Complete Parts A, B, and C for this assignment. Part A: Sheila Meyer, a medical

Question

Complete Parts A, B, and C for this assignment.

Part A:    Sheila Meyer, a medical assistant in Dr. Ryan’s large cardiovascular practice, is taking the medical history of Edna Helm, an obese elderly woman with congestive heart disease. Edna states, “I’m always short of breath, and I perspire all the time. I guess I’m gaining weight, but the funny thing is that only my legs seem heavier. My heart is pounding when I lie down at night; it even seems to stop sometimes. I’ve even started to wear red nail polish to hide the funny blue color of my nails.

               Edna gives you a copy of her medical history from an out-of-state physician. The medical history indicates that she has had the following conditions, tests, and procedures:

Conditions

Tests

Surgical Procedures

Positive Babinski sign

Allergic rhinitis

Aortic insufficiency

Ascites

Gastritis

Osteoarthritis

Holter monitor testing

Radioimmunoassay test

Protein bound iodine test

Glucose tolerance test

Basal cell carcinoma removed in 1992

Sebaceous cyst removed in 1982

Meniscectomy in 1978

Rhytidectomy in 1970

               Using correct medical terms, chart Edna’s presenting symptoms. Define each of the procedures and conditions listed on her medical record. Your response should be one (1) page in length.

Part B:    Victor Krenz is assisting Dr. Connors with the fifth cataract surgery for the day. The patient is Kathy Wall, a diabetic patient, whose condition has been stable enough for her to undergo a surgical procedure. Victor has performed a six-minute surgical scrub on his hands before each of the five procedures. Dr. Connors indicates that he is in a hurry to get back to his office for a heavy afternoon schedule of patients. After both Dr. Connors and Victor are scrubbed, gowned, and ready to begin the operation, Victor feels a slight prick on the tip of his gloved finger as he moves the sterile syringe and needle on the tray. Dr. Connors, who does not notice the accidental needlestick to Victor’s glove, states again that he is in a hurry to finish this procedure. Victor knows that it will delay the surgery if he has to change gloves. He also knows that his hands have had a surgical scrub five times that morning and that they are clean.

Provide detailed answers for each of the following questions. Your response should be one-half (1/2) page in length.

Can Victor justify not changing into new gloves?

What could happen to Ms. Wall as a result of Victor’s needlestick?

How should Victor handle this situation?

Part C:    José Menendez is an elderly patient of Dr. Juárez, a board-certified urologist. José has a history of recurrent UTIs dating back more than 10 years. When he becomes symptomatic, he has been instructed to call Dr. Juárez’s office and schedule a urinalysis. Dr. Juárez’s receptionist has just received a call from Mr. Menendez. He says he knows he is supposed to come in for a urine test but that he just wants a prescription phoned in to his pharmacy instead. The receptionist asks Emilia, Dr. Juárez’s medical assistant, to take the call from Mr. Menendez.

               Emilia listens as Mr. Menendez recounts that he is experiencing dysuria—painful, burning urination. She asks him to come in for a urinalysis, explaining that, as per standing orders, a clean-catch midstream specimen needs to be collected. Mr. Menendez repeats to Emilia that he does not want to come in to the office. “Why can’t you call in a prescription for Bactrim? That is what I took last time, and it helped.”

               Provide detailed answers for each of the following questions. Your response should be one (1) page in length.

What is your response?

Should the responsibility for this call have fallen on Emilia, or should the receptionist have either handled the call herself or passed it on to Dr. Juárez?

What, if anything, could or should Emilia say to Mr. Menendez to persuade him to come in for the urinalysis?

Might the cost of the procedure be a factor in the reason why Mr. Menendez does not want to have a urinalysis, and, if so, what, if anything, can Emilia do or say about the cost?

Is it appropriate in this case, given the patient’s extensive history, to indeed call in a prescription for Bactrim?

If not, how should Emilia handle Mr. Menendez’s request for his prescription?

If so, what procedure should Emilia follow to arrange for a prescription?

How should this telephone call be charted?

What, if anything, should Dr. Juárez be told about the conversation with Mr. Menendez?

Conditions

Tests

Surgical Procedures

Positive Babinski sign

Allergic rhinitis

Aortic insufficiency

Ascites

Gastritis

Osteoarthritis

Holter monitor testing

Radioimmunoassay test

Protein bound iodine test

Glucose tolerance test

Basal cell carcinoma removed in 1992

Sebaceous cyst removed in 1982

Meniscectomy in 1978

Rhytidectomy in 1970

Explanation / Answer

Part A

Edna's Presenting symptoms:

Conditions:

Positive Babinski's sign: When the lateral aspect of the foot is stroked by a tongue blade, the toes contract and drawn together. toe fanning is an abnormal response called positive Babinski.

Allergic Rhinitis: It is a most common form of respiratory allergy presumed to be mediated by an immediate (type 1 hypersensitivity) immunologic reaction.

Aortic insufficiency: The valves of the heart control the flow of the blood through the heart into the pulmonary artery and aorta by opening and closing in response to the blood pressure changes as the heart contracts and relaxes through the cardiac cycle. when the flow of blood through the valve is decreased is called 'aortic insufficiency'.

Ascites: In ascites, the fluid accumulates in the abdominal cavity. Obstructed blood flow through the damaged liver results in increased blood pressure(portal hypertension) throughout the portal venous system. Although ascites is often a result of liver damage, the fluid moving from the vascular system into the peritoneal space.

Gastritis: It is the inflammation of the gastric or stomach mucosa. In gastritis, the gastric mucous membrane becomes edematous and hyperemic (congested with fluid and blood) and undergoes superficial erosion.

Osteoarthritis: Osteoarthritis also known as degenerative joint disease is the most common and frequently disabling of the joint disorders. It affects the articular cartilage, subchondral bone, and synovium.

Procedures:

Basal cell Carcinoma removed in 1992: The most common type of skin cancer is basal cell carcinoma. The surgical removal of a tumor entirely. It is done to maintain cosmetic appearance and the scar is less noticeable.

Sebaceous cyst removed in 1982: The surgical removal of the retention cyst caused by the blockage of a duct from a sebaceous gland so that sebum collects.

Meniscectomy in 1978: The surgical removal of semilunar cartilage from the knee joint.

Rhytidectomy in 1970: Rhytidectomy (i.e Facelift) is a surgical procedure that removes the soft tissue folds and minimizes cutaneous wrinkles on the face.

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