Plundo lecture

Question 1

describe the ways to hinder a good relationship

Answer 1

• Keep them waiting, no explanation
• be in hurray; talk with one foot out the door
• belittle their concerns and emotional responses
• IGNORE their life streses

Question 2

we react negatively when patients are difficult:

Answer 2

• Demanding
• Wanting or feeling entitled to special treatment
• always on the edge of a lawsuit
• really and often impressed with self determined status fro themselves but really quite dependent
• Self- destructive and inattentive to instructions
• always testing you (rejecting, distrusting, testing your competency and reliability)

Question 3

What are some guidelines for handling the communication of bad news:

Answer 3

• TURN OFF PAGER or equivalent
• make area as quiet and free of distractions
• Involve other such as family, significant other or clergy
• be specific in details
• be deliberate in the flow of information but adjust to patients needs
• jargon free language adapted to patients understanding
• inform the patients as soon as possible

Question 4

Describe the comprehensive type of history

Answer 4

• designed to make you thoroughly familiar with patient
• NEW PATIENTS
• YEARLY physicals
• preoperative physicals
• hospitalized patients

Question 5

describe the problem oriented focused history

Answer 5

• Typical office progress note
• sick visit
• taken when problem is acute
• life threatening problem
• Requiring immediate attention, only the need is given full attention

Question 6

describe the expanded history

Answer 6

• If chief complaint involves that system or they have had morbidity in this system in the past
• Example: hospital follow up for a stroke and have history emphysema (need neurologic and respiratory exam)
• Some patients have multiple expanded areas
• importance of scheduler

Question 7

describe the basic history

Answer 7

• test major function of the system
• does not go into the “fine tuned” examination
• used when no deficit is found
• Example: lung examination (normal finding = no egophoney)
• all patient deserve a “basic” heart and lung

Question 8

describe the oral presentation format

Answer 8

• Useful for clincial or hospital presentations
• shorter the better (brief but include important info)
• does not need to include everything that you will put in your not
• Lab reports
• differential diagnosis in mind
• treatment plan

Question 9

always reassess yourself?

Answer 9

• Greet, maintain comfort, minimize distractions
• explain, assess paitent’s understanding
• begin with a comfortable opening statement
• make patient at ease
• move from open ended questions to more specfic
• maintain eye contact, sit comfortably
• speak at appropriate pace, allow patient to express self
• summarize and recheck for accuracy
• ask more questions as needed
• indicate the next steps
• thank and goodbye