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1. The document provides contact information for Mr. Lewishere and states that a resume will be attached. It also notes availability on November 1st with no time restrictions. 2. It describes 4 case study responses: asking Charlie additional medical questions, examining Olivia and discussing her medical concerns privately, addressing Todd's frequent medical visits with his manager while maintaining patient privacy, and suggesting Sarah speak to her manager about an unspecified issue.
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Insight into the use of probability in the medical community:
Probability is a recurring theme in medical practice. No doctor who returns home from a busy day at the hospital is spared the nagging feeling that some of his diagnoses may turn out to be wrong, or some of his treatments may not lead to the expected cure. Encountering the unexpected is an occupational hazard in clinical practice. Doctors after some experience in their profession reconcile to the fact that diagnosis and prognosis always have varying degrees of uncertainty and at best can be stated as probable in a particular case.
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The document discusses the clinical interview, which is a major tool used by clinical psychologists to gather data and make decisions. It defines the clinical interview and describes its importance. Several types of interviews are covered, including intake interviews to understand a patient's symptoms, case history interviews to obtain background information, mental status examinations to assess psychological functioning, crisis interviews for emergency situations, diagnostic interviews to determine appropriate treatment, and structured interviews with standardized questions. The document also addresses reliability and validity considerations for clinical interviews.
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In the mid 1970s, a nursing educator in Idaho had contact, through a student, with a female client who had chronic myelogenous leukemia. This form of leukemia can often be managed for years with little or no chemotherapy. The woman had done well for about twelve years and ascribed her good condition to health foods and a strict nutritional regime. However, her condition had turned worse several weeks before and her physician had advised her that she needed chemotherapy if she were to have any chance at survival. The physician had also advised her of the potential side effects of the therapy including hair loss, nausea, fever, and immune system suppression.
The woman consented to the therapy and signed the appropriate forms, but later, she began to have second thoughts. The nursing educator and student had given the patient one dose of the therapy when the woman began to cry and express her reservations about the therapy. She questioned the nurse about alternative treatments to the use of chemotherapy. The patient related that she had accepted the therapy because her son had advised her that this was the best treatment. She related that she had not asked about alternate forms of treatment as the physician had indicated that chemotherapy was the only treatment indicated. The nurse did not discuss the patient's concerns with the physician, and later that evening, she talked to the patient about alternate therapies. In the discussion, rather nontraditional and controversial therapies were covered including reflexology and the use of laetrile. During the talk, the nurse made it very clear that the treatments under discussion were not sanctioned by the medical community.
The patient's feelings toward alternate therapies were strengthened by the evening's conversation; however, she continued with chemotherapy. The treatments, however, did not bring remission to her crisis and she died two weeks later. Upon hearing about the conversation between the off duty nurse educator and his patient, the physician brought charges against the nurse for unprofessional conduct and interfering with the patient-physician relationship. (In re Tuma, 1977).
1. What, if anything, did the nurse do wrong?
2. Had she moved beyond her scope of practice?
3. Could the nurse's conduct be justified under the patient advocate portion of her role?
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Support your responses with evidence and cite your sources.
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History 1 web 2004
This document outlines the structure and expectations of a physical diagnosis course. It discusses the importance of developing interviewing and physical examination skills. Students will be evaluated based on their performance in tutorials, exams, and how they respect patients, peers and instructors. The goal is for students to learn how to obtain a history, perform an exam, organize findings and use this information to help patients.
The Profile4-year-old biracial male living with his grandmother
The patient profile is a 76-year-old black male with disabilities living in an urban setting. The discussion summarizes how the clinician would conduct an interview and assessment for this patient. Effective communication techniques are emphasized, such as speaking slowly and clearly given potential hearing loss. A full assessment of functional status, activities of daily living, fall risk, medications, mental health, and social support systems would be conducted using tools like HEEADSSS. Targeted questions focus on living situation, assistance needs, falls history, medications, expenses, and substance use. Risk factors addressed include falls, functional impairment, polypharmacy, and potential for depression or substance abuse issues.
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Tina meets the diagnostic criteria for generalized anxiety disorder, specific phobia, and panic disorder with agoraphobia based on her symptoms. Her disorders can be explained from various perspectives including socio-cultural, existential, cognitive, and biological factors. Treatment options that may help Tina include humanistic therapy to address underlying conflicts, rational emotive therapy to change irrational beliefs, and medications for antidepressants and anti-anxiety to reduce panic symptoms. An integrated treatment approach targeting all her comorbid disorders could provide the most benefit.
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Naomi is asked to assess whether Lisa, a 15-year-old girl with low intellectual function, can validly consent to labioplasty surgery. Naomi accepts the role but does not disclose her personal bias against cosmetic surgery. She conducts a thorough assessment of Lisa's mental health and intellectual capacity. This includes tests for depression, anxiety, body dysmorphia, trauma, and IQ. Based on the results, which show Lisa has the capacity to understand the procedure, Naomi recommends the committee find Lisa able to consent. She also proposes family meetings and limits on further surgeries to ensure Lisa's best interests and care.
