Patient Case Scenarios

Ms. Webster is a 28 year old female who presented to the ED via LEO under IVC by her mother for suicidal ideation and alcohol dependence. Ms. Webster denies allegations to nursing staff. Per documentation she appears intoxicated. Per documentation Ms. Webster states, "Going through withdrawals". Before assessment this clinician spoke with nursing staff about Ms. Webster, they reports she has been asking for Ativan since she has been placed in her room. They reports she informed them that she had not consumed any alcohol today. At the time of the assessment Ms. Webster is found sitting upright in her room. Ms. Webster reports she had a plan to hang herself. She states, " you know I have to say that to get into detox." Ms. Webster reports alcohol abuse as primary stressor contributing to her distress. She denies depressive symptoms. Ms. Webster states,

Mrs. Passmore is a 31 year old female who presented to the ED via LEO attempting to harm herself. Per documentation Mrs. Passmore reports someone taking her Klonopin several days ago and has not been able to take it. Today she allegedly tried to cut her wrist. She denies suicidal ideation, homicidal ideation, and symptoms of psychosis to nursing staff. At the time of the assessment Mrs. Passmore reports a mental health history of bipolar, anxiety, and depression. Mrs. Passmore noted she has only been hospitalized when she was 15 year old for behavior issues. She denies having a history of self harm or suicidal attempts. Mrs. Passmore reports recently she has been going through a lot. She reports her father died 3 weeks ago, financial issues,

The patient is a 10 year old male who presented to the ED with multiple lacerations on his left hand. The patient denies suicidal ideations, homicidal ideations, and symptoms of psychosis. The patient states, " I don't know why I cut myself." Later on, the patient denies threats towards other students and admits he cut himself because it felt good.

This response will describe my answers to the question: “If you are a doctor, what will you say to a patient who refuses vaccines like the patient Ofri encounters? Will there be any difference in what you say depending on whether the patient is an adult, or an adult refusing for their child?”. In Ofri’s article, she described her encounter with an adult patient who refused to receive an annual flu shot. She narrated the conversation between her and her patient and included her attempt to correct misconceptions the patient had concerning vaccinations while also respecting the patient’s view and ending with the claim that the most she could ask for is for the patient to walk away and think about the vaccine.

Case Scenario 1: It has become necessary to ration a vaccine for a contagious disease. There is only enough vaccine available to cover 75% of the U.S. population. It is necessary to determine an appropriate method for doing this. Analyze this case by applying each of the theories of Utilitarianism, Rights-based, Justice-based and Virtue-based ethics as discussed in Module 2. (20 points)

Patient is a 46 year old female who presented to the ED via EMS due to overdose on Benadryl. Patient reports financial issues with supporting her daughter going to college. Patient reports depressive symptoms of fatigue,worthlessness, hopelessness, tearfulness,irritable, and anhedonia. At the time of assessment, patient denies feeling suicidal or having a plan. While patient currently denies suicidal ideation and plan, review of the patient's medical documentation does not support that. When confronted about admitting being suicidal and having a plan, the patient presented guarded and later reports she felt like harming herself during overdose due to financial situation.The patient reports she does not want to let any of her daughters down.

The patient is a 33 year old female who presented to the ED with acute psychosis. Before the assessment the patient paranoia escalated, however she was stabilized and has been since. At the time of the assessment she appear to be calm, however answers minimal questions. Mrs. Luvianos Bringas was brought in by her family 12/10/16 for presecutory delusions, visual hallucinations, and unspecified delusions. Mrs .Luvianos answers a few questions by shacking her head. She current denies suicidal ideation, homicidal ideation, and symptoms of psychosis. Per documentation she believes her husband is trying to kill her. She states in MCM documentation they were trying to kill her because they were wearing different colors, red, black, and pink. She

Some of the most important issues that should be addressed before deciding where should Jack reside are the following:

1. I do believe that large pharmaceutical companies as well as doctors prescribing opioid medication should be held partially responsible in cases when patients are over-prescribed drugs. Although they are in no way actually forcing those patients who are over-prescribed these drugs to misuse them and it is ultimately the fault of the individual misusing the medication, they are, however, allowing for the the misuse.In regards to pharmaceutical companies, I think that they should be held responsible for marketing and allowing such drugs available to virtually the mass public opposed to only those that need it in order to increase their profits. If they would not advertise the medication to medical professionals as something that they could

As a young boy, fear isn't something to worry about, however, going to the dentist arises an uneasy emotion making it hard for clinicians to do their job. The unknown of what might happen such as seeing needles or the loud screeching of the drills is what heightens most children's fear. Nevertheless, the young boy in this image is trying to depict the opposite. Compared to everything around him, he is full of color, formulating all the attention to be centered around him. As young boys grow up, there is this stigma that they're fearless and unstoppable, his cowboy belt shows off his masculinity which has a strong connotation to strength and determination that he can make it through the war that is going to come his way.

Mr. Allison is a 26 year of male who presented to the ED via LEO reporting feeling depressed and suicidal ideation without a plan. Mr. Allison reported to nursing staff relational conflict with a female he started to see after his wife and he separated. At the time of the assessment Mr. Allison presents calm and cooperative. According to Mr. Allison 5 months ago his wife and he separated after a 7 year long relationship and 2 daughter. Mr. Allison reports for the past two months seeing another female who he has become involved with. Mr. Allison reports this new female told him a few weeks ago she cheated on him. Mr. Allison noted this female has issues with alcohol. He reported being a supportive person in her life, which has caused additional stressors in his life. He expressed feelings of depression. Mr. Allison describe feelings as feelings of hopelessness, worthlessness, tearfulness, sadness, isolation, increased sleep and fatigue. Mr. Allison reports relational issues, family conflict, legal issues, recent anxiety attacks and substance abuse as stressors contributing to his distress. He reports no history of self harm, no hospitalization for mental health, a strong support system (referring to his father, mother, and wife). Mr. Allison was seen on 10/08/16 and 10/09/16 for anxiety attacks, however was discharged. On 10/9/16 he mentioned issues with his recent female friend and reports he felt better over his situation and want to go home. No mention of suicidal ideation

The patient is a 34 year old female who presented to the ED with increase depressive symptoms and SI since medication changed last week. Denies suicidal plan and reports having back pain for 2 months due to passing of kidney stones as well as upper jaw pain from tooth being pulled last week. Patient denies HI or symptoms of psychosis.

For scenario one I would tell the patient not to worry because I speak Spanish too. I would acknowledge her pain and asked her questions about her headache, for example “ when did the headache started, where does it hurt, front, back side of your head?, Does it radiate? How long has it last? Is this common for you? In a scale from one to ten how bad is it? What makes it better or worse? Do you have other symptoms? Once I have all the information I need, I would tell her that “ I am going to go speak with the doctor about your head ache and ill be right back.

A social worker called on 11/1/2017 to report that patient had threatened to commit suicide and they want Vitas to remove a patient from the facility right away. Sandra Calderin, RN and Sandra Harrison, SW did an unscheduled visit to elevate the patient for suicidal idealization. Sandra stated the patient denied making any statement about committing suicide. The patient is on continuous Care for pain management and the CC nurses stated that she has not witnessed patient’s making any statement relating to suicide. The RN and, team social worker, queried the matter with the facility, nurse, director of nurses and the administrator who stated they were not aware. Follow-up visits 11/2/2017 by Dr. Thompson, Sandra Calderin, RN and Rachael, SW.

Because 85% of Tulsa citizens are on some form of government insurance: For this reason it causes the citizens on government insurance not to think twice before calling for an ambulance because they are not going to pay for it the government is going to pay for their ambulance ride.