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Andrei [34K]
3 years ago
13

A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric

and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment?
Health
1 answer:
Ipatiy [6.2K]3 years ago
4 0
Good doctor-patient communication has the potential to help regulate patients' emotions, facilitate comprehension of medical information, and allow for better identification of patients' needs, perceptions, and expectations.4,7,17 Patients reporting good communication with their doctor are more likely to be satisfied with their care, and especially to share pertinent information for accurate diagnosis of their problems, follow advice, and adhere to the prescribed treatment.1,6,7,9,14,16,18–23 Patients' agreement with the doctor about the nature of the treatment and need for follow-up is strongly associated with their recovery.10

Studies have shown correlations between a sense of control and the ability to tolerate pain, recovery from illness, decreased tumor growth, and daily functioning.16,20,24Enhanced psychological adjustments and better mental health have also been reported.6,10,16,25,26 Some studies have observed a decrease in length of hospital stay and therefore the cost of individual medical visits and fewer referrals.1,27

A more patient-centered encounter results in better patient as well as doctor satisfaction.1,5–7,9,13,15,18,19,22,25,26,28–30Satisfied patients are less likely to lodge formal complaints or initiate malpractice complaints.1,5,9,19,22,28 Satisfied patients are advantageous for doctors in terms of greater job satisfaction, less work-related stress, and reduced burnout.4,26

THE PROBLEMS

There are many barriers to good communication in the doctor-patient relationship, including patients' anxiety and fear, doctors' burden of work, fear of litigation, fear of physical or verbal abuse, and unrealistic patient expectations.31

Deterioration of Doctors' Communication Skills

It has been observed that communication skills tend to decline as medical students progress through their medical education, and over time doctors in training tend to lose their focus on holistic patient care.32 Furthermore, the emotional and physical brutality of medical training, particularly during internship and residency, suppresses empathy, substitutes techniques and procedures for talk, and may even result in derision of patients.32

Nondisclosure of Information

The doctor-patient interaction is a complex process, and serious miscommunication is a potential pitfall, especially in terms of patients' understanding of their prognosis, purpose of care, expectations, and involvement in treatment.12 These important factors may affect the choices patients make regarding their treatment and end-of-life care, which can have a significant influence on the disease.33 Good communication skills practiced by doctors allowed patients to perceive themselves as a full participant during discussions relating to their health.10 This subjective experience that influences patient biology is the “biology of self-confidence” described by Sobel, which emphasized the critical role of patients' perception in their healing process.

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Why is a child’s maximum heart rate different?

Maximum heart rate is the highest heart rate a healthy person can achieve without experiencing severe problems related to exercise stress. Once you determine your maximum rate, doctors recommend you exercise in your “target heart rate zone,” typically at 60% to 80% of your maximum heart rate for a healthy adult.

Children, however, generally have a higher resting heart rate than adults because they have a smaller heart size, decreased stroke volume, and decreased blood volume. These characteristics throw off the formula and make it inaccurate for children, Dr. Zahka says.

Typically, children ages 6 to 18 tend to have lower maximum heart rates than the formula would indicate, often measuring as low as 185. However, maximums for children can climb as high as 215, he says. The actual heart rate varies by child and is likely genetically determined.

Your doctor can pinpoint your child’s actual maximum heart rate with a formal exercise test, if necessary.

Why does the difference matter?

Knowing that some children have lower maximum heart rates than others could change how schools conduct certain fitness tests, Dr. Zahka says.

Currently, for example, some fitness tests require students to reach 70% of their maximum heart rate.

For a 10-year-old, under the common formula, that means a target heart rate zone of 170 for exercise. But, if a child is genetically predisposed to a maximum heart rate of 180, he should aim for 70% of that, which is only slightly more than 140.

Gender also is a factor for exercise at certain ages, Dr. Zahka says.

Data shows that, at a young age, there’s very little difference in maximum heart rates between boys and girls. That doesn’t change much in adolescence, but it does impact exercise capacity. Between ages 10 and 18, a boy’s ability to exercise harder can increase up to 20%.

What happens when a child pushes too hard?

Pushing your heart rate up too high is dangerous, Dr. Zahka says. It can cause dizziness and shortness of breath. Exercising at or beyond the maximum heart rate for too long can also cause a burning sensation in the muscles due to a buildup of lactic acid.

A child who has these symptoms does not necessarily have an underlying heart or lung problem, Dr. Zahka says. But signs like these show that he is working beyond his abilities that day under those conditions.

Overall, children are typically good self-regulators — unlike adults, who will sometimes push themselves too hard and raise their heart rates dangerously high, Dr. Zahka says.

“Most children under most circumstances will limit themselves appropriately with exercise,” he says. “They’ll slow down or stop when they need to. The important thing is that they know to listen to their bodies.”

Explanation:

Hope it helps!!!!

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