q(dont have the answer)

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q(dont have the answer)

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anne
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03/29/04 - 09:29 AM 0 of 1 forum leaders found this post helpful

14. A physician is in an elevator with three residents and overhears their conversation. "How could you make such a mistake?" one asks another. "You knew Mr. Morris was allergic to penicillin!" he continues. "You know that the antibiotic cross reacts with penicillin. Now he has a rash everywhere! You'd better hope he doesn't develop respiratory problems. We are all going to get sued!" Which of the following is the most appropriate response for the physician?

A) Advise the residents to report this as an adverse drug reaction

B)Ascertain which ward the patient is on so that he can review the chart

C)Ask the resident which antibiotic was used so that he does not make a similar mistake

D)Get off the elevator at the next floor

E)Ignore the conversation

F)Remind the residents that discussions about patients should be kept private

usmleasr
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03/29/04 - 09:34 AM

i am confused between A &B..
i will go for B :?

asmi
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03/29/04 - 09:41 AM

yep it can be either A /B :wink:

sk
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03/29/04 - 10:16 AM

A....
.If the residents dont report it as an adverse drug reaction, the on floor consultant might think the rash is due to the disease.....ANd.. by the looks of it...the residents just hope that the rash will go away instead of doing anything abt it?...

anne
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03/29/04 - 11:33 AM

thanx to all

peekay
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03/29/04 - 12:55 PM

IF HE IS NOT PART OF THE CONVERSATION IN OTHER WORDS IF HE IS JUST HAPPENED TO BE THERE ,AND HE IS LISTNING THE CONVERSATION , HE SHOULD JUST REMIND THEM NOT TO HAVE THAT CONVERSATION IN THE ELEVATOR.
QUESTION IS HE IS THERE WITH RESIDENTS AND IS NOT CONVERSATING.

mjl1717
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03/29/04 - 01:48 PM

I kind of agree with peekay on this one, in this litigious society its probably best for the physician to remind the residents that discussions about patients should be kept private. (its probably already in the chart that the patient is allergic to pennicillin based on the initial admission, a triage, and a nursing admission) writing that there has been an adverse drug reaction may be complete note taking but will
Not decrease the amount of a law suit settlement!
I go with answer-f.
By stepping in the physician could be saving the residents and the hospital.
[by the way Anne you get the most thought provoking qs] :?:

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rubensssss
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03/29/04 - 03:54 PM

elevator and overheard are for me the clue, so the answer is F.

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drrabines
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03/29/04 - 08:09 PM

Residents are always on training they are talking about a typical drug reaction (they knew tha patient was allergic and now has a Rash) so this might be report as a drug reaction to prevent further fatal complications

dr.shar
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03/30/04 - 02:13 AM

#10

F)Remind the residents that discussions about patients should be kept private

this appears to be correct.

why the choice A

drrabines
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03/30/04 - 07:30 AM

#11

Because at this point they do not Know what they will do, for sure they have to remind the discussion has to be private, but first you as an attending must tell them to advise about the actual condition to prevent further complications

dr.shar
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03/30/04 - 08:02 AM

#12

is he attending physician, it is not mentioned in this case, it is not clearly stated that the relation ship of physician with residents.

mjl1717
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03/30/04 - 10:14 AM

#13

in general medicine is a conservative field. If you know the pt is pennicilin allergic, explain -Why would you risk getting in to trouble by giving any beta lactam?? Especially if there are alternative antibiotics.
[I have thought that pennicillin allergy meant there was a higher probability for adverse drug reaction ranging from most commonly a simple rash to most lethal being respiratory failure,on that second administration] The main point is that being a resident doesnt mean start experimenting with antibiotics.

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