Medical Scenarios

Complete Parts 1 and 2 – A, B, and C (D for Part 2) for this assignment. Answer in complete sentences, and be sure to use correct English, spelling and grammar. Sources must be cited in APA format. Each part (A & B) the response should be at least two and one-half (2 ½) double-spaced pages.

Part 1.

A: Sheila Meyer, a medical assistant in Dr. Ryan’s large cardiovascular practice, is taking the medical history of Edna Helm, an obese elderly woman with congestive heart disease. Edna states, “I’m always short of breath, and I perspire all the time. I guess I’m gaining weight, but the funny thing is that only my legs seem heavier. My heart is pounding when I lie down at night; it even seems to stop sometimes. I’ve even started to wear red nail polish to hide the funny blue color of my nails.

Edna gives you a copy of her medical history from an out-of-state physician. The medical history indicates that she has had the following conditions, tests, and procedures:

Using correct medical terms, chart Edna’s presenting symptoms. Define each of the procedures and conditions listed on her medical record. Your response should be one (1) page in length.

B: Victor Krenz is assisting Dr. Connors with the fifth cataract surgery for the day. The patient is Kathy Wall, a diabetic patient, whose condition has been stable enough for her to undergo a surgical procedure. Victor has performed a six-minute surgical scrub on his hands before each of the five procedures. Dr. Connors indicates that he is in a hurry to get back to his office for a heavy afternoon schedule of patients. After both Dr. Connors and Victor are scrubbed, gowned, and ready to begin the operation, Victor feels a slight prick on the tip of his gloved finger as he moves the sterile syringe and needle on the tray. Dr. Connors, who does not notice the accidental needlestick to Victor’s glove, states again that he is in a hurry to finish this procedure. Victor knows that it will delay the surgery if he has to change gloves. He also knows that his hands have had a surgical scrub five times that morning and that they are clean.

Provide detailed answers for each of the following questions. Your response should be one-half (1/2) page in length.

· Can Victor justify not changing into new gloves?

· What could happen to Ms. Wall as a result of Victor’s needlestick?

· How should Victor handle this situation?

C: José Menendez is an elderly patient of Dr. Juárez, a board-certified urologist. José has a history of recurrent UTIs dating back more than 10 years. When he becomes symptomatic, he has been instructed to call Dr. Juárez’s office and schedule a urinalysis. Dr. Juárez’s receptionist has just received a call from Mr. Menendez. He says he knows he is supposed to come in for a urine test but that he just wants a prescription phoned in to his pharmacy instead. The receptionist asks Emilia, Dr. Juárez’s medical assistant, to take the call from Mr. Menendez.

Emilia listens as Mr. Menendez recounts that he is experiencing dysuria—painful, burning urination. She asks him to come in for a urinalysis, explaining that, as per standing orders, a clean-catch midstream specimen needs to be collected. Mr. Menendez repeats to Emilia that he does not want to come in to the office. “Why can’t you call in a prescription for Bactrim? That is what I took last time, and it helped.”

Provide detailed answers for each of the following questions. Your response should be one (1) page in length.

· What is your response?

· Should the responsibility for this call have fallen on Emilia, or should the receptionist have either handled the call herself or passed it on to Dr. Juárez?

· What, if anything, could or should Emilia say to Mr. Menendez to persuade him to come in for the urinalysis?

· Might the cost of the procedure be a factor in the reason why Mr. Menendez does not want to have a urinalysis, and, if so, what, if anything, can Emilia do or say about the cost?

· Is it appropriate in this case, given the patient’s extensive history, to indeed call in a prescription for Bactrim?

· If not, how should Emilia handle Mr. Menendez’s request for his prescription?

· If so, what procedure should Emilia follow to arrange for a prescription?

· How should this telephone call be charted?

· What, if anything, should Dr. Juárez be told about the conversation with Mr. Menendez?

Part 2

A: Marge Riley, an overweight 50-year-old woman with a history of abdominal pain, has been scheduled for a lower GI series on Monday morning. She states she has board meetings every Monday morning at which breakfast is served and that she will come in for her x-rays after the meeting is over. Marge indicates that she does not understand why she needs these procedures.

