Tutor profile: Katie B.
Subject: Professional Development
There is a nurse that works with you in your very busy medical clinic and she is often overwhelmed trying to complete the medical orders for multiple patients. One day, she accidentally gave a medication meant for one patient to the wrong patient. Only you and this nurse knows what happened. Although this medication should not cause the patient any harm, how do you proceed?
Although this unfortunately occurs in medicine, the patient must be informed of what occurred, of what medication was accidentally given, and what potential adverse effects may occur, such as allergic reaction, anaphylaxis, etc. The incidence should be documented in the patient's chart and also conveyed and documented with the nurse's supervisor.
Subject: Health and Medicine
You have a 4 year old female patient who presents to your clinic with her mother. The mother reports the child has had a cough and fever for the past 5 days and is worsening. Vital signs are normal other than the child is febrile at 102F tympanic. On exam, you hear mild rhonchi in the right base, otherwise her exam is normal. Strep test, RSV and influenza testing are negative. White blood cell count is elevated at 18. You want to perform a chest X-ray on the patient but must first discuss the risks versus benefits of plain films. What do you explain to the mother?
X-rays do emit very small amounts of radiation and the more radiation one gets at a young age or multiple doses of radiation in a short amount of time can increase the risk of developing cancer at a later age. The mother should be asked about any past radiation by plain films or CT scans and if any imaging has been done recently. You should also explain the benefit versus risk of X-ray and the importance of chest x-ray in this patient to rule out/in pneumonia as the etiology of her symptoms. If the mother agrees to proceed with chest imaging, the mother should be instructed to refrain from any unnecessary radiation in the future.
What is the pathophysiology related to condition of diverticulitis and what complications can it cause?
To answer this question, you must be able to understand diverticulosis first. Diverticulosis is a common condition that can occur secondary to lifestyle (specifically a low-fiber, poor diet) in which pockets develop in the (typically) large intestine. Having diverticulosis does not necessitate treatment. However, if one of the pockets called diverticulum become infected or inflamed, then diverticulitis ("-itis"= inflammation) results and requires antibiotic treatment. If diverticulitis goes untreated, then several complications can occur: an abscess can develop which is a collection of infection and purulent material around the affected diverticulum which can lead to sepsis or death; a fistula can develop which is an abnormal communication between 2 organs that don't usually connect; or the inflammed/infected diverticulum can perforate which causes the normal gut bacteria to have a channel into the sterile abdominal cavity which can lead to sepsis or death.
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