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PSL > Q to ask: Patient Scenarios > Flashcards

Q to ask: Patient Scenarios Flashcards

1
Q

How do you start every interaction?

A
  • Introduce yourself as the pharmacist and ask “how may I help you today?”
  • Offer patient counselling room and be sure to state that everything that is said there is confidential.
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2
Q

In a medication scenario (Someone is coming to pick it up for themselves) what are key questions to ask?

A
  1. Ask if it is for themselves
  2. Ask their name
  3. Confirm with DOB or address
  4. Ask if they’ve taken this before
  5. Make sure they know how to take the medication
  6. Ask if they are on any other medications
  7. Ask about allergies
  8. Ask about any other possible questions or concerns
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3
Q

In a PHIA scenario (someone is coming to pick it up for another person in which they don’t have consent) what are key questions to ask?

A
  1. Ask if they have every picked this up for them before (determining if they have consent or not)
  2. Explain PHIA and why you are not able to disclose this information
  3. Explain that they need consent
  4. Offer to call that person and obtain verbal consent or ask for some form of written consent if that won’t work
  5. Be empathetic and understand that this is convenient
  6. If you can’t call the person, then say that they will have to come in and when they come in, you can talk to them about giving the person consent to pick up for them.
  7. Thank them for being understanding
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4
Q

In a weight loss scenario what are key questions to ask?

A
  1. Determine why they want to lose weight
  2. Have they ever tried losing weight before?
  3. Ask about lifestyle (diet/exercise/smoking/alcohol)
  4. Tell them to be patient with expecting results
  5. Ask about lifestyle changes
  6. If they are not 100% sure on losing weight explain to them that it can better their health in many ways such as: decrease risk of hypertension, heart disease, type 2 diabetes, increase energy
  7. Suggest resources such as Canada’s food guide
  8. Request a follow up in a month and if you aren’t feeling better or seeing progress, then offer to refer them to a dietician
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5
Q

In a smoking cessation scenario, what are key questions to ask?

A
  1. Ask why they want to quit, if they say because someone told them to, be sure to explain that they need to have the motivation themselves in order for this to be successful.
  2. Ask if they’ve ever tried to quit before
  3. Establish that they know the benefits to quitting smoking such as reduce risk of heart disease, cancer, respiratory problems, save $, improve taste of food.
  4. Talk about support groups available.
  5. Recommend trying nicotine patches/spray to help aid them in their goal
  6. Definitely request a followup with you in a week to see how things are going
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6
Q

In a dry skin scenario, what are the key questions to ask?

A
  1. Ask where it is
  2. Ask how long have you had it
  3. Ask if this is normal or new for them
  4. Discuss lifestyle changes
  5. Ask about showering habits
  6. Ask about laundry soap/ things with harsh perfumes in it
  7. Climate: Indoor: is it dry? Outdoor: is it dry? Suggest a humidifier
  8. Occupation
  9. Pain/itchiness/redness, signs of infection
  10. Family history of dry skin/exzema
  11. Have you tried treating this before?
  12. Ask about water and caffeine intake
  13. Allergies?
  14. Suggest a an occlusive, humectant, or an emollient (ointment, cream, or lotion)
  15. Ask about medical conditions: IF IT IS DIABETES YOU MUST REFER
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7
Q

What is an occlusive?

A

It forms a barrier on the skin that physically blocks water loss from the skin’s surface.
Recommended for dry skin on hands and feet

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8
Q

What are examples of an occlusive?

A

beeswax, mineral oil, vaseline, preview, eucerin, etc.

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9
Q

What is a humectant?

A

It increases water content of the skin by drawing water from the dermis to the epidermis.
Applied 2-3 times daily.
Recommended for

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10
Q

What are examples of a humectant?

A

Glycerin, urea & lactic acid, uremol 20

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11
Q

What is an emollient?

A

Moisturizer - ointment, cream, or lotion
-Fills the cracks/fissures produced by dry skin by filling the spaces around the cracks – lubricates & softens skin
Effect usually lasts 2-3 hours then you have to reapply

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12
Q

What are ointments?

A
  • 80% oil
  • 20% water
  • greasy
  • may be difficult to spread
  • require less frequent applications than creams or lotions
  • never use on face or skin holds
  • never use on areas that are moist, weeping, oozing, infected, or areas prone to acne, etc.
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13
Q

What is a cream?

A
  • 50% oil
  • 50% water
  • can be applied to areas that are moist, weeping, oozing, or very dry
  • cosmetically more acceptable than ointments
  • can use on face and body
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14
Q

What is a lotion?

A
  • contain more water than oil
  • useful for hair areas or if immediate absorption is necessary
  • not effective for really dry skin
  • easy to spread
  • short acting, must be applied more often than creams or ointments
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15
Q

What is a gel?

A
  • can be drying when used for long periods of time
  • useful for hairy areas
  • liquefy on contact with skin and leave a thin layer of active medication
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16
Q

In a bug bite scenario, what are key questions to ask?

A
  1. When did the bite happen
  2. What are the symptoms like?
  3. Determine if it’s allergic reaction by asking if it’s red/painful/itchy. Is a fever present? Body aches?
  4. Were they wearing bug repellent?
  5. Where is it located?
  6. Tried anything yet?
  7. History of stings/ reactions?
  8. Recommend treatment by removing insect/stinger, apply ice, clean area, avoid scratching, OTC antihistamines to relieve itching.
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17
Q

What are tips that you could give patient to prevent bites from bees, wasps, or hornets from occurring?

