2.1 study guide
If a physician is rude or offensive, how might that affect the patient interview and ultimately hinder the diagnosis?
If a physician is rude or offensive, their patient may not feel comfortable sharing sensitive information with them. This could result in the physician receiving false or incomplete information about a patient's health history, which could compromise their treatment plan and care.
Describe the role of a Primary Care Physician. What are they trained to do? Please give examples of the types of patients/cases they typically see.
Primary Care Physicians are specialists that are trained to work on the front line of a health care system. They provide care for any health problems that a patient might have. Typically, primary care physicians are the first contact for a person with a basic health concern. They provide routine checkups and physicals, as well as ongoing care to patients with chronic or persistent, long-lasting illnesses. Primary Care Physicians see patients of all ages, and within varying health states, from someone with no concerns at age 55 for an annual checkup, to a 21 year old with suspected strep throat. They often refer patients to specialists, such as a dermatologist or endocrinologist, when the need arises.
Explain the difference between the Pulmonary and Systemic circuits.
Pulmonary Circulation moves blood between the heart and lungs, from the heart (RV to Pulmonary Arteries) to the lungs and back to the heart (Pulmonary Veins into the LA). Systemic circulation moves blood between the heart and the rest of the body, providing the functional blood supply to all body tissues. Systemic circulation carries oxygenated blood from the Left Ventricle through the Aorta/arteries, through the capillaries and into all tissues of the body.
List the pathway of blood through the heart, starting from the Vena Cava and ending with the aorta.
1. Vena Cava (superior or inferior) 2. Right Atrium 3. Tricuspid Valve 4. Right Ventricle 5. Pulmonary Valve 6. Pulmonary Arteries 7. Lungs 8. Pulmonary Veins 9. Left Atrium 10. Bicuspid/Mitral Valve 11. Left Ventricle 12. Aortic Valve 13. Aorta
In order to make an accurate diagnosis, why is it important to pay attention to more than just the patient's spoken words?
The patient may be embarrassed, shy, and/or unaware. The patient may not have gone to medical school, and is likely not an expert in what is relevant pertaining to their health. They may also be worried about repercussions if doing something they know isn't good for them, like smoking or taking medication not as prescribed. It is important to pay attention to the patient's nonverbal cues and body language during their appointment, along with the things they are verbalizing to you to obtain the full picture and help make an accurate treatment plan.
medical assistant
unlicensed caregiver who works primarily in a doctor's office and or clinic. They assist the doctor/medical director with a wide variety of duties, including but not limited to taking medical histories, explaining medical procedures to patients, collecting and preparing laboratory specimens, instructing patients about medications and special diets, preparing patients for examinations, and performing basic laboratory tests.
Medical Technicians
use sophisticated equipment while working alongside directly with patients, and/or work indirectly for patient care within a laboratory setting. An example would be a phlebotomist, someone who draws blood, and a histotechnician, someone who analyzes tissues. They do not complete patient physicals, but work in a specific setting and are experts with equipment for a particular purpose. Ex: X-ray, MRI, ultrasound, etc.
What are some ways in which a health care provider can show empathy while working with a diverse group of patients?
Being aware that patients will come from all areas of life, may not have the same life experiences as you or your other patients Offering options in care, based on a patient's financial/insurance situation which may vary greatly in any practice Asking patients for their preferred pronouns Not assuming that everyone celebrates the same holidays Being aware of different culturally relevant traditions and practices as they pertain to medicine
Imagine you are a doctor running behind schedule due to the needs of a patient earlier in the morning. This has backed up all of your other appointments for the day and has led to several grumpy and rude patients. How would you balance being a good listener and providing solid care with the logistics of the day?
Being honest with your patients, thanking them for their patience and explaining why your office is behind that day. Not leaving patients "in the dark", informing them of longer than normal wait times and offering them the opportunity to reschedule if desired. Offering cold water, new magazines, clean toys for children etc. in your waiting rooms Intentionally scheduling gaps in the day beforehand to account for instances where this might happen Trying to truly listen to your patients during their interviews, while being cognizant of time and not elaborating or offering too many personal anecdotes to keep the productive parts of the conversation moving forward
What are the components of a patient's medical history? Please list each one below and describe how it can help produce an accurate treatment plan.
