Test #1 Lecture Dr. Heaton
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| internal factors in communication | 1. liking others
2. empathy-viewing from their shoes
3. ability to listen-active
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| external factors in communication | 1. privacy
2. refuse interruptions
3. physical environment
4. dress
5. note taking
6. recording
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| how many direct questions should you ask at a time? | 1 but if unavoidable pause in between
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| Types of Responses | Patients perspective
Facilitation
Silence
Reflection
Empathy
Clarification
Our perspective:
Confrontation
Interpretation
Explanation
Summary
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| 10 Traps | 1. False Reassurance
2. giving unwanted advice
3. using authority
4. using avoidance language
5. engaging in distancing
6. using professional jargon
7. using leading or biased questions
8. talking too much
9. interrupting
10. using "why" question
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| older adult considerations in the interview | -takes longer
-slow speech
-in appropriate pronouns
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| acute ill considerations in the interview | -glean information from family or when becomes stable
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| 4 different types of space | 1. intimate 0-1.5' (breath & body odor)
2. personal 1.5-4' (physical assessment)
3. social 4-12' (much interviewing occurs here)
4. public 12'+ (impersonal)
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| mental disorder | a significant behavioral or psychological pattern that is associated with distress or disability & has a significant risk of pain, disability, or death or loss of freedom
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| organic vs. psychiatric mental illnesses | organic has a known cause vs. psychiatric etiology unknown yet
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| mood & affect | mood: a prolonged display of feeling that color the whole emotional life
affect: is temporary expression of feelings
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| abstract reasoning | pondering a deeper meaning beyond the concrete & literal
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| thought process | the way a person thinks
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| thought content | is what the person thinks
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| MMSE | mini mental state examination
A&O
Registration (point & identify)
Naming
Reading
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| Mini Cog | 3 word recall & draw a clock
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| lethargic | not fully alert drifts off to sleep when no stimualation but can arouse with voice
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| obtunded | sleeps most of time difficult to arouse & needs shout or vigorous shaking
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| stupor or semi-coma | unconscious only responds to persistent vigorous shake or pain
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| coma | unconscious no response to pain or external/internal stimuli
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| delirium | clouding of consciousness
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| dementia | decreased cognitive ability
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| Biomedical model | absence of disease=healthy
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| Reason for seeking care should be documented how? | Patients own words
Use quotations
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| Health history PQRSTU | Provocative/palliative
Quality/quantity
Region/radiation
Severity
Time
Understand patients perception
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| During a health hx if person was hospitalized or had an operation what information should be recorded? | hospital, Dr., what was done/what illness, complications, how long hospitlization
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| Obstetrical hx | G-# of pregnancies
T-reached term
P-early/ask how early
A-incomplete/ask whether spontaneous/induced
L-# living kids
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| When asking about course of pregnancy what things should be addressed? | length of pregnancy & labor, complications, date of delivery, c-section/vaginal, weight/sex/condition of baby
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| What to document about allergies? | types: medications, food, & skin irritants
what happens?
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| nutritional status | balance between nutrient intake and nutrient requirements
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| Consume sufficient nutrients to handle | everyday routine needs AND any increased demands
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| People who have optimal nutritional status are: | typically more active, fewer physical illnesses, & live longer
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| Vulnerable groups for undernutrition | Infants & children
Elderly
Pg women
Recent immigrants
Low income families
Hospitalized people
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| Having undernutrition effects people by... | lower resistence to infection & disease, delayed wound healing longer hospital stays & higher health care costs, impaired g&d
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| Cultural & religious considerations | latin: chili pepper is not food
viantmese: low dietary consumption
Religious
mormons: no caffiene/alcohol
jewish: animals are prepared certain way
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| Nutrition screening includes: | height & weight hx
diet
routine labs
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| Screening tools used for whom: MST & MNA | MST (malnutrition screening tool) older adults
MNA (mini nutritional assessment) geriatric
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| methods to collect nutritional info | Comprehensive nutritional assessment
24 Hr - recall
Questionnaire or interview
Food frequency questionnaire
Food diaries
Direct observation
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