Clinical Reasoning Flashcards
analytical approach
- Logical, step-wise
- Comprehensive; attempts to identify every possibility
- A necessary approach, especially for complex problems or HCPs early in their career
- Several factors included
What factors are included in the analytical approach?
- PMH
- HPI (SCHOLARS)
- Medication history
- Social history
- Review of systems
- Physical examination
- Lab assessment
- Include pertinent positives / negatives
Literature demonstrates that a correct diagnosis can be made based on patient history alone up to how many percent of the time?
90%
What order can you go in with respect to review of systems?
- From head to toe
- In order of modules → general assessment → cardio → renal → resp → derm → endo → GI → rheumatology → infectious diseases → oncology → neurology → psychiatry
non-analytical approach
- used more frequently
- HPI is the major factor
- diagnostic schemata approach
What is the diagnostic schemata approach?
- recognizing patterns
- schemata represent 80-90% of the causes for a specific symptom based on how frequently they occur
What can narrow down the suspicions of diagnostic schemata approach?
- objective tests
- for example, rapid strep test / throat culture
What are the 3 C’s?
- control
- compliance
- complications
key items that emerge during review of a prescription
- review of the prescribed medication
- informational retrieval
- information processing
- identification of medication-related issues
- collaborative planning
- decision making
- reflection
review of a prescribed medication
- Is the prescription valid?
- Is anything missing?
- Is this a medication I am comfortable dispensing or do I need to review drug info before proceeding?
- Does the medication have a narrow therapeutic window?
information retrieval of a prescribed medication
- Gather medication history from patient and/or dispensing records
- Drug information – interaction checks, adverse effect profile, evidence-based guidelines
information processing of a prescribed medication
- Does the information presented seem normal or abnormal?
- Distinguish between relevant and irrelevant information
- Relate information to patient’s history
- prioritize conditions / medications
identification of medication-related issues
Medication-related issues related to the prescription that must be addressed so pt can have optimal benefits with minimal adverse effects
collaborative planning
- Elicit ideas and opinions from others
- Especially from pt, ex How do you feel about starting insulin?
decision making of a prescribed medication
- Verify the prescription is correctly prescribed and filled.
- Justify your thoughts and actions.
- Select appropriate interventions.
