Consultation Process in Family Practice.pptx
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The ‘Consultation’ is the most fundamental skill in family practice. The core clinical skill of the family physician is the ability to INTERVIEW the patient effectively. Mastering consultation arts is essential for good patient care. The consultation can take place in the primary health care center, the hospital, or the patient’s home.
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The document outlines the scientific process of nursing, which involves assessment, nursing diagnosis, planning, implementation, and evaluation. It describes these components in detail. The nursing process is a systematic method nurses use to provide individualized care by collecting data, identifying issues or problems, setting goals, implementing interventions, and evaluating outcomes. It is a cyclic and dynamic problem-solving approach that is client-centered.
Nursing Process.pptx
The nursing process involves 5 steps: assessment, diagnosis, planning, implementation, and evaluation. It is a systematic, critical thinking process that nurses use to provide individualized care. During assessment, nurses collect both subjective and objective client data to identify health problems. They then make nursing diagnoses to label each problem. Next, they plan care by setting goals and selecting interventions. Nurses then implement the planned care and document their actions. Finally, they evaluate if the goals were achieved and the care plan was effective.
Nursing process
The document discusses the nursing process, which includes assessment, nursing diagnosis, planning, implementation, and evaluation. It describes each component in detail. Assessment involves collecting client data through various methods. Nursing diagnosis identifies client problems based on the assessment. Planning establishes goals and interventions. Implementation carries out the planned interventions. Evaluation assesses client progress and intervention effectiveness. The nursing process is a systematic approach to providing individualized care.
nursing process (1).pptx
The nursing process is a systematic, 5-step method for planning and providing individualized nursing care: 1) assessment, 2) diagnosis, 3) planning, 4) implementation, and 5) evaluation. It involves collecting client data, identifying issues, setting goals and interventions, executing the care plan, and determining its effectiveness. The nursing process focuses on the client's response to health issues and promotes holistic, evidence-based, and collaborative care.
Nursing process.pptx
The document discusses the nursing process, which is a systematic method for planning and providing nursing care. It outlines the key steps as assessment, diagnosis, planning, implementation, and evaluation. Assessment involves collecting both subjective and objective data from various sources like the client, family, and medical records. This data is then organized, interpreted, and documented. The nursing diagnosis phase further analyzes the collected data to identify any actual or potential health problems nurses can address. The overall nursing process provides structure to nursing care and allows for continuity and quality of care.
Unit-2. Assessment in Nursing process.ppt
This presentation is about an overview of assessment in the nursing process
Kumpulan audit klinik
1. The document outlines a draft clinical audit process for medical officers at health clinics to improve patient care quality.
2. The objectives are to ensure competency and safety, identify management weaknesses, and ensure comprehensive care.
3. The audit involves reviewing patient records and observing consultations using standardized forms. Medical officers will be audited at least twice yearly.
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The Comprehensive Geriatric Assessment.pptx
Comprehensive Geriatric Assessment (CGA) is a process of care comprising a number of steps. Initially, a multidimensional holistic assessment of an older person considers health and wellbeing and leads to the formulation of a plan to address issues which are of concern to the older person (and their family and carers when relevant). Interventions are then arranged in support of the plan. Progress is reviewed and the original plan reassessed at appropriate intervals with the interventions reconsidered accordingly.
H. Pylori in Geriatric People.pptx
Helicobacter pylori (H. pylori) has so far infected more than half the global population. It is the most important and controllable risk factor for gastric cancer. The elderly, who are at a higher incidence of the infection, are also commonly found to develop antibiotic resistance. The symptoms, diagnosis, clinical features (of gastric or extra-digestive diseases), and treatment of H. pylori infection in the elderly, are different from that in the non-elderly. Health conditions, including comorbidities and combined medication have limited the use of regular therapies in elderly patients. However, they can still benefit from eradication therapy, thus preventing gastric mucosal lesions and gastric cancer. In addition, new approaches, such as dual therapy and complementary therapy, have the potential to treat older patients with H. pylori infection.
DYSLIPIDAEMIA Management the European approach.pptx
Atherosclerotic cardiovascular diseases are responsible for millions of deaths worldwide each year.
More patients are surviving their first CVD event and are at high-risk of recurrences.
The prevalence of some risk factors, notably diabetes and obesity, is increasing.
In recent years, a number of international and regional guidelines were developed to deal with this problem.
Frailty in older adults.pptx
Frailty is a common clinical syndrome in older adults.
It is a risk factor for many health problems that older adults face.
Frailty is a major focus of geriatrics medicine.
This lecture will review the definition, epidemiology, etiologies, and consequences of frailty.
It will also discuss how to identify and manage frail older adults.
Primary Health Care.pptx
PHC represents a philosophical approach to health and health care.
