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13 Cards in this Set
- Front
- Back
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Entering room- what you say:
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1. Knock three times, enter confidently.
2. Say, "Good morning/afternoon Ms. Johnson, I am Michele LaGrone, a medical student. Is everything in the room all right for you? 3. Pt says yes. 4. Say, "Let me make you more comfortable." Drape the patient. 5. Sit on stool and lean forward. 6. Say, "So, Ms. Johnson, it seems that you have come in today for a racing heart.Could you tell me more about it?" |
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After patient tells you chief complaint- what you say:
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"Oh, I'm sorry to hear that. I'll try my best to help you. Hope you don't mind if I make a few notes while you speak?" [SMILE]
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How to ask questions
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Go through COLDER BARS and focus esp on your DDX mnemonic (which by now you have memorized). Then go through PAM HUGS FOSS.
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What to do between PAM HUGS and FOSS
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Say, "Ms. Johnson, the way clinical medicine works, there could be some clues hidden in a few personal questions I need to ask you. Is that ok?"
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What to do when you have finished asking questions
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Say, "Is there anything else you would like to tell me?"
*DO NOT say you are done asking questions. You may have more later. Then say, "I will now need to perform a quick physical examination on you and then look at your heart. I will keep you informed as to what I am doing throughout the exam. Is that ok?" Patient says yes. Then say, "Ok! Before we do that, please excuse me for a moment while I wash my hands." |
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What to say while washing your hands
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"So, do you work? What do you do?" [Smile the WHOLE time and look at patient as much as possible.]
Pt answers. "Oh, my uncle used to do something similar." |
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What to say just before you examine patient
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"I now will have to do a quick physical exam and then examine your chest (or lungs, etc). I will keep you informed of what I am doing the whole time, ok?"
Pt says ok. "Great! Let's start with your eyes." |
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Basic exams to do every time
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HEENT-pupil reflex, mouth with ophthalmoscope
CV-auscultate Lung-auscultate Abd-inspect, palpate, auscultate |
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What to say after exam
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SUMMARIZE: "Based on the physical exam and what you have told me, there are several diagnostic possibilities, such as 1. ___, 2. ___, 3. ___. But to be more certain, let's order a few tests--blood tests, EKG, holter monitoring--and then discuss further management."
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What to say after summary
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Counseling!
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What to say after counseling
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"Have you understood everything we have discussed today?"
"Are there any special concerns you may have?" |
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How to say good-bye
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"Thank you very much, Ms. Johnson. I will leave my contact information with my nurse - feel free to contact me anytime with concerns or questions."
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What to say if you run out of time
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Look at fake pager and say, "Oh! Ms. Johnson, we have an emergency and have to leave! I will see you as soon as I get free." [SMILE really big and walk out]
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