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The first question I would ask if the patient has any financial difficulty obtaining any prescribed medications since the patient does not have health insurance due to his career. Many studies show many people with
low income cannot afford health insurance which means they are unable
to adhere to medications (Rohatgi et al., 2021). Without health insurance, the patients mostly pay their medication out of pocket which is unaffordable for them. They may get one month's supply of medication and use it for 2 or 3 months. Some of them may not even pick up the medication in the first place. As responsible providers, it is our responsibility to understand patient’s financial struggles and help them to locate local resources to help them manage their chronic illnesses. The second question I would ask about is his exercise routine. Since the patient is a taxi driver who would sit in the driver's seat about 12 hours a day, the patient’s lifestyle is sedentary. A sedentary lifestyle is a major risk factor for cardiovascular disease and develop hypertension. In a study analyzing the mortality rates of people with more than 10 hours of sitting time a day, the sitting time was significantly correlated with all causes of mortality (Park, et al., 2020). It is important to understand if the patient would be able to add an exercise routine in his
daily life after work or his day-off. The additional questions that I would ask the patient is whether he experienced any chest pain after exercise and I would also ask him if he thinks he has good eating habits, such as how he and his family prepare
their meals. Since the patient has not been in a doctor office in years, a comprehensive physical assessment is needed for the patient. Even though the patient is only concerned about his blood pressure, a comprehensive physical assessment and focus assessment are performed. The patient’s physical exam is within normal range. HEENT system does not have an abnormality. The cardiovascular system is within normal range, no edema, regular rate and rhythm, the patient did
not complain of chest pain. Regular S1 and S2. No murmurs, thrills and rubs. The respiratory system is clear to auscultation bilaterally. No cough is noticed. No crackles, no wheezing. The gastrointestinal system is within normal range. The patient is alert and oriented x 3 and has no nerve or neurological complaints. Diagnosis instruments are needed for this examination:
a platform scale with height capability
a blood pressure (BP) cuff with a sphygmomanometer
a stethoscope with a bell and diaphragm end pieces
a thermometer
a flashlight or penlight
an otoscope, an ophthalmoscope
a reflex hammer
clean gloves
Hypertension Hypertension can be cause by increased salt absorption resulting in volume expansion,
an impaired response
of the renin-angiotensin-
aldosterone
system (RAAS), and increased activation
of the sympathetic nervous system. These changes
lead to the development of
increased total peripheral resistance
and increased afterload, which
in turn leads to the development of hypertension (Iqbal & Jamal., 2023)
Anxiety The amygdala plays an important role in tempering fear and anxiety. Patients with anxiety disorders have been found to show heightened amygdala response to anxiety cues. The amygdala and limbic system structures are connected to prefrontal cortex regions, and prefrontal-limbic activation abnormalities may be reversed with psychological or pharmacologic interventions (Chand & Marwaha., 2023). Renal Artery Stenosis
In patients with renal artery stenosis, the chronic ischemia produced by the obstruction of renal blood flow leads to adaptive changes in the kidney which
include the formation of collateral blood vessels and secretion of renin by juxtaglomerular apparatus. The renin enzyme has an important role in maintaining homeostasis in that it converts angiotensinogen to angiotensin I.
Angiotensin I has then converted to angiotensin II with the help of an
angiotensin-converting enzyme (ACE) in the lungs. Angiotensin II is responsible for vasoconstriction and release of aldosterone which causes sodium and water retention, thus resulting in secondary hypertension or renovascular hypertension.
The patient has not been in the doctor office for over 5 years. I would order CBC, CMP, PT/ INR, BNP and lipid, A1C and thyroid levels for the patient to check for any underlying health issues. Reference: Bokhari MR, Bokhari SRA. (2023, July 23) Renal Artery Stenosis. In: StatPearls. Treasure Island (FL): StatPearls Publishing.
Available from: https://www.ncbi.nlm.nih.gov/books/NBK430718/
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Related Questions
what are some causes that patients may not be able to afford their medications.
arrow_forward
There is a finite amount of money that is available to spend on healthcare (and drugs). It is important to make rational choices considering the consequences of actions and the limited resource that is available.
Try these questions:1. You are working as a practice pharmacist and have been asked to help the practice reduce expenditure on medicines. As a result, you are reviewing the use of tolterodine 4 mg m/r tablets, as these costs more than tolterodine 2 mg tablets at an equivalent dose.