Provide detailed answers for each of the following questions. Your response should be at least 150 words in length.

· What, if anything, would you tell the patient regarding her need for these procedures?

· How would you describe these procedures to the patient?

· What combination of teaching methods would you use to explain the procedures?

· You are still concerned, after explaining everything to Marge, that she will not follow the instructions. What do you do?

B: Jenny Watmore, a medical assistant working in Dr. Cory’s orthopedic practice, has been asked to assist Mr. Ivy from the wheelchair onto the examination table. Mr. Ivy, who is 70 years old, is weakened on the left side of his body from a cerebrovascular accident (CVA). He weighs 200 pounds and is reluctant to provide much help to Jenny when she has to transfer him from the wheelchair to the examination table.

Provide detailed answers for each of the following questions. Your response should be at least 150 words in length.

· How can Jenny get Mr. Ivy to help her assist him?

· Describe the body mechanics that Jenny should use to assist Mr. Ivy.

· What patient education does Mr. Ivy need?

· What documentation should Jenny provide on Mr. Ivy’s record?

C: Dr. Waring has a solo practice. When she is on vacation, she arranges for Dr. Dumphey to cover her patients. Dr. Dumphey’s medical assistant, Theresa, has just received a call from a patient of Dr. Waring. The patient is an elderly woman, with multiple medical problems, who is possibly having a reaction to a medication that Dr. Waring prescribed two days ago for bronchitis. Her symptoms include nausea, upset stomach, dizziness, headache, rash on her chest, and extreme exhaustion. Theresa senses that the patient may be exhibiting some disorientation to time and place, because it is difficult to elicit consistent responses from her regarding her medications. The patient reports to Theresa that the newest medication she has been taking is Biaxin. The other medications she takes include Prinivil, Cardizem CD, Premarin, Prilosec, Robaxin, Zocor, Ambien, Prozac, Fosamax, Seldane, and aspirin. The patient does not know the dosage of any of these medications but is willing to “open up her bag of medicine” and read each prescription label to Theresa.

Provide detailed answers for each of the following questions. Your response should at least 200 words in length.

· Does Theresa have an obligation, as Dr. Dumphey’s medical assistant, to handle this situation with this patient, or should Dr. Waring simply be notified?

· Is this an emergency situation or potential emergency situation and, if so, what should Theresa do immediately?

· Because the patient seems disoriented, should Theresa even trust what the patient is reporting?

· Should Theresa have the patient read the label of each of her medications?

D: Stacy Friedlander is the lead medical assistant in an ophthalmology practice of ten physicians. The eye clinic has patients, literally, from all over the world. Several of the physicians are leaders in their specific area of ophthalmology, such as Dr. Keeler, who specializes in retinal diseases.

Today, Stacy is going to interview a potential new employee, Sarah Banks. Sarah is currently finishing a CAAHEP-approved medical-assisting program at a local college and is searching for full-time employment. She has some on-the-job experience dating back to when she was an after-school receptionist for a general practitioner, but that was more than ten years ago.

The clinic tends to hire medical assistants who are certified, experienced, and very capable of dealing with patients from different age groups, races, and cultures. However, Sarah is being considered for the position because, first of all, her father is a personal friend of Dr. Keeler and, second, qualified medical assistants are difficult to find because of the high demand.

Provide detailed answers for each of the following questions. Your response should at least 150 words in length.

· What should Stacy do to prepare for the interview with Sarah?

· Considering that the practice is limited to ophthalmology, would any special requirements be warranted in a medical assistant who was going to work in this area?

· Considering that the clinic’s patient population is mixed by age and race, would any special requirements in a medical assistant be warranted in this case?

· Is it proper procedure for Sarah to be applying for this position given that she has not yet completed her medical assisting program?

· Should Stacy, given the circumstances, invest a lot of time in interviewing Sarah? Why or why not?

· Should Sarah’s ten-year-old job experience be factored into Stacy’s decision to hire Sarah or not?

· If Stacy decides not to hire Sarah, does Stacy need to personally contact the reference and thank him anyway, given that he is a friend of Dr. Keeler?

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