A
  • Stay away from nests
  • Don’t wear perfume or used scented soaps
  • Don’t leave food or water outdoors
  • Avoid wearing bright coloured clothing
  • Avoid outdoors at dusk and dawn
  • Cuff clothing around ankles, wrists, and neck.
18
Q

Tips for prevention of fleas?

A
  • Treat pets who carry/become infested
  • Don’t sleep with infested pets
  • Clean daily
  • Avoid contacts with animals who may carry fleas
19
Q

Tips for prevention of spiders?

A
  • Avoid areas where spiders live (rock/wood piles)

- Remove access to home

20
Q

Prevention of bed bugs?

A
  • Avoid bringing invested luggage/clothes into the home
  • Wash bedding frequently using hot water
  • Vacuum frequently
  • Inspect mattresses
21
Q

Prevention of mosquitoes?

A
  • Avoid or time limit in areas where mosquitoes are commonly found
  • Remove standing water
  • Wear light coloured clothing
  • Avoid scented products
  • Wear insect repellents
22
Q

What do you want to be concerned with regarding mosquito bites?

A

West Nile

23
Q

What are symptoms of west nile?

A 
Mild:
-symptoms appear within 2-15 days
-flu like symptoms
-mild rash, swollen lymph glands
Severe:
-rapid onset of severe headache, high fever, stiff neck, nausea, difficulty swallowing, vomiting, drowsiness, muscle weakness
24
Q

Prevention for ticks?

A
  • avoid swampy areas, dense woods, stay on pathways

- use DEET insect repellants

25
Q

When can you not use DEET or Icaridin repellents or sunscreens?
How do you protect them?

A

Under 6 mo old

Physical protection: stay inside, limit time outside, long clothing, hats, sunglasses

26
Q

What do you determine first for a burn?

A

Severity:
1st - red/pink irritated skin (3-6 days)
2nd(sup) - moist, weeping blisters, red skin (7-20 days)
2nd (deep) - wet or waxy, pain with pressure, large blisters (21 or more days)
3rd - blisters, be oozing, painless to touch, leathery, black, grey or white (long time)

27
Q

What do you determine second for a burn?

A 
Cause:
Thermal
Chemical
Radiation
Electrical
28
Q

When do you refer a burn?

A
  • face, ear, eyelids, inner arm, groin
  • children under 2 or adults over 55
  • chemical, electrical or inhalation burn
  • burns with lots of large blisters
  • medical conditions (diabetes, immunosuppressed, HIV)
29
Q

What is treatment for thermal burns?

A
  • remove heat source
  • cool area with tepid water
  • cover with a non-stick gauze if necessary
  • leave blisters in tact
30
Q

What is treatment for chemical burns?

A

-clean/ remove the caustic agent
-remove clothing that has been doused in the chemical
-wash with lots of water
REFER

31
Q

What is treatment for an electrical burn?

A
  • remove from source of electricity

- CALL 911, get him to EMERG

32
Q

Describe the general first aid treatment for burns

A
  • cool area
  • gently cleanse
  • apply a non-stick gauze if necessary
  • pain relief such as ibuprofen, acetaminophen, or naproxen
33
Q

Describe some risk factors for sunscreen

A
  • skin types
  • family history
  • medications (photosensitizing medications)
  • ozone depletion
  • out door workers who have long-term exposure to UV radiation
34
Q

Describe phototoxic

A
  • common
  • onset minutes or hours following exposure
  • appears as an exaggerated su burn
  • not immunological!!
  • chemically induced reaction that occurs when a drug absorbs UV light
35
Q

Describe photo allergic

A
  • rare
  • result of am immune response (UV light triggers this)
  • -happens 1-3 days after contact
  • inflammation of skin
  • red and itchy rxn
36
Q

List prevention for sunburns

A
  • limit time in sun
  • don’t go out between 10 and 4
  • wear hats, sun glasses
  • wear sunscreen and lip balm with sun protection
  • wear long clothing
  • go in shade
For babies:
NO SUNSCREEN
-just physical protection
-shade over stroller
-cover as much skin as possible
-limit time in sun
37
Q

How do you choose a good sunscreen?

A
  • broad spectrum (UVA and UVB protection)

- CDA approved

38
Q

How much sunscreen do you apply?

A 
TEASPOON RULE:
1 teaspoon for front torso, back torso, and each leg
1/2 teaspoon for head, neck and each arm
OR
30 mL for entire body
39
Q

Describe appropriate application and reapplication of sunscreen

A
  • 15 to 30 minutes before exposure
  • reapply every 2 hours
  • reapply 40 minutes after swimming or sweating
  • reapply after towel drying
40
Q

What is the general treatment for a sunburn?

A
  • cool tap water compress
  • drink lots of water
  • acetaminophen for pain
  • moisturize the skin
  • topic anesthetics for pain relief such as benzocaine
  • topical antibiotics only if skin is broken and pt at risk of infection
41
Q

When do you refer a bug bite?

A
  • anaphylactic rxn within 30 mins
  • systemic rxn with hours
  • allergic response away from site
  • history of previous stings
  • stings to tongue or mouth
  • less than 2 years old
  • unresolved prob after a week
  • if the area worsens or spreads after 24 hours
42
Q

When do you refer for dry skin?

A
  • very large areas of dry skin
  • under 2 years old or over 60 years old
  • if its infected
  • medical conditions like HIV
  • if sleep is affected
  • severe itching/inflammation
  • if they have diabetes!! (especially if dry skin is on lower feet)

PSL (4 decks)

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