Current costs are shown below: Tolterodine 4 mg m/r tablets £25.78 per 28 tablets Tolterodine 2 mg tablets £2.88 per 56 tablets
You have reviewed nine patients who are prescribed tolterodine 4 mg m/r tablets daily on repeat prescription and have identified that seven of them could potentially switch to using the tolterodine 2 mg tablets at a dose of one tablet twice a day. The practice has a repeat prescribing policy of 56 days treatment on a prescription.What is the total saving for the practice…
arrow_forward
There is a finite amount of money that is available to spend on healthcare (and drugs). It is important to make rational choices considering the consequences of actions and the limited resource that is available.Try these questions:1. You are working as a practice pharmacist and have been asked to help the practice reduce expenditure on medicines. As a result, you are reviewing the use of tolterodine 4 mg m/r tablets, as these costs more than tolterodine 2 mg tablets at an equivalent dose.
Current costs are shown below: Tolterodine 4 mg m/r tablets £25.78 per 28 tablets Tolterodine 2 mg tablets £2.88 per 56 tablets
You have reviewed nine patients who are prescribed tolterodine 4 mg m/r tablets daily on repeat prescription and have identified that seven of them could potentially switch to using the tolterodine 2 mg tablets at a dose of one tablet twice a day. The practice has a repeat prescribing policy of 56 days treatment on a prescription.
What is the total saving for the practice…
arrow_forward
Explain whether you agree or disagree with the following comments: “It always puzzles me why the cost of healthcare is such a big issue. Aren’t about 60% of our hospitals not-for-profit? That means that about 60% of the healthcare needs out there are being satisfied free of charge through charitable organizations.”
arrow_forward
You just got a job as the newest pharmacist
at the community drugstore in your town.
One day, a medical resident, Dr. Gomez,
presented you this prescription. He said that
this medication helps with his back pain. Dr.
Gomez also told you that he regularly buys
it in your pharmacy. As a pharmacist, will
you dispense the drug? Why or why not? *
Rene Emilio Gutierrez, M.D.
LAA Medical Center
555-12-34 Loc 5678 • 09178901234
drregutierrez@gmail.com
Name: akı Gomez Age: 30
Address: Ermita, Manila Sex: M
Date: Sept 18,2020
R
Morpehine sulfete 30ng
(MST Continus)
#20
Sig: Tade
12 hours
fab every
for moderate to sěvene pain
fenet
Rene Emplip Gutierrez, M.D.
License No.: 9875432
PTR No.: 0490556
arrow_forward
Why do you think some individuals obtained lethal doses of medication through the Oregon Death with Dignity Act and then did not take it?
arrow_forward
Josh Cohen is a high school student interested in being a pharmacist. He is in a career planning class that helps students explore career options. One of the assignments is to shadow a healthcare professional. You are a seasoned nurse on a medical-surgical unit and have agreed to help him. He watches you calculate doses, prepare and check medications, and administer medications. How would you answer these questions that he asks you after medication administration?
3.Can drug companies make all the medication come as a liquid since it’s easier to take?
4.Why are some tablets scored so you can break them and with other tablets you need a pill cutter?
arrow_forward
Read the following scientific paper from J.K Aronson titled:
Medication errors: what they are, how they happen, and how to avoid them
QJM: An International Journal of Medicine, Volume 102, Issue 8, August 2009, Pages 513– 521, https://doi.org/10.1093/qjmed/hcp052
Focus on the following sections:
Abstract
One particular medication error
Frequency and outcomes of medication errors
Conclusion: a prescription for better prescribing
Once you have done the reading:
Prepare a 150-200 words reflection piece on the importance of Topic 1 measurements for future health care professionals as you.
Base your reflection on the resources provided.
Drug Dosage and Body mass
Medication errors: what they are, how they happen, and how to avoid them)
You are most welcome to do quick research on measurement errors in your desired field of practice too (Pharmacy, Paramedic, Nutrition, Health Science, Exercise Science, Physiotherapy etc).
To help you out here are some questions to answer in your…
arrow_forward
I want the solution very quickly within 15 minutes
arrow_forward
How would your policy apply in each of the cases below (e.g., are there certain people or categories of individuals with whom information regarding the condition and treatment of the patient would always, sometimes, or never be shared)? Please give support for your conclusions.
A school bus has overturned, and 30 elementary school children are rushed to your hospital. Some are in serious condition, some are dead when they arrive at the hospital, and some have merely cuts and bruises and will be released shortly. As the person, the hospital has designated the contact person regarding patients involved in this terrible accident, from whom would you likely receive requests for information about these children and their condition? To whom would you disclose PHI and to whom would you not disclose PHI? Why?
arrow_forward
You are working as a licensed practical nurse in a small urgent care center. You love the work. The physicians are excellent, and you have the opportunity to work with a variety of patients.