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Sally S. is a client with bipolar disorder and addictions to opiates, amphetamines, and alcohol who overdosed and had to be resuscitated. The therapist contacted emergency services, Sally's doctor, sponsor, and other support systems to ensure her safety and proper care. Sally was hospitalized initially and then transferred to an inpatient treatment program. After treatment, she received disability benefits and began an outpatient program along with vocational rehabilitation to find stable housing and employment.
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An anesthesiologist administers anesthesia to patients undergoing surgery to relieve their pain and calm their nerves. The job involves monitoring patients' vital signs during surgery, deciding on appropriate treatments, and prescribing medication. It requires four years of undergraduate education, four years of medical school, and three to eight years of residency training. While the training is lengthy, it is a growing field with high earnings potentially exceeding $186,000 annually. A related occupation is pediatrician, which also involves extensive schooling but treats children instead of surgical patients.
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- The document discusses ISBAR, a communication tool adapted from SBAR to standardize verbal and written communication, especially telephone referrals.
- ISBAR stands for Identify, Situation, Background, Assessment, Request. It provides a framework to organize crucial patient information when communicating between clinicians.
- The document encourages readers to practice using ISBAR through examples and roleplays to improve referral quality and patient safety.
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WHAT IS PROBABILITY?
Insight into the use of probability in the medical community:
Probability is a recurring theme in medical practice. No doctor who returns home from a busy day at the hospital is spared the nagging feeling that some of his diagnoses may turn out to be wrong, or some of his treatments may not lead to the expected cure. Encountering the unexpected is an occupational hazard in clinical practice. Doctors after some experience in their profession reconcile to the fact that diagnosis and prognosis always have varying degrees of uncertainty and at best can be stated as probable in a particular case.
Critical appraisal of medical journals also leads to the same gut feeling. One is bombarded with new research results, but experience dictates that well-established facts of today may be refuted in some other scientific publication in the following weeks or months. When a practicing clinician reads that some new treatment is superior to the conventional one, he will assess the evidence critically, and at best he will conclude that probably it is true.
Types of probabilities
Suppose that we want to determine the probability of obtaining an ace from a pack of cards (which, let us assume has been tampered with by a dishonest gambler), we proceed by drawing a card from the pack a large number of times, as we know in the long run, the observed frequency will approach the true probability. Since there are 4 aces in a 52 card deck, the real probably of drawing an ace on a single draw would be ¼ or 7.69%. Mathematicians often state that a probability is a long-run frequency. Consider the statement, “The cure for Alzheimer’s disease will probably be discovered in the coming decade.” This statement does not indicate the basis of this expectation or belief. However, it may be based on the present state of research in Alzheimer’s. A probabilistic statement incorporates some amount of uncertainty, which may be quantified as follows: A politician may state that there is a fifty-fifty chance of winning the next election.
Consider a 26-year-old married female patient who suffered from severe abdominal pain is referred to a hospital. She is also having amenorrhea for the past 4 months. The pain is located in the left lower abdomen. The gynecologist who examines her concludes that there is a 30% probability that the patient is suffering from ectopic pregnancy.
If you were to ask the gynecologist to explain on what basis the diagnosis of ectopic pregnancy is suspected, the Dr. might state that he/she has studied a large number of successive patients with this symptom complex of lower abdominal pain with amenorrhea, and that a subsequent laparotomy revealed an ectopic pregnancy in 30% of the cases.
If we accept that the study cited is large enough to make us assume that the possibility of the observed frequency of ectopic pregnancy, it is natural to conclude that the gynecologist’s probability claim is ‘evidence based’.
Medical False Positives a.
Welcome to Darling Downs Health
Here's what to expect during your time in our hospitals. If you have any questions, don't hesitate to ask. Read on for more information on parking, what to bring to hospital, and information for visitors.
Lesson 16
The document discusses the clinical interview, which is a major tool used by clinical psychologists to gather data and make decisions. It defines the clinical interview and describes its importance. Several types of interviews are covered, including intake interviews to understand a patient's symptoms, case history interviews to obtain background information, mental status examinations to assess psychological functioning, crisis interviews for emergency situations, diagnostic interviews to determine appropriate treatment, and structured interviews with standardized questions. The document also addresses reliability and validity considerations for clinical interviews.
Interview & Interrogation
This document provides guidance on conducting interviews and interrogations. It discusses establishing rapport with interviewees, reading body language for signs of deception, using alternative questioning techniques to obtain confessions, analyzing statements for truthfulness, and dealing with juveniles and requests for legal counsel. The goal is to objectively gather facts, discover new evidence and leads, and establish the truth through respectful but firm questioning.