Current History: The patient's chief complaint, along with any other current health issues/concerns, symptoms, and any treatments or tests the patient has recently had or is scheduled to have related to these concerns/conditions. Nutrition, allergies, medications, health habits, (such as exercise), is also a part of the patient's current medical history. Previous History: Any information about past health issues/concerns. This includes past procedures/surgeries, medications, vaccinations, and previous hospital stays. Social History: This information addresses aspects of the patient's life, such as their living situation, their occupation, school, travel, social habits, diet, and any other activities that could have a direct or indirect impact on health. Family History: Includes medical information about the patient's close relatives. For example, a patient may have inherited a health condition that could place them at a higher risk of having many disorders, such as heart disease, high blood pressure, stroke, certain cancers, or diabetes.
Consider other aspects of patient/physician interaction. Explain the differences between empathy, tact, and demeanor, and explain how each is beneficial in the clinical setting.
Empathy is the ability to place yourself in someone else's shoes, and to consider their perspective/perceive things as they might be, even though you may not have ever shared their experience before. Medical professionals who can empathize with their patients are able to show kindness and offer no judgement, only support. Tact is the ability to be sensitive with your words. Medical professionals who are able to be tactful are mindful of what they are saying to their patients and how they say these things. People who are not able to show tact may come of as abrasive, harsh, or mean, which could hinder a medical professional's ability to gain their patient's trust and respect, which may ultimately hinder a diagnosis. Demeanor: One's outward behaviour. The demeanor of a medical professional to their patient is extremely important in earning and maintaining trust and respect, and obtaining truthful information in order to come to an accurate diagnosis. A medical professional's demeanor should be kind, supportive, and compassionate. They should pay attention to their body language, and maintain an approachable, easy-going demeanor during their line of questioning and beyond.
In the space below, please describe the routine physical test performed to determine potential areas of concern regarding a patient's: gait, memory, peripheral vision, and facial nerve function.
Gait: walking in straight line, turning on a point Memory: asking five simple questions and having the patient repeat their answers minutes later Peripheral Version: having the patient stare straight ahead and introduce objects into their side vision view slowly, asking them to alert you when the object is noted in their periphery Facial Nerve Function: Ask the patient to smile, stick out their tongue, move their eyebrows up and down; look for facial symmetry in movements
In the space below, please explain why it is important for a health care provider to maintain accurate records.
It is important for a health care provider to maintain accurate patient records so that their are no gaps in a patient's medical history. Furthermore, accurate patient records provide the full picture of relevant information about a patient's past and current state of health, which fosters clues and next steps towards maintaining accurate diagnoses.
In the space below, please explain the differences between the following careers: Licensed Practical Nurse (LPN), Registered Nurse (RN), Nurse Practitioner (NP) regarding education and training, certification, and main job duties.
LPNs usually provide more basic nursing care and are typically responsible for patient comfort, while RNs administer medication, wound care response, perform and lead emergency response and treatments, and offer educations advice to patients and the community LPNs will likely earn lower salaries than RNs because RNs have more advanced training and may carry out more complex types of patient care Nurse practitioners perform more training than RNs, and are given more autonomy In many states, NPs are able to work independently and have their own offices, while RNs must work under a clinician, such as a doctor or a NP
In the space below, please explain some of the tests completed in a routine physical exam inside the nose, ears, eyes, and throat.
Look: For inflammation, redness, spots, drainage, fluid accumulation, mucus, secretions Listen: for sounds: Crackling, wheezing, stridor
What steps can a patient take to maintain healthy cholesterol levels and prevent heart disease?
Maintain a diet low in saturated (animal, red meat) fat and high in unsaturated (plant) fats. Daily exercise, monitor blood pressure and cholesterol, in some cases cholesterol-lowering medication and/or blood thinners
the key elements that must be collected during the medical interview: medical history, chief complaint, physical signs, symptoms.