You have become good friends with your coworkers and enjoy an especially close relationship with the administrative medical assistant, Amy. One day you observe Amy removing medication from the drug cabinet. You find this to be unusual because the administrative staff do not normally work with medications. While performing a routine inventory check later that day, you discover a shortage of a drug that is classified as a controlled substance. Explain what you would do in this situation.
arrow_forward
When asked the difference between a health maintenance organization (HMO) and a preferred
provider organization (PPO) plan, what would be the correct response?
A patient with a PPO plan will have no additional costs for services.
An HMO provides better access to outpatient services and drug benefits.
The two plans are essentially the same.
A patient may choose any physician with an HMO plan.
arrow_forward
The following case study is a paraphrase from "Good Clinical Practice. Standard Operating Procedures for Clinical Researchers" (Kolman, J., Meng, P. and Scott, G. editors; John Wiley and Sons publishers, 1998):
“While a study subject and a relative were walking in town one day during the summer, a hanging flower basket fell on a study subjects head, resulting in the study subject falling down and becoming unconscious. The subject’s relative called for an ambulance. On arrival at a local hospital’s Emergency Department, in which the subject regained consciousness but could not recall the event, a x-ray revealed a fractured skull. The subject’s consciousness level at this point was deteriorating and after further tests a subdural hematoma was diagnosed, which was evacuated under general anesthesia. Postoperative recovery was uneventful and progressing well until day four, when the patient developed acute dyspnea (shortness of breath) at rest during visiting time. An emergency lung scan…
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What are some of the complications caused by our insurance system for individual consumers and providers of care? Discuss some new approaches that could have promising new changes in our health system, resulting in more efficient care.
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Patients who are taking herbal remedies or dietary supplements do not need to list them on medication histories since they have no interactions with medications. true or false
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#3 As a nurse, you are getting ready to welcome a new patient to your unit who has just had surgery. The patient, a 71-year-old male with a broken femur, underwent surgery to correct the injury. You find out about his medical history from the post-anesthesia recovery unit, which includes COPD, 40 pack-years of smoking, and hypertension. Although his surgical repair was successful, the heavy bleeding made things difficult, therefore he is now taking IV fluids to make up for it. His three children are dispersed throughout the country, and he is widowed. He hires a cleaning service to keep his home clean, receives Meals on Wheels, and lives alone.
1. What general outcomes would you expect to establish from this information?
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As a pharmacist, cite at least 5 medication errors that you might encounter in dispensing medicines and indicate how will you avoid it.
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Which of the following behaviors will NOT help you prevent antibiotic resistance:
a. Don't demand an antibiotic when your health care provider determines one isn't appropriate. Ask about ways to help relieve your symptoms.
b. Take an antibiotic for a viral infection such as a cold, a cough, or the flu.
c. Take medicine exactly as your health care provider prescribes. If he or she prescribes an antibiotic, take it until it is gone, even if you're feeling better.
d. Don't take leftover antibiotics or antibiotics prescribed for someone else. These antibiotics may not be appropriate for your current symptoms. Taking the wrong medicine could delay getting correct treatment and allow bacteria to multiply.
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It is stated in our course text that more efficient methods to detect frailty and measure its severity in routine clinical practice need to be developed, especially methods that are useful for primary care. Do you agree with this statement? Why or why not? Please explain in detail
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How would you advise and manage patients to take their medications
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SEE MORE QUESTIONS
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Related Questions
- what are some causes that patients may not be able to afford their medications.arrow_forwardThere is a finite amount of money that is available to spend on healthcare (and drugs). It is important to make rational choices considering the consequences of actions and the limited resource that is available. Try these questions:1. You are working as a practice pharmacist and have been asked to help the practice reduce expenditure on medicines. As a result, you are reviewing the use of tolterodine 4 mg m/r tablets, as these costs more than tolterodine 2 mg tablets at an equivalent dose. Current costs are shown below: Tolterodine 4 mg m/r tablets £25.78 per 28 tablets Tolterodine 2 mg tablets £2.88 per 56 tablets You have reviewed nine patients who are prescribed tolterodine 4 mg m/r tablets daily on repeat prescription and have identified that seven of them could potentially switch to using the tolterodine 2 mg tablets at a dose of one tablet twice a day. The practice has a repeat prescribing policy of 56 days treatment on a prescription.What is the total saving for the practice…arrow_forwardThere is a finite amount of money that is available to spend on healthcare (and drugs). It is important to make rational choices considering the consequences of actions and the limited resource that is available.Try these questions:1. You are working as a practice pharmacist and have been asked to help the practice reduce expenditure on medicines. As a result, you are reviewing the use of tolterodine 4 mg m/r tablets, as these costs more than tolterodine 2 mg tablets at an equivalent dose. Current costs are shown below: Tolterodine 4 mg m/r tablets £25.78 per 28 tablets Tolterodine 2 mg tablets £2.88 per 56 tablets You have reviewed nine patients who are prescribed tolterodine 4 mg m/r tablets daily on repeat prescription and have identified that seven of them could potentially switch to using the tolterodine 2 mg tablets at a dose of one tablet twice a day. The practice has a repeat prescribing policy of 56 days treatment on a prescription. What is the total saving for the practice…arrow_forward
