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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
There are two special populations that require extra consideration when you are calculating medication dosages. These are pediatric (children) and geriatric (mature adult) patients. Generally speaking, pediatric patients are under the age of 18, and geriatric patients are 65 and over. Explain the factors impacting dosing and medication administration to these patients. Additionally, explain how a patient's weight influences their dosage.
arrow_forward
Customers drop off their prescriptions either at the drive-through counter or at the front counter of the pharmacy. Customers can request that their prescriptions be filled immediately. In this case, they have to wait at least one hour depending on the current workload. Most customers are not willing to wait that long, so they opt to nominate a pick-up time at a later point during the day. Generally, customers drop their prescriptions in the morning before going to work (or at lunchtime) and they come back to pick up the drugs after work, typically after 5 pm. When dropping their prescription, a technician asks the customer for the pick-up time and puts the prescription in a box labeled with the hour preceding the pick-up time. For example, if the customer asks to have the prescription be ready at 5 pm, the technician will drop it in the box with the label at 4 pm (there is one box for each hour of the day). Every hour, one of the pharmacy technicians picks up the prescriptions due to…
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
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
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
In your own words describe the dispensing process, we needs to follow starting from receiving the prescription from the patients to dispensing the drugs.
arrow_forward
Scenario
Mr. and Mrs. Barnum is a retired couple living in a large house in an affluent neighborhood in central Minnesota. Mr. Barnum, 86 years old, is a retired naval officer who is orderly, controlling, and very "set in his ways." He suffers from hearing loss and severe back pain for which he takes strong pain medication. Mrs. Barnum, 80 years old, always has been a housewife and caregiver for the family. After several bouts of cancer she is weak and frail. Though quite well off financially, Mr. and Mrs. Barnum have always lived a very private and isolated life with no real support network. They have had a long-standing dispute with their immediate neighbor and are suspicious of the "newcomers" on the block. No family members live nearby except their grandson Bob.
Bob is a 37 year old divorcee and always "between jobs." He is estranged from his parents and siblings. He used to occasionally stop by and do odd jobs around his grandparent’s home, but he spends most of his free time…
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 a nurse caring for an 87-year-old retired teacher who underwent hip replacement surgery 2 weeks ago and has transferred to your rehabilitation unit for physical therapy and nursing care until she is physically able to return home. Before her surgery, she lived alone, maintained an immaculately clean house, and was very socially active, with several events scheduled throughout her week. She travelled extensively but limited her personal driving to daylight hours. Upon admission to your rehab unit, the patient wonders aloud how she’ll return to her former lifestyle and who will help her.
What data can you gather based on available patient information?
2. How should you assist the patient to facilitate maximal health?
3. What questions should you ask yourself when caring for this patient to help ensure quality of life?
arrow_forward
When Dr. Richards demonstrates that she "knows best" and thus does not present all of the available treatment alternatives to her patients, she is demonstrating the ______________ model of medicine. When Dr. Johnson relies primarily on facts, evidence, and scientific methods to "fix" a case, viewing a patient more as a collection of cells than as a whole human being, he is demonstrating the _________________ model of medicine.
A.) Biomedical…Biopsychosocial
B.) Paternalistic… Biopsychosocial
C.) Paternalistic…Biomedical
D.) Biomedical…Paternalistic
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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You are a city council member for a distant suburb of Gotham City, New York. Your suburb does not have its own hospital; in fact, the nearest hospital is 20 miles away. Last week, two competing health care systems both approached the city council about building a hospital within city limits. The city council chairperson has called for a special meeting to discuss these proposals. She is asking all members to do some research and submit a written summary of what ethical, legal, regulatory, and moral factors must be considered by the city council.
What are the most important legal, regulatory, ethical, and moral factors that must be discussed in the meeting?
As your classmates submit their summaries, participate in a preliminary online discussion about the various factors that have been presented.
arrow_forward
How can you identify a rational prescription? Please shortly answer at your own easy words. Answer should be to the point.
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How to cite appropriately below sources?
Book: Writing With Precision: How to Write So That You Cannot Possibly Be Misunderstood by Jefferson D. Bates; Publisher: Penguin Books, New York; 2000
Article in Fast Company (magazine): “Continental’s Turnaround Pilot” by Keith Hammonds 2001 December; pp. 96-101
Newspaper article from The Washington Post, no author listed: “New Drug Appears to Sharply Cut Risk of Death from Heart Failure,” page A12 on July 15, 1993
Article in journal: “Chicana Feminism and Postmodern Theory” by Paula M. Moya in Signs: Journal of Women in Culture and Society, volume 26, issue 2, Winter 2001. University of Chicago Press pp. 28-41
Electronic copy of printed journal article (with DOI): “Theory of Mind Function, Motor Empathy, Emotional Empathy and Schizophrenia: A Single Case Study” by Karen Addy in Journal of Forensic Psychiatry & Psychology, Vol. 18, issue 3, Sept. 2007, pp. 293- 3065 DOI: 10.1080/09670870701292746
Electronic copy of printed journal article…
arrow_forward
A health insurance policy pays 80 percent of physical therapy costs after a deductible of $220. In contrast, an HMO charges $16 per visit for physical therapy. How much would a person save with the HMO if he or she had 10 physical therapy sessions costing $55 each?
