Client and Patient Care Skills

Health Occupations

Instructor:Mr. Eric Clifford

Table of ContentsUnit Introduction 3

Grading Rationale 4

Grade Tracker 6

Curriculum Standards 7

Curriculum Grid 8

Lesson #1 – Safety in the Healthcare Setting 9

Lesson #2 – The Basics of Effective Healthcare Communication 11

Lesson #3 – SOAP Notes 13

Lesson #4 – Tools of the Trade 15

Lesson #5 – 1st Hospital Job Shadows 17

Appendices

Appendix 1-1 Healthcare Communications Quiz 19

Appendix 2-1 SOAP Note Handout 20

Appendix 2-2 Patient 1 21

Appendix 2-3 Patient 2 22

Appendix 2-4 Patient 3 23

Appendix 3-1 Vital Statistics Sheet 24

References 25

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Unit IntroductionThe healthcare field is growing every year and hospitals are always

looking for the best and brightest the lead the healthcare revolution. The goal of this course is to introduce students to life in the healthcare field and give them a feel for what could possibly be a career path. From the basics of healthcare to actual job shadows and volunteer opportunities, this course will prepare and enlighten students to what can be expected.

This two-week unit introduces students to the basics of client and patient care skills. They will begin by learning aspects of safety in the healthcare setting, with a lesson geared toward protective clothing and general hospital safety. Proper communication is also an essential part of healthcare work and students will be coached on the basics of patient and coworker communication. The next lesson will focus on patient assessment, with SOAP notes being the main focus. Students will learn the proper way of taking and recording patient information in an effort to form a plan of action. The next lesson will focus on some of the more common tools and equipment that are used in a healthcare setting. Students will have the opportunity to practice using the tools and should become competent with the basics. The final lesson will be the first of several job shadow/volunteer experiences at the local hospital. Students will now have the opportunity to practice what they have learned and will see firsthand what goes on daily in the medical field.

This unit will continue to reinforce key points of life in the medical field and should provide students with a relevant and enjoyable experience.

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Grading RationaleItems to be assessed:-Journals-Class notebooks/organization of class materials-Participation/Attendance-Lab Notebooks-Lab Reports-Projects-Accountability Assessments-Exams

My Rationale for using above items:-As a Science/Medical classroom, educating students in the scientific method is one of my key aims. Scientists record thoughts and findings in journals, so that they can have access to those thoughts throughout their careers. The journal utility will serve to give students a place to answer sponge questions and record thoughts for the day. Time will be given on a weekly basis to write in the journal, and guiding questions will be provided as necessary. Entries may be reflective, formal, or informal. Journals will be collected at the end of each week to check for completion. The overlying though here is that students see and value the journal as a personal and professional utility.

-Effective organization of useful materials is another key part of scientific/medical work. In accordance with this mindset, each student will be required to keep an organized notebook of all class handouts and utilities. Helpful materials will be distributed at the beginning of the semester and at designated times throughout. Students will keep notebook clean and organized with tabs. This will help students with their academic work in my classroom and also serve as a parallel to the science world. Notebooks will be observed and assessed after each unit exam.

-As with any good Science/Medical classroom, attendance and participation are necessary. On most days, students will be actively engaged in some form of Science. Group participation, conversation, inquiry, experiments and other items will be commonplace and students are expected to participate as necessary. I feel that this is a very important part of learning of science, and students will receive a decent grade percentage for being in class and being involved.

-Lab experiments will be utilized throughout the semester to further explore concepts and ideas and to add relevancy to the topics discussed. Participating in the lab will be part of the participation grade for the day, but students will also be expected to keep and complete a lab notebook. An accurate lab notebook is an essential part of scientific work and students will be introduced to the correct ways of completing such a utility. The lab notebook serves the purpose of allowing the experimenter to record each and every step of the experiment, so that someone else may be able a to replicate it, an important aspect of scientific work. Lab notebooks will be collected after every experiment and assessed on content and form.

-Upon completion of a lab experiment or job shadow, students will also write a formal

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report. Information taken from the lab notebooks will be arranged into a report, documenting the steps that the student took to reach the outcome. Once again, information on the proper way of completing a lab report will be given to students. This is another very important utility that further emphasizes the skills needed to work in the field of science. Lab reports will be assessed on content, form and thoroughness.

-Throughout the course, students will also be expected to complete various projects. Science projects allow students to use the material and ideas learned in class to construct their own findings outside of the classroom. A rubric will be given to each student about content expectations, but generally, creativity will be stressed above all else. I feel that students should be given the freedom to make a project “their own,” and therefore, I will seek to facilitate and guide this project, rather than hover over it.

