During this first week of my guided practicum, I met with my preceptor and held an interactive discussion for about half an hour. This discussion was basically an informal orientation that was used to discuss the practicum details that I will be undertaking this semester, my objectives for this practicum and anticipated challenges. My goal for these practicum sessions is to develop the capacity to blend clinical expertise in diagnosing, treating, prevention and health management strategies (Dains, Bauman, and Scheibel, 2012).

In this day, my patient was 70 year old Caucasian Male who had undergone facet injection for chronic back pain and left-side Sciatica. The patient past health history includes hypertension, coronary artery disease, Type 11 Diabetes and hyper-lipidemia. When performing physical examination, I noticed that the patient abdomen was hard, distended and had hypoactive bowel sounds. The patient stated that it has been three days since the last bowel movement ………..