arrow_forward
The use of technology in telehealth and telemedicine has allowed providers to keep in contact with their patients in both real time (synchronous) and over a period, or not real time (asynchronous). It assists in the provider’s ability to diagnose and treat during an acute episode along with monitoring a chronic disease for continued management.
ABC Home Health is looking at telemedicine products to monitor their clients with Congestive Health Failure (CHF) at home. ABC is looking for Remote Monitoring Devices (RMD’s) to enhance the care given and assist in reducing readmissions (less than 30 days) to the hospital. You have been tasked to review and to report back on the device you would like to see demonstrated by the vendor.
From the list below, choose 4 important criteria that need to be addressed when looking for equipment.
1. Integration with physician and hospital Electronic Medical Records (EMR)
2. User friendly for client
3. Cost- buy vs. lease.
4. Easy to retrieve data-…
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SEE MORE QUESTIONS
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Related Questions
- There are two special populations that require extra consideration when you are calculating medication dosages. These are pediatric (children) and geriatric (mature adult) patients. Generally speaking, pediatric patients are under the age of 18, and geriatric patients are 65 and over. Explain the factors impacting dosing and medication administration to these patients. Additionally, explain how a patient's weight influences their dosage.arrow_forwardCustomers drop off their prescriptions either at the drive-through counter or at the front counter of the pharmacy. Customers can request that their prescriptions be filled immediately. In this case, they have to wait at least one hour depending on the current workload. Most customers are not willing to wait that long, so they opt to nominate a pick-up time at a later point during the day. Generally, customers drop their prescriptions in the morning before going to work (or at lunchtime) and they come back to pick up the drugs after work, typically after 5 pm. When dropping their prescription, a technician asks the customer for the pick-up time and puts the prescription in a box labeled with the hour preceding the pick-up time. For example, if the customer asks to have the prescription be ready at 5 pm, the technician will drop it in the box with the label at 4 pm (there is one box for each hour of the day). Every hour, one of the pharmacy technicians picks up the prescriptions due to…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
- 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_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_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_forward
- In your own words describe the dispensing process, we needs to follow starting from receiving the prescription from the patients to dispensing the drugs.arrow_forwardScenario Mr. and Mrs. Barnum is a retired couple living in a large house in an affluent neighborhood in central Minnesota. Mr. Barnum, 86 years old, is a retired naval officer who is orderly, controlling, and very "set in his ways." He suffers from hearing loss and severe back pain for which he takes strong pain medication. Mrs. Barnum, 80 years old, always has been a housewife and caregiver for the family. After several bouts of cancer she is weak and frail. Though quite well off financially, Mr. and Mrs. Barnum have always lived a very private and isolated life with no real support network. They have had a long-standing dispute with their immediate neighbor and are suspicious of the "newcomers" on the block. No family members live nearby except their grandson Bob. Bob is a 37 year old divorcee and always "between jobs." He is estranged from his parents and siblings. He used to occasionally stop by and do odd jobs around his grandparent’s home, but he spends most of his free time…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_forward) You are a nurse caring for an 87-year-old retired teacher who underwent hip replacement surgery 2 weeks ago and has transferred to your rehabilitation unit for physical therapy and nursing care until she is physically able to return home. Before her surgery, she lived alone, maintained an immaculately clean house, and was very socially active, with several events scheduled throughout her week. She travelled extensively but limited her personal driving to daylight hours. Upon admission to your rehab unit, the patient wonders aloud how she’ll return to her former lifestyle and who will help her. What data can you gather based on available patient information? 2. How should you assist the patient to facilitate maximal health? 3. What questions should you ask yourself when caring for this patient to help ensure quality of life?arrow_forwardWhen Dr. Richards demonstrates that she "knows best" and thus does not present all of the available treatment alternatives to her patients, she is demonstrating the ______________ model of medicine. When Dr. Johnson relies primarily on facts, evidence, and scientific methods to "fix" a case, viewing a patient more as a collection of cells than as a whole human being, he is demonstrating the _________________ model of medicine. A.) Biomedical…Biopsychosocial B.) Paternalistic… Biopsychosocial C.) Paternalistic…Biomedical D.) Biomedical…Paternalisticarrow_forward
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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