Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and possible differential diagnosis.

In addition to answering the following questions i will attach a sample of a students clinical experience week to help you get an idea. Please Follow APA format closely.Describe your clinical experience for this week.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 possible differential diagnosis.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.Classmates sample clinical week for guidence:This week in clinical went really well and I continue to learn so much more than I could ever simply learn from a book. I really appreciate that my preceptor takes her time with the patients and considers each person as an individual. She respects their opinions and comes up with a plan of care that involves the patient’s input. I have seen so many providers that treat patients in a one size fits all approach and do not listen to their patient’s concerns. I feel that having such a great preceptor to learn from is the biggest success possible. A challenge for me this week was just learning more about hormones. I find this area very interesting, but it can be so complicated and vary from patient to patient. This office has a lot of patients that are concerned about their hormone levels.One of our patients this week was a 45 year old female who was coming in for her annual physical exam and lab review. On her lab work from 2019 her follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were elevated, but her estradiol levels were still within normal range. My preceptor educated her that elevated FSH and LH levels can indicate perimenopause and approaching menopause. FSH is what tells the body to make estradiol. As a woman comes to the end of her reproductive years oocytes begin to build resistance to FSH causing the levels to rise (Bechmann et al., 2014, p. 363). On the last annual visit the patient was still having regular menses, but reported that her flow was not as heavy.On this visit her estradiol levels were low and her FSH and LH levels continued to be elevated. The patient reports that she has been missing periods and has only had about three menses this year. She also has experienced hot flashes and trouble sleeping. Her blood pressure in the office was slightly elevated at 138/86. The rest of her physical exam findings were normal. The hot flashes, problems sleeping, and increased blood pressure can all be due to perimenopause. A differential diagnosis of thyroid dysfunction should be ruled out, but this patient’s thyroid stimulating hormone was within normal range (Peacock & Ketvertis, 2020).The patient was educated that her symptoms may worsen and can last for years. Education was also given that menopause increases a woman’s risk for osteoporosis and cardiovascular disease (Peacock & Ketvertis, 2020). The patient was educated that if the symptoms become intolerable there are medications available such as hormone therapy, but that there are risks associated with this. The patient wanted to know more about natural ways to cope with perimenopause and my preceptor told her that some patients have found relief with black cohosh. The patient was asked to schedule a follow up appointment in six months and call for any concerns.It is helpful to my future practice to learn about complementary and alternative therapies that can be offered to patients in addition to medications. Lifestyle modifications can help improve menopause symptoms and risks. The Mediterranean diet may help to decrease the risk of cardiovascular disease and may also help decrease hot flash symptoms. Adding a combination of weight bearing exercises and resistance exercises can help to decrease the risk of cardiovascular disease and osteoporosis (Bavender, 2018). ReferencesBavender, K. L. (2018). Hormonal havoc: Alternative therapies to hormone replacement. Nutritional Perspectives: Journal of the Council on Nutrition, 41(3), 18–23. Retrieved from http://proxy.stu.edu:2114/login.aspx?direct=true&db=ccm&AN=131588998&site=ehost-live&custid=s3296502Bechmann, C.R., Ling, W. F., Herbert, N. W., Laube, W. D., Smith, P. R., Casanova, R., & Weiss, M.P. (2014). Obstetrics and gynecology (7th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.Peacock, K., & Ketvertis, K.M. (2020). Menopause. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK507826/