This approach is characterized by a holistic understanding of health as well-being, rather than the absence of disease.
It integrates knowledge of the medical, biological, physical, social, psychological, and behavioral sciences.
PHC provides a comprehensive care including health promotion, illness prevention, treatment and care of the sick, and rehabilitation.
Communication Skills in Medical Practice.pptx
The document discusses communication in medical practice. It defines communication as a two-way process involving a sender, message, channel, receiver and feedback. It identifies the key elements of communication including encoding, decoding and understanding. The document explores different forms of communication including verbal, non-verbal and paralanguage. It defines doctor-patient communication and its benefits. Barriers to communication are discussed along with strategies to improve communication such as active listening, using clear speech and silence appropriately.
Polypharmacy and Rational Prescribing in Elderly Patients.pptx
Polypharmacy is typically defined as the prescription of five or more medications.
It also refers to the prescription of medications that do not have a specific current indication, that duplicate other medications, or that are known to be ineffective for the condition being treated.
In other words, polypharmacy is the use of multiple medications that are unnecessary and have the potential to do more harm than good.
Cardiac Axis Simplified.pptx
The cardiac axis represents the average direction of electrical depolarization through the ventricles. It is normally between -30 and 90 degrees but can deviate right or left. Right axis deviation occurs when the axis swings right of normal, seen as a negative deflection in lead I. Left axis deviation occurs when the axis swings left of normal, seen as a negative deflection in lead II. Specific conduction defects or conditions can cause axis deviation by altering the pathways of ventricular depolarization.
Falls in Elderly People.pptx
The document discusses falls in elderly people, which are a major public health issue. Approximately 30% of people over 65 fall each year. Falls can cause serious injuries like fractures and head traumas and increased risk of death. Risk factors for falls include age, weakness, poor vision and balance, fear of falling, and medical conditions. A falls assessment evaluates history, medications, vision, gait, balance, neurological and cardiovascular systems. Management includes treating risk factors, exercises, modifying home hazards, and reducing high-risk medications.
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هو نهج جديد يتم تطبيقه في بعض مراكز الرعاية الصحية الأولية، يهدف الى دعم وتحسين نظام الرعاية الصحية الأولية والمساهمة بتوفير حزمة الخدمات الصحية الأساسية بجودة عالية، وبتكلفة يسيرة، ومستندة الى الأدلة العلمية المحدثة.
Depression in Elderly People.pptx
Depression in elderly people, also known as late-life depression, is a clinical syndrome characterized by persistent feelings of sadness, loss of interest or pleasure in activities, and a range of emotional, cognitive, and physical symptoms that significantly impact the individual's functioning and quality of life.
Insulin Therapy.pptx
Insulin has three characteristics:
Onset: is the length of time before insulin reaches the bloodstream and begins lowering blood glucose.
Peak time: is the time during which insulin is at maximum strength in terms of lowering blood glucose.
Duration: is how long insulin continues to lower blood glucose.
Constipation in Elderly People.pptx
Constipation is one of the most frequent GIT disorders encountered among older adults in clinical practice.
Up to 50% of elderly experiencing constipation at some point in their lives.
Elderly women are having 2–3 times more constipation than men.
Approximately, 30% of older adults are regular nonprescription laxative users, such as stimulant and bulking laxatives.
Osteoporosis in Elderly People.pptx
Osteoporosis is a chronic, progressive skeletal disease characterized by low bone mass, microarchitecture deterioration of bone tissue, bone fragility, and a consequent increase in fracture risk.
Managing Hypertension in Primary Care
In this overview, we draw inspiration from the article titled "Managing Hypertension in Primary Care“, published in the Canadian Family Physician journal (Vol 65: October 2019).
The article, edited by Khrystine Waked PharmD, Jeff Nagge PharmD, and Kelly Grindrod PharmD MSc,.
It provides valuable insights and evidence-based approaches to tackle Hypertension Management In Primary Care.
By incorporating the recommendations discussed in this article, we can enhance our ability to manage hypertension and ultimately improving patient outcomes and quality of life.
المداخلات المبسطة للتحرر من التبغ.pptx
التدخين هو عملية يتم فيها حرق مادة التبغ وإستنشاقه.
يعتبر التدخين واحداً من أسوأ الأختراعات التي عرفها التاريخ ومن أهم المشاكل التي تواجه مجتمعات العالم وخاصة النامية منها.
لوحظ تسارع إنتشار هذه الظاهرة بين الفئات العمرية كافة وخاصة فئة الشباب والمراهقين وبين أوساط النساء أيضاً.
إن ضرره يتعدى الجانب الصحي, فهو يساهم بحدوث أضرار بيئية وأجتماعية وأقتصادية كبيرة.
