PA 33 Flashcards
You have diagnosed a patient with HIV, and they do not want to tell their partner. What do you do?
I would first talk to the patient about how important it is to tell their partner, for both their health and their partner’s health. I would explain the risk of passing HIV to their partner and offer support, such as counseling, on how to share this news. In many places, there are rules that require providers to protect people who could be harmed. If the patient still refuses to disclose and the law allows it, I may have to tell the partner or a public health authority. My main goal is to balance the patient’s privacy with the need to keep others safe.
YOU ARE A PA. YOUR COLLABORATING MD ASKS YOU TO ADMINISTER A MEDICATION TO A PATIENT. YOU DO NOT AGREE WITH HIS DECISION AND FEEL IT COULD HARM THE PATIENT. WHAT DO YOU DO?
If my collaborating physician asked me to give a medication, I believed could harm the patient, I would first gather more information. I would review the patient’s chart and talk with the nurse and the patient to get a clear picture of their condition. Then I would try to reach out to my collaborating physician to discuss my concerns. If I still felt the medication was unsafe or if I could not reach the physician, I would trust my own judgment and not give it. Keeping the patient safe is always my top priority. I would also document my decision and the steps I took so there is a clear record of why I chose not to follow the initial order.
YOU ARE IN A SURGERY AND THE ANESTHESIOLOGIST BEGINS TO MAKE INAPPROPRIATE COMMENTS ABOUT THE PATIENT ONCE THEY ARE ASLEEP. WHAT DO YOU DO IN THIS SITUATION?
I would politely but firmly address the anesthesiologist and remind them that making inappropriate comments about a patient is unprofessional and disrespectful.
YOU HAVE AN ELDERLY PATIENT WHO NEEDS TO STAY AT THE HOSPITAL FOR OVERNIGHT OBSERVATION. THE PATIENT IS REFUSING, BUT THE PATIENT’S SON STATES THE PATIENT HAS DEMENTIA AND IS INCAPABLE OF MAKING MEDICAL DECISIONS. THE PATIENT’S SON WANTS THE PATIENT ADMITTED. WHAT DO YOU DO?
I would first see if the patient is able to make decisions for themselves. Even with dementia, some patients can still understand what is happening and the risks of their choices. I would talk with the patient to see if they know why we want them to stay overnight. If I decide they are not able to understand or make a safe decision, I would confirm if the son is the legal decision-maker or has power of attorney. If he does, I would admit the patient for observation, since that is in their best interest. However, if the patient shows they can understand and make their own decision, I would respect their wishes, even if it goes against my advice. I would also document everything and involve social work or an ethics team if needed.
YOU ARE SEEING A JEHOVAH’S WITNESS PATIENT. DUE TO RELIGIOUS BELIEFS, THEY DO NOT ACCEPT BLOOD TRANSFUSIONS, BUT IT COULD BE LIFE-SAVING. WHAT DO YOU DO?
I would first make sure the patient fully understands why a blood transfusion might be necessary and what could happen without it. I would then respect their decision if they have the capacity to make medical choices and still refuse the transfusion. Since they are a competent adult, they have the right to decide what treatments they do or do not accept based on their beliefs. I would also explore all possible alternatives that align with their religious views, such as bloodless surgery techniques or other treatments. Throughout this process, I would document their decision, confirm their capacity, and involve an ethics committee or consult with colleagues if needed.
