cause. The patient did well while in triage and experienced relief of symptoms. The patient was ultimately discharged with strict return precautions. It was also explained to the patient that pregnancy reduced lung capacity and this can also be a source of shortness of breath as the fetus continues to develop. The second patient that I prepared for the site evaluation was a 16 y/o female that presented with prolonged and heavy menstrual period. She had a history of unremarkable regular periods since onset of menses at age 13. Patient also complained of dizziness and lightheadedness for two days. She denies syncopal episode but admits feeling lightheaded when standing up. Patient underwent workup and was found to be significantly anemic. She was treated with blood transfusion and was ultimately transferred to a pediatric ICU in another hospital. During the site evaluation, we discussed the importance a thorough history and comprehensive physical exam when working up patients. We also discussed the various underlying causes for the patient’s prolonged menses. For this site evaluation, I also prepared a total of 10 drug cards. I chose to focus on drugs that I had seen used throughout the rotation as I was curious to learn more about them and understand their indications and methods of action more clearly.

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