- Explain whether you agree or disagree with the following comments: “It always puzzles me why the cost of healthcare is such a big issue. Aren’t about 60% of our hospitals not-for-profit? That means that about 60% of the healthcare needs out there are being satisfied free of charge through charitable organizations.”arrow_forwardYou just got a job as the newest pharmacist at the community drugstore in your town. One day, a medical resident, Dr. Gomez, presented you this prescription. He said that this medication helps with his back pain. Dr. Gomez also told you that he regularly buys it in your pharmacy. As a pharmacist, will you dispense the drug? Why or why not? * Rene Emilio Gutierrez, M.D. LAA Medical Center 555-12-34 Loc 5678 • 09178901234 drregutierrez@gmail.com Name: akı Gomez Age: 30 Address: Ermita, Manila Sex: M Date: Sept 18,2020 R Morpehine sulfete 30ng (MST Continus) #20 Sig: Tade 12 hours fab every for moderate to sěvene pain fenet Rene Emplip Gutierrez, M.D. License No.: 9875432 PTR No.: 0490556arrow_forwardWhy do you think some individuals obtained lethal doses of medication through the Oregon Death with Dignity Act and then did not take it?arrow_forward
- Josh Cohen is a high school student interested in being a pharmacist. He is in a career planning class that helps students explore career options. One of the assignments is to shadow a healthcare professional. You are a seasoned nurse on a medical-surgical unit and have agreed to help him. He watches you calculate doses, prepare and check medications, and administer medications. How would you answer these questions that he asks you after medication administration? 3.Can drug companies make all the medication come as a liquid since it’s easier to take? 4.Why are some tablets scored so you can break them and with other tablets you need a pill cutter?arrow_forwardRead the following scientific paper from J.K Aronson titled: Medication errors: what they are, how they happen, and how to avoid them QJM: An International Journal of Medicine, Volume 102, Issue 8, August 2009, Pages 513– 521, https://doi.org/10.1093/qjmed/hcp052 Focus on the following sections: Abstract One particular medication error Frequency and outcomes of medication errors Conclusion: a prescription for better prescribing Once you have done the reading: Prepare a 150-200 words reflection piece on the importance of Topic 1 measurements for future health care professionals as you. Base your reflection on the resources provided. Drug Dosage and Body mass Medication errors: what they are, how they happen, and how to avoid them) You are most welcome to do quick research on measurement errors in your desired field of practice too (Pharmacy, Paramedic, Nutrition, Health Science, Exercise Science, Physiotherapy etc). To help you out here are some questions to answer in your…arrow_forwardI want the solution very quickly within 15 minutesarrow_forward
- How would your policy apply in each of the cases below (e.g., are there certain people or categories of individuals with whom information regarding the condition and treatment of the patient would always, sometimes, or never be shared)? Please give support for your conclusions. A school bus has overturned, and 30 elementary school children are rushed to your hospital. Some are in serious condition, some are dead when they arrive at the hospital, and some have merely cuts and bruises and will be released shortly. As the person, the hospital has designated the contact person regarding patients involved in this terrible accident, from whom would you likely receive requests for information about these children and their condition? To whom would you disclose PHI and to whom would you not disclose PHI? Why?arrow_forwardYou are working as a licensed practical nurse in a small urgent care center. You love the work. The physicians are excellent, and you have the opportunity to work with a variety of patients. You have become good friends with your coworkers and enjoy an especially close relationship with the administrative medical assistant, Amy. One day you observe Amy removing medication from the drug cabinet. You find this to be unusual because the administrative staff do not normally work with medications. While performing a routine inventory check later that day, you discover a shortage of a drug that is classified as a controlled substance. Explain what you would do in this situation.arrow_forwardWhen asked the difference between a health maintenance organization (HMO) and a preferred provider organization (PPO) plan, what would be the correct response? A patient with a PPO plan will have no additional costs for services. An HMO provides better access to outpatient services and drug benefits. The two plans are essentially the same. A patient may choose any physician with an HMO plan.arrow_forward
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SEE MORE QUESTIONS
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Recommended textbooks for you
- Comprehensive Medical Assisting: Administrative a...NursingISBN:9781305964792Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy CorreaPublisher:Cengage Learning
Comprehensive Medical Assisting: Administrative a...
Nursing
ISBN:9781305964792
Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa
Publisher:Cengage Learning