Interview Basics Flashcards
1
Q
Patient-Centered
A
- recognizes the importance of the patients expressions of personal concerns, feelings and emotions
- encourages the patient to tell their story in their own words
- effective use of open-ended questions
2
Q
Physician-Centered
A
- clinician takes charge of the interaction to meet their own need to acquire the sxs or details needed to make a dx
- direct, more focused questions
- typically a yes/no or short answer aka closed ended questions
3
Q
Open-Ended Questions
A
- How can I help you today?
- Tell me more about that…
- What else do you think may be important?
- What have you tried to make this better?
4
Q
Closed-Ended Questions
A
- When did your cough start?
5
Q
Closed-Ended Questions
A
- When did your cough start?
- Have you taken any meds?
- Have you had a HA?
- Have you ever had to stay overnight in the hospital?
- Do you have allergies?
6
Q
Non-Verbal Communication
A
- Professional dress and hygiene
- Posture
- Eye contact
- Active listening
- Professional touch
- Cultural humility
7
Q
Verbal Communication
A
- Open-ended questions
- Closed-ended questions
- Understandable language
- Empathetic responses
- Written documentation: SOAP Note
8
Q
Body Language
A
- Eye Level: empowers the patient as a partner in care (be at or below eye level of the patient)
- Open body language
- Reflective (active) listening (ex. nodding, leaning forward, mirroring patient)
- Respectful or supportive touch
9
Q
Sitting vs. Standing
A
- in studies where physicians sat down during appointments, they were perceived to be in the room longer
- position within 3-4 feet of patient; >5 feet is impersonal; <3 feet is invasive
10
Q
Empathy
A
- the capacity to identify with the patient and feel the patients pain as your own, then respond in a supportive manner
11
Q
Reasons why you should NOT shake your patient’s hand
A
- infection control: wash or sanitize hands prior to exam or touching patient
- cultural humility: not all cultures shake hands as a greeting; some cultures do not permit opposite-gender individuals to touch in a non-clinical situation
12
Q
Components of HPI
A
OLDCAAARTS
(1) Onset
(2) Location
(3) Duration
(4) Character
(5) Aggravating
(6) Alleviating
(7) Associated sxs
(8) Radiation
(9) Timing/Temporal pattern
(10) Severity
13
Q
Wong-Baker Pain Rating Scale
A
- typically has faces associated with each rating
0 = No hurt
2 = Hurts little bit
4 = Hurts little more
6 = Hurts even more
8 = Hurts whole lot
10 = Hurts worst
14
Q
Initial Steps of SPE that occur BEFORE you sit down
A
(1) Introduction
(2) Sanitize hands
(3) Make eye contact
15
Q
Initial Steps of SPE that occur AFTER you sit down
A
(1) Verify name and DOB
(2) How should I address you?
(3) And how old does that make you?
(4) Opening question
16
Q
What information is found in the Subjective portion of the SOAP Note?
A
- CC
- HPI
- ROS
- PMH
- PSH
- MEDS
- ALL
- SH
- FH
17
Q
What information is found in the Objective portion of the SOAP Note?
A
- PE
- Laboratory Data (includes Radiology reports)
18
Q
What information is found in the Assessment portion of the SOAP Note?
A
- Most likely Dx
- Somatic Dysfunction
19
Q
What information is found in the Plan portion of the SOAP Note?
A
- Self-care
- Diagnostic procedures (Xray, labs)
- Management (medications)
- F/u or RTC
20
Q
Review of Symptoms
A
- body divided into 14 systems
- different levels of acuity or severity require different ROS
- require ONE sx out of TWO systems
21
Q
Definition of Symptom
A
- a physical or mental problem that a person experiences that may indicate a disease or condition
- cannot be seen and do not show up on medical tests
- Ex. fatigue, chills, shortness of breath
22
Q
Definition of Signs
A
- findings observed during the PE and any laboratory data or reports
- can be measured or reproduced
- Ex. vital signs (BP, Temp, RR, HR)
23
Q
Examples of “Red Flags” (must not miss sxs)
A
- CC: Ear Pain; ROS: Dizziness and swollen glands = infection
- CC: Back Pain; ROS: Blood in urine and unintentional weight loss = kidney stones, cancer
- CC: Cough; ROS: Night sweats and back pain = TB, pneumonia
- CC: Joint Pain; ROS: Fever and rashes = septic joint, connective tissue disease
24
Q
Where would you document immunizations?
A
PMH
25
What is NOT included in PSH?
- Dental extractions
- Sutures for minor injuries
26
What is included in PSH?
- Preventative surgeries
- Commonly included: tonsillectomy, appendectomy, CS
27
Expressing Empathy: Respecting Technique Examples
- I can see how much you love your family
- You did the right think by coming in
- It must be a lot of stress to deal with ...
28
Expressing Empathy: Naming Technique Examples
- I can see how sad this makes you
- Some people would feel ... in this situation
29
Expressing Empathy: Understanding Technique Examples
- I can imagine what that would feel like
- This has been a hard time for you
30
Expressing Empathy: Supporting Technique Examples
- I'm going to be with you through all of this
- I am here to help you in any way that I can
31
Expressing Empathy: Exploring Technique Examples
- Can you give me a sense of what you're thinking
- How are you coping with ...
32
Importance of Transition Statements
- keep the patient informed of the new direction or topic
- act as a sign-post for new topic
- allows patient time to process the information covered
33
Components of Social History
FED TACOS4
- Food
- Exercise
- Drugs
- Tobacco
- Alcohol
- Caffeine
- Occupation
- Safety
- Support and living situation
- Spirituality
- Sexual history
34
Exercise Guidelines
150 minutes / week
35
Effects of Caffeine
- high doses can be toxic resulting in arrhythmia, vomiting, seizures, coma and death
- most commonly associated with energy drinks
- can lead to insomnia, anxiety, palpitations, HAs
36
Definition of a Drink
- Beer:
- Wine:
- Liquor:
- 12 oz of 5% beer
- 5 oz of 12% wine
- 1.5 oz of 80 proof liquor
37
Maximum Recommended Alcohol Intake for Men: Per Day? Per Week?
< 4 drinks per day and/or 14 drinks per week
38
Maximum Recommended Alcohol Intake for Women: Per Day? Per Week?
< 3 drinks per day and/or 7 drinks per week
39
Alcohol Use Disorder
- must fulfill 2 of 11 criteria that include craving, tolerance, inability to cut down, etc
40
CAGE Questions: C
Cut
- have you ever felt you should Cut down on your drinking?
41
CAGE Questions: A
Annoy
- do people Annoy you by criticizing your drinking?
42
CAGE Questions: G
Guilty
- do you feel Guilty about your drinking?
43
CAGE Questions: E
Eye-opener
- do you ever have an Eye-opener first thing in the morning to steady the nerves, or get rid of a hangover?
44
Psychosocial Health Pyramid
Top -> Bottom
- Self-actualization: growth, creativity
- Self-esteem: self respect, social recognition, job satisfaction
- Belonging: love, friendship
- Safety: health and safety, stability
- Physiologic: food, water, clothing
45
What 3 things are ALWAYS required in SH?
- Tobacco: current or past use, type, amount
- Alcohol: current or past use, drinks per day or drinks per week
- Drugs: current or past use, type