For this assignment, consider the following case and then using th.docx
For this assignment, consider the following case and then using the internet, course materials, and the Library, compose reasoned responses to the questions that follow.
In the mid 1970s, a nursing educator in Idaho had contact, through a student, with a female client who had chronic myelogenous leukemia. This form of leukemia can often be managed for years with little or no chemotherapy. The woman had done well for about twelve years and ascribed her good condition to health foods and a strict nutritional regime. However, her condition had turned worse several weeks before and her physician had advised her that she needed chemotherapy if she were to have any chance at survival. The physician had also advised her of the potential side effects of the therapy including hair loss, nausea, fever, and immune system suppression.
The woman consented to the therapy and signed the appropriate forms, but later, she began to have second thoughts. The nursing educator and student had given the patient one dose of the therapy when the woman began to cry and express her reservations about the therapy. She questioned the nurse about alternative treatments to the use of chemotherapy. The patient related that she had accepted the therapy because her son had advised her that this was the best treatment. She related that she had not asked about alternate forms of treatment as the physician had indicated that chemotherapy was the only treatment indicated. The nurse did not discuss the patient's concerns with the physician, and later that evening, she talked to the patient about alternate therapies. In the discussion, rather nontraditional and controversial therapies were covered including reflexology and the use of laetrile. During the talk, the nurse made it very clear that the treatments under discussion were not sanctioned by the medical community.
The patient's feelings toward alternate therapies were strengthened by the evening's conversation; however, she continued with chemotherapy. The treatments, however, did not bring remission to her crisis and she died two weeks later. Upon hearing about the conversation between the off duty nurse educator and his patient, the physician brought charges against the nurse for unprofessional conduct and interfering with the patient-physician relationship. (In re Tuma, 1977).
1. What, if anything, did the nurse do wrong?
2. Had she moved beyond her scope of practice?
3. Could the nurse's conduct be justified under the patient advocate portion of her role?
4. If you were a member of the state board for nursing and had to decide the issue of unprofessional conduct and interference with the patient-physician relationship, would you sanction the nurse?
Support your responses with evidence and cite your sources.
Length 4 pages not counting the case. At least 4 references; scholarly sources
COURSE MATERIAL INFORMATION
: Ethical Principles and Dilemmas of Confidentiality, Veracity, and Fidelity
Health care .
AETCOM module: Bioethics for Undergraduate Medical Students
The Attitude, Ethics & Communication module introduced by the National Medical Commission is being followed in Medical Colleges. Here's a simple understanding of aspects on Bioethics & solution to Phase 2 MBBS modules
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This document discusses strategies for effectively communicating bad news to patients. It begins by defining bad news and outlining objectives for discussing this topic. Some key strategies discussed for breaking bad news include the SPIKES protocol, which involves setting up the conversation, assessing the patient's perception, allowing them to invite information, providing knowledge of the medical facts, expressing empathy, and summarizing next steps. The document also identifies obstacles to communicating bad news and emphasizes practicing with compassion.
Communication with patients
The document discusses communication strategies for difficult patient interactions. It provides a framework called NURS to improve communication by naming the patient's emotions, understanding and validating them, respecting their experience, and supporting partnership. Specific types of difficult patients are described such as angry, non-compliant, seductive, and manipulative patients. Strategies are outlined for each type, emphasizing active listening, validating concerns, and setting clear boundaries. The goal is to de-escalate conflicts and establish trust and shared understanding to improve the patient-provider relationship.
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Mr
- 1. Mr. Lewishere isthe informationthatyourrequestedperthe email. Contact # 804-243-4985 Date of Birth 09/27 My resume will be attached I will be availableonNovember1,2016 withnottime restrictions Case StudyResponses 1. I wouldas Charlie more questionsaboutthe injurysuchashas ithappenedbefore, the pain level anddoesthe painradiate anywhere else. Iwouldalsoremindhimof the policythatisin place and make sure that he understandsthe repercussionsthatmayoccur. 2. I wouldletOliviaknowthatshe isa safetyconcernfor herself andothersandthat we can better talkabout herconditioninthe medical office. Iwouldfurtherexamine hertake vital signsand ask herhas thiseverhappenedbefore,whatmedical historydoyouhave andare youtakingnew prescribedmedications. Iwill tryto make explaintoherthe safetyconcernandthe risksof not seekingmedical attentionaswell asassuringherthatseekingmedical attentionisnothingtobe afraidof. 3. I will explaintoToddwhatI have noticedfromhisactivitywithcomingtothe medical office and the breaktime intervals. AsforTodd’smanager,I wouldlethimknow thatI will addressthe situation withToddandfinda solutiontothe problem. The issue maynotbe somethingIcan discusswithTodd’smanager(HIPPA) laws,sothere isapossibilitythatsomeoneelsemayhave to getinvolved. 4. I wouldlistentoSarah’sviewpointwithconcernandsuggesttoherthat thismay be an issue that she should speaktoher Managerabout.