-Due to the short time periods, students may be expected to read and perform duties outside of class time. Busy work will not be given, therefore, every item will be important, and students will be given brief accountability assessments throughout the semester to check for completion. This may be done in the form of a short quiz, or a journal entry, but students will be given notice the class period before.

-A necessary evil in the classroom is an exam, and students shall be expected to complete an exam at the end of each unit. Exams can be stressful, therefore, I will outline useful study strategies, as well as, provide an overview of what to expect on the exam. Multiple exam strategies will be used in the creation of an exam, such as short answer, true/false, multiple choice, essay, and fill in the blank, among others. Practical exams will be also be used on occasion as I feel that they can be very useful in a Science classroom. Using multiple exam strategies allows me to assign full and partial credit based on the efforts and strategies put forth by the students, and I feel that this is a much better option than simple ScanTron tests that do not allow for leeway. The exam will allow students to see how they are progressing, as well as letting myself know how I am doing. If a particular area is found to be troublesome, I will make time to clarify and go over it. Exams should not serve to test for memorization skills, but rather for synthesis and understanding. Grades will be given for each tests and counted towards the final grade.

Final Thoughts on Grading:-The use of grades for determining student comprehension levels and achievement has come under much fire, but I feel that if they are used correctly and the student is involved in the process, they can be much more useful. In saying this, I plan to make the student part of the grading process in some areas, allowing them to assess their comprehension and performance. A single letter grade does not give the whole picture of a student and I intend to keep grades from becoming the overwhelming motivation for succeeding in my classroom.

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Grade Tracker – First 9 weeksDate

Journal Entries 5 points per week1 point per day

/45

Class NotebookChecked after each Unit Assessment10 points

/20

Participation/Attendance5 points per day

/450

Lab NotebookChecked after each Lab Exercise50 points possible

/450

Lab/Shadowing ReportChecked after every Lab Exercise50 points possible

/450

Projects100 points each

/100

Accountability Assessments5 points each for completion

/90

Exams100 points each

/200

First 9 Weeks gradeTotal points accumulated out of 1805

/1805

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Curriculum StandardsContent Standard:

Client and Patient care skills: Student will demonstrate knowledge of and delivery of appropriate care skills for healthcare customers.

Performance Standards:

3.1 The student will demonstrate an understanding of the existing and potential hazards to clients, co-workers, and self. He/she will prevent injury or illness through safe work practices and follow health and safety policies and procedures.

3.2 The student will demonstrate effective communication(s) in healthcare.

3.3 The student will demonstrate an understanding of the process of care: assessment, planning, implementation, and evaluation.

3.4 The student will demonstrate knowledge and use of appropriate healthcare technology, equipment, tools and supplies.

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Curriculum Grid

Performance Standard MondaySafety in

the Healthcare

Setting

WednesdayCommunicatio

n and the Chain of

Command

FridaySOAP Notes

TuesdayTools of

the Trade

ThursdayA Day at

the Doctor’s

Office (Job Shadow

Day)3.1

The student will demonstrate an understanding of the existing and potential

hazards to clients, co-workers, and self. He/she will prevent injury or illness through

safe work practices and follow health and safety policies and procedures.

3.2The student will demonstrate effective

communication(s) in healthcare.

3.3The student will demonstrate an

understanding of the process of care: assessment, planning, implementation, and

evaluation.3.4

The student will demonstrate knowledge and use of appropriate healthcare

technology, equipment, tools and supplies.

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Lesson #1 – Safety in the Healthcare SettingTeacher: Mr. CliffordGrade Level: 9-12Lesson Title: Safety in the Healthcare Setting

Overview: The lesson introduces one of the most important aspects of working in the Healthcare field: safety. Students will be briefed on necessary preventative equipment and apparel. Evacuation protocol as well as universal safety signs will be also be discussed. Students will be issued their own safety clothing for their upcoming hospital job shadows. Students will also respond to an emergency situation and outline what their specific tasks will be. CPR/First aide courses will also be discussed as it is necessary for students to become certified.

Connection to the Curriculum: Science

Connection to the Standards: Health Occupations 3.1

Multiple Intelligences/Modalities: Bodily Kinesthetic, Logical, Linguistic, and Interpersonal

Technology: Appropriate safety attire.