The Patient Hidden Agenda.pptx
To the consultation, the patient brings ideas, concerns, expectations, feelings and emotions related to his health problem. These areas are often grouped together and called the “Patent’s Agenda”.
Some of these emotional concerns may be explicit “Open Agenda”, but a large part may never be expressed openly if doctors do not proactively elicit them.
In 1981, Barsky, an American psychiatrist, gave a name to this assortment of hidden concerns; he called it the “Hidden Agenda”.
An important objective of a medical consultation is to understand as much as possible these hidden emotions.
Unless the doctor is able to fathom these, the patient may only be left with therapy that will treat his most obvious symptoms but not resolve the underlying problems.
Referral Process in Family Practice.pptx
It the process that involve seeking the assistance of another specialist with a resource to guide in managing a specific problem and sharing responsibility in patient care.
Ideally, it would result in “a closed referral loop”, in which the referral appointment is completed and results are then shared with the patient’s referring physician.
Apart from consultants and hospitals, a referral might be considered to family physician colleagues with special interests or expertise, and other members of the primary health care team, such as physiotherapists, dietitians, and social workers.
How To Pass Your OSCE.pptx
The OSCE is an approach to the assessment of clinical competence in a structured way with attention being paid to the objectivity of the examination.
Ethical Issues in Obtaining Informed Consent.pptx
Medical ethics is a set of moral principles, beliefs and values that guide decisions about patient care.
It is an integral part of good medical practice.
The health care professional uses knowledge, experience, and judgment and considers the ethical principles to make decisions on management recommendations.
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
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Physiology of Special Chemical Sensation of Taste
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Novas diretrizes da OMS para os cuidados perinatais de mais qualidadeProf. Marcus Renato de Carvalho
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Non-respiratory Functions of the Lungs.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The Best Ayurvedic Antacid Tablets in India
Treat the symptoms of indigestion, heartburn and stomach reflux with the 10 Best Ayurvedic Antacid Tablets in India.
Physiology of Chemical Sensation of smell.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Consultation Process in Family Practice.pptx
- 1. Consultation Process in Family Practice Ahmed Khairi Mshari Consultant Family Physician drahmadtemimi@gmail.com
- 2. • Consultation Definition • Characteristic Features of Family Practice Consultation • Stages of the Consultation • Case Scenario
- 4. Consultation in Family Practice
- 5. Characteristic Features of Family Practice Consultation
- 7. The Patient’s Agenda The Patient’s Agenda
- 9. Reasons for the Patient’s Attendance
- 10. STAGES OF THE CONSULTATION 1 • Establishing Rapport Stage. 2 • Diagnostic Stage: History Taking. Physical Examination. Investigations. 3 • Management Stage: Patient Education. Prescribing Medication. Referral.
- 12. To establish an effective rapport, the doctor needs to consider the following techniques: Establishing Rapport Stage
- 13. DIAGNOSTIC STAGE / History Taking 1. Inviting the Patient’s Story. 2. Expanding and Clarifying the Patient’s Story. 3. Establishing an Agenda for the Interview. 4. Creating a Shared Understanding of the Problem. 5. Generating Diagnostic Hypotheses. 6. Negotiating the Plan.
- 14. History Taking
- 15. History Taking
- 16. History Taking
- 17. History Taking
- 18. History Taking — What do you think is causing your health problem? — Why do you think that is happening? — What are you worried that it might be? — What was the worst thing you were thinking it might be? — What are you hoping we might be able to do for this? — How best might I help you with this?
- 19. History Taking
- 20. DIAGNOSTIC STAGE / Physical Examination
- 21. Physical Examination For medico-legal purposes, the following guidelines have been recommended for physical examinations:
- 22. DIAGNOSTIC STAGE / Investigations
- 23. Investigations Generally, investigations should be performed only when the following criteria are satisfied:
- 24. The management stage of the consultation may immediately follow history taking, physical examination, investigations, or referral. This stage consists of 3 main processes: 1. Patient education, 2. Prescribing medication, and 3. Referral. MANAGEMENT STAGE
- 25. REFERRAL • One of the main family physician responsibilities is the coordination of the patient’s care, that is, the organization of health care services in order to meet the needs of the patient. • A key element of health care coordination is the referral of patients to health professionals. • 5% of patient problems seen in the family practice needs other medical specialist attention. MANAGEMENT STAGE
- 26. MANAGEMENT STAGE / Patient Education
- 27. Summarize the consultation and check the patient’s understanding.. Chunk and check. Give explanation in clear and well-organized fashion. Safetynetting. Invite questions and ask the patient to write down any questions to answer later. Provide your contact details in case further questions arise. Arrange a follow-up meeting. Thank the patient. Closing the Interview Session
- 28. CASE SCENARIO
- 29. CASE SCENARIO
- 30. CASE SCENARIO
- 31. CASE SCENARIO