Acute Obstructive Laryngitis (croup)
Describe your clinical experience as a Nurse Practitioner in a child and family clinic for this week/ 0-18yrs old
Did you face any challenges, any success? If so, what were they?
Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
Mention the health promotion intervention for this patient.
What did you learn from this week's clinical experience that can beneficial for you as an advanced practice nurse?
Support your plan of care with the current peer-reviewed research guideline.
Sample Answer
It sounds like you're looking for a comprehensive reflection on a clinical rotation week, combining practical experience with evidence-based practice—a perfect exercise for an Advanced Practice Nurse!
Here is a description of my clinical experience this week, focusing on a case of Acute Obstructive Laryngitis (Croup).
Clinical Experience Reflection: Pediatric Clinic Week
This week in the child and family primary care clinic (serving ages 0-18 years) was dominated by acute respiratory illnesses, characteristic of the changing seasons. The caseload varied widely, from routine well-child checks (WCCs) for school-aged children and first-time immunization counseling for infants, to urgent sick visits for fever, otitis media, and viral gastroenteritis. We also managed several follow-ups for stable chronic conditions, such as asthma and ADHD medication titration. My primary focus was on streamlined triage and diagnostic reasoning for children presenting with acute symptoms, ensuring rapid intervention when needed, especially for respiratory compromise.
Challenges and Successes
Challenge: The main challenge this week was managing parental anxiety associated with acute respiratory distress. I saw three patients presenting with a "croupy" cough (barking cough and stridor). Even with mild disease, the sound of the cough and the stridor is terrifying for parents. A key challenge was conducting a non-agitated assessment—you cannot safely evaluate a child who is thrashing and screaming, as crying significantly worsens stridor and work of breathing.
Success: My success was de-escalating anxiety and ensuring safe discharge. For the moderate croup case (detailed below), I successfully leveraged the current evidence-based practice—administering oral Dexamethasone swiftly—and used a calm, focused approach with the parents. This therapeutic relationship minimized the need for more invasive treatments (like nebulized epinephrine) and allowed us to discharge the patient safely home with clear education and return precautions, preventing an unnecessary trip to the Emergency Department (ED).
Patient Case: Acute Obstructive Laryngitis (Croup)