Medical History: A record of information about a patient's past and current health. This includes information about the patient's habits, lifestyle, past surgeries and/or hospital stays, and medications, along with the health of their family. Physical Signs: Pieces of evidence that can be observed externally, that indicate an illness. For example: Coughing, a rash, elevated temperature, slurred speech, body language, anxiety, etc. Symptoms: Any subjective evidence of disease that a patient perceives/verbalizes, such as nausea, aches, loss of appetite, and fatigue. Symptoms allow the healthcare provider to narrow down the possible conditions that may be affecting the patient, and subsequently run tests to confirm a diagnosis. Chief Complaint: The patient's description of what they feel is their main health problem/concern.
please list and describe behaviors and strategies that foster effective conversations with a patient.
Questions about diet, food intake, social preferences, weather, local sports teams, hobbies Personal life/non-clinical questions to foster comfort/trust The medical professional should be friendly, kind, approachable, perhaps making jokes, and also be able to empathize with their patient even if they have not shared the same experience. It helps to establish a friendly rapport, to sit across from the patient and maintain eye contact, to truly listen to the patient and to take their questions/answers one at a time, and also to try and take brief, concise notes but also frequently look up from their clipboard/computer/tablet while the patient is talking. The medical professional should pay attention to the patient's facial expressions and gestures, taking note of any that seem relevant. Nonverbal cues and body language could provide clues that help to guide productive follow-up questions. It is also extremely important to be respectful and open-minded, and be careful not to make any pre-judgements or assumptions about the patient.
What are some of the benefits of self-monitoring vital signs at home versus having your doctor monitor them, such as blood pressure, oxygen saturation, blood glucose, etc.? What are some of the disadvantages of this?
Self- Monitoring: Do not have to go into office/zero exposure to pathogens elsewhere, comfort of your own home, can take easily every day (consistence of data) Home care is performed by non-medical experts, may not know when there is a problem/need to be seen, may cause additional anxiety when not necessary Doctor Monitoring: Expert is collecting the data, can provide reassurance and emergency treatment on the spot if necessary, can be costly and time consuming, and also may expose vulnerable patients to pathogens within health care facilities instead of remaining in their own homes
A common phrase involving the cardiovascular system states: Arteries carry oxygenated blood and veins carry deoxygenated blood. In the human body, where is the exception to this "rule"? Please explain your answer.
The Pulmonary Circuit within the heart is the exception to this rule. Most arteries in the body are oxygenated, having been to the heart (and lungs) and are now leaving the heart to oxygenate the rest of the body; however the Pulmonary Arteries are leaving the heart to head to the lungs, in order for gas exchange to happen and to take in oxygen there. So the Pulmonary Arteries are deoxygenated. Similarly, the Pulmonary Veins are rich in oxygen, having just been to the lungs for gas exchange and re-entering the oxygenated part (left side) of the heart. While most veins in the body supply deoxygenated blood to the heart, the Pulmonary Veins are richly oxygenated.
How do vital signs allow medical professionals to access a patient's physiology and overall health?
Vital signs (when taking consistently and often) provide the full picture of a patient's health, and can offer information about the trajectory of a disease or health concern. Vital signs can be a form of preventative care and identify a problem before it becomes emergent.
Please explain why physical exams can be considered "preventative medicine."
When taken consistently and often, vital signs may track patient health information and identify a health concern/problem before it becomes emergent.
nurse
a licensed health care professional who is skilled in promoting and maintaining health, and provides a wide variety of services to patients and medical health professionals. Nurses may work in a patient's home, in a hospital, medical office building, outpatient clinic, urgent care facility, or any other healthcare organization. Depending on their speciality and certification, a nurse may conduct patient physical exams, take detailed health care histories, listen to patients and analyze their physical and emotional needs, providing counseling care and education to patients, coordinate care with doctors and other health care providers and specialists, check a patient's vital signs, draw blood, and perform other health related testing, and many more functions related to a patient's treatment plan, and physical and emotional well-being.
pediatrician
a specialist physician who provides medical care to infants, children, and adolescents. Pediatricians do not treat adults, or anyone over the age of 18. They are specially trained to treat children, who require different diagnostic approaches, tools, and treatment plans than those of adults.
