Patient Case Scenarios

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.

R.O. is a 43-year-old female Latino patient who has been living at home alone since she got divorced three months ago. She does not have any living or available family in the United States. She is the oldest of three children. Her parents died of an accident when she was little. Two of her sisters live in Mexico. She has lost contact with her family in Mexico when she got married and move to the United States. She also has stopped communicating with her ex husband since they got divorced. Although she does not have any support from her family, she states that her church member has been very supportive. Moreover, R.O. states she was a homemaker until the divorce. Currently, she has been working as a dishwasher near her house.

This is 34 year old WF. Patient is a resident at the Lovelady Center. Patient stataes she had a baby 7 weeks ago. She is depressed and misses her bacy. She is to stay at the love lady for 90 days, but possibly for 9 to 12 months. The bay is well taking care of by her boyfriend (the baby's father). Patient denies thoughts of suicide or homicide. Wants to get through the program and get back to her baby. Patient denies chest pain, SOB, N/V/ D, or fever.

The patient has 53 years and completed the electronic screening assisted by this therapist. The results were negative for suicide ideation (C-SSRS), positive mild for depression symptoms (CAD-MDD, CAT-DI: 56.3), severe for anxiety symptoms (CAT-AND: 74.5), elevated for mania/hypo mania symptoms (CAT-M/HM: 59.8), positive for medication non adherence (MMAS-8: .50) and positive for tobacco (NIDA assist). The patient verbalized financial issues among other factors to contribute on his symptoms. He forgot the referral for mental health services to McIntosh Trail, however, he said by phone that he will pick up the referral previous his appointment next Thursday. The recommendation is psychiatric evaluation and counseling services. Eunice Malavé

HISTORY OF PRESENT ILLNESS: This patient is a 10-year-old male. He was in a Motocross accident this past Saturday, sustaining tibial eminence fracture, displaced. He presents today for evaluation.

Patient is 52 year male with diagnosed with Schizoaffective disorder, Type 2 diabetes mellitus, Generalized anxiety, Gastro-esophageal reflux Constipation, Alert orient X 3, was and cooperative during SN visit. Denied SI, HI, V/H, A/H, self harm behavior and contracted for safety. Mood/affect flat. pt has poor family dynamic , a family that have not been supporting him. pt has been under CHD for financial managements. and A better life home care with his which provide him with daily skilled visit in provided daily assessments of patient vital signs, medication administration/management (assessing compliance of pre-poured medication), assessing patient’s mood, mental status, coping skills as well as safety which has in turn kept the patient out of any possible hospitalization this period. Patient continue on clozaril which requires to be carefully administered and monitored if any side effect.patient is also continue on Vistaril Oral 25 MG 1 Cap(s) by mouth twice daily AM & PM as needed for anxiety which he requires daily d/t being

On Monday, August 29, 2016, at approximately 1:38PM, I, Officer Larry Thomas, was contacted by medical staff to come to the peep area, in reference to a patient control assist.

I completely agreed with you about the safety issues that are encountered daily in the surgical areas. There has been implementation of safety intervention to remedy these concerns on patient safety. In most cases, nurses are rushed with the consequences that patients are not properly prepped in the pre-op areas prior to the surgical procedures. Personally I have been in same problem of being rushed to bring the patient in the room. In this particular incident, I just finished a case in another room and have not interviewed this particular patient. I informed the Anesthesiologist and the surgeon to give me few minutes to interview the patient prior to transfer to the operating room. To everybody’s surprise the surgeon wheeled the patient

I spoke to the patient in CCU whilst his wife was here. This proved useful as the patient has Alzheimer’s disease, and although it is only mild he did struggle to piece together what actually brought him into hospital.

There are many ways families can be involved in a patient’s therapy. There will be opportunities for patients and the families to be apart of the learning process of the diagnoses. Whether the diagnoses is depression, alcoholism, marital and relationship problems, mental illness, etc., I will offer workshops for the opportunity to become more educated on the subject matter. They will then feel empowered and ready to deal with the condition in an optimal way. As a therapist, its my job to inform families about important information. I can do so by scheduling meeting to discuss programs clients can be involved in. Its also important to have open communication to help enhance the patients therapy experience for a better outcome. Family are more

Maggie Solis (approaching both Officer Myers and Officer Ramirez): Both children seem to be Ok, but we’ll need to transport them to the Hospital for a full medical evaluation. Will Child Protective Service be at the Hospital?

Laura, based on personal experience, beginning your career by working in a clinical setting will prove to be very educational in many ways. I have worked in various large and small clinics and hospitals. I have found that to be instrumental to my success, thus far. I would suggest working in a multi-specialty facility in order to learn where your passion in health care resides. On the job experience differs from classroom experience. Throughout my career, I have discovered that, like your change in desire to work in coding/billing, my thoughts going into various experiences changed as time elapsed.

Patient recently had his medication changed and he feels like "his attention and memory is improving and it is helping him to focus more."

I understand what you are saying, professor. I may have a patient that may come into my office that may suffer from anxiety that stem from a phobia like heights, but I may also be involved with another patient suffering from anxiety that stem from socializing. Patient A and patient B both suffer from similar forms of anxiety, yet both patients' anxiety are triggered from different sources. I am not sure if that is a good example, but I am sure you will let me know.

This is 41 year old white male who is here to establish PCP, sinuse congestion, ear pain, throat pain, and depressive moods. Patient reports that he is divoresed with 3 children. He lost his job of 17 years, got divorced, lost his money, and doesn't get to see his children. Patient states that, "Things just happen so fast," "I just feel so sad and don't have any energy."Patient is a current smoker, smokes 1/2 pack per past 22 years. Patient states that he still has a good relationship with his wife and children and if he can recover from this depressive moods, he will get to see them. He talks to his children often per patient report. Patient denies thought or plans of sucide or homicide, "I just want to feel better!" Patient reportds he has