Question

Claudette is a 35 year old woman who was referred to your health clinic for follow...

Claudette is a 35 year old woman who was referred to your health clinic for follow up care after she spent the night in the Emergency Room with severe stomach cramps and vomiting. She was diagnosed with food poisoning but had elevated blood pressure and revealed to the ER provider that she had not seen a physician for a physical in over ten years. She left the sexual orientation question on her patient self assessment form blank but did report herself as recently married to her wife Marie. They live in Brooklyn but she tells you she came into Manhattan for her physical because she doesn’t want anyone her neighborhood to “be all up in my business”.

  1. What are the challenges and potential barriers to engaging and maintaining this patient in care?

  1. What screenings and assessment should be done and what is the best way to engage her in that process?

  1. How do you handle her concerns about treatment?

  1. What would be the most effective preventive and treatment plan/approach for her care?

  1. What potential referrals might you make and where?

Homework Answers

Answer #1

1) As the patient may have sexual related barriers.

There may be difficulty in adressing her sexual orientation.

Feeling of being judged.

Feeling of biasness and lack of trust.

Fear about the health care personals reaction to her sexual orientation.

2) check vital parameters.

Check rft, lft, usg.

Assess the vomitus for blood or any other food products.

Assess the gynaecological status.

Assess the sexual status of the patient.

Provide a rationale for every intervention

3) observe the patient for episodes of vomitting and cramps  

Assess the vital signs of the patient.

Explain and educate the patient about the treatment process.

Educate the patient to relax and educate about the treatment process.

4) educate the patient not to have contaminated food.

Educate the patient to assess for any allergic reaction.

Educate the patient to assess the vomitus.

Educate patient to have warm meals

Educate the patient about food habits.

Promote a good conversation with the Patient to ehance a talk on self sexual orientation.

4) referal must be given for gastro conditions, Hematological studies along with psychiatry references.

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