Time: 90 minutes

Objectives: Students shall:-Recognize personal protective clothing as appropriate to the environment-Demonstrate competency in responding to healthcare hazards-Be able to interpret universal safety signs found throughout healthcare locations

Suggested Procedure:

Opening: Teacher will appear to students clothed in hospital safety gear (scrubs, shoe covers, rubber gloves, face mask, hair covering, and a face shield). Students will be instructed to take out their journals and then choose one safety item that the teacher is wearing to write about. The students will need to describe what they think the item protects, why it is important, and a possible situation where its function will be vital to the safety of a healthcare worker. Time will be given to share any entries at the conclusion of the writing (10 min.).

Development: Teacher and students will then proceed to the lab where a hands on presentation will be given on the proper use of the equipment, when it is appropriate to wear the specific elements, and why such measures are important in the healthcare setting. The teacher will model the correct procedures for putting on the equipment, as well as, how to remove any items that become contaminated in the workplace. Students will have a chance to touch each piece of equipment and become familiar with it.

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-The second portion of the lab will consist of viewing safety signs, symbols and labels, while being advised what they mean and what actions should be taken when they are encountered. The evacuation plan for the local hospital will also be on hand and students will be walked through the procedure.

Closing: To conclude this portion, students will be issued their scrubs for their future hospital visits.

Student Assessment: Upon returning to their seats, students will now have scenarios posed to them by the teacher: 1) “You have just finished your shift, and are leaving the hospital when you come across a person who has fallen and bloodied their head. They are conscious, but have lost quite a bit of blood. What steps do you take?” 2) “You are preparing to examine an patient who has become very impatient. You reach for a pair of gloves and find that they are out. The patient says its okay to continue, what do you do?”Students need to take out two clean sheets of paper and respond to each question in a thoughtful and accurate manner.

Extending the Lesson: Students will be required to obtain CPR/First Aide certification to fully participate in this course (per hospital regulations). The school nurse will be providing a course this weekend and students are expected to attend to fulfill this requirement.

Additional Resources: N/A

Adaptations for Diverse Learners: Role-play can be substituted for written response in the student assessment portion of the plan. This will allows students to actually respond, rather than write about it.

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Lesson #2 – The Basics of Effective Healthcare Communication

Teacher: Mr. CliffordGrade Level: 9-12Lesson Title: The Basics of Effective Healthcare Communication

Overview: Effective communication is a must in the healthcare field and students will be introduced to the basics of patient and coworker dialogue. Confidentiality is also a very important topic and the students will be introduced to the HIPAA law that governs patient confidentiality. Students will also have the opportunity to practice self-introduction, along with procedural introduction and patient dialogue, in front of their peers.

Connection to the Curriculum: Science, Speech, English

Connection to the Standards: Health Occupations 3.2

Multiple Intelligences/Modalities: Interpersonal, Bodily Kinesthetic, Spatial, and Logical

Technology: N/A

Time: 90 minutes

Objectives:Students shall:

- Demonstrate communications according to facility, protocol, and scope of practice.- Be able to properly explain procedures before administering them- Distinguish between appropriate and inappropriate language concerning patient

confidentiality

Suggested Procedure:

Opening: As the bell rings, teacher approaches the class and waits for them to quiet down. When teacher has the attention of the students, he/she begins formally introducing himself/herself (name, title, etc.), followed by explaining the procedures that they are going to do today. Teacher introduces the lesson on the importance of communication in the healthcare setting and has students take out journals for the day. Students need to write about why they think clear communication is important when dealing with patients and peers in the healthcare setting. They must also list one negative consequence that can come from failing to communicate properly. After writing has stopped, teacher will ask for volunteers to share their ideas from their journals.

Development: Teacher begins a lecture on the importance of clear communication along with the proper protocol for sharing information in the health care setting. As teacher

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presents each topic, he/she will involve students by asking questions and gaining their input and ideas. Topics for the lecture/discussion include:-Proper introduction of yourself-Clear statement and explanation of the procedures to be performed-Communication adaptation for patients who need it.-Importance of using appropriate terminology and withholding from a bias.-Importance of conveying information in a thoughtful and appropriate manner.-Importance and necessity of confidentiality when discussing patient information.

Closing: As lecture/discussion begins to wind down, teacher will shift to a more serious tone to emphasize the importance of this information. Teacher will explain the HIPAA law and that each student will be signing a statement of confidentiality before participating in hospital work. Pass out the HIPAA forms and have students sign them and then collect all of them before moving on.

Student Assessment: Students will take a 5 question quiz with question pertaining to effective communication and patient confidentiality.

Extending the Lesson: Students will now have the opportunity to practice their introductions in front of their classmates. One student at a time will come to the front of the class, introduce themselves, explain the procedure (will be give to students as they come up: blood pressure, pulse, weight, etc.), and then they will be asked two questions from their peers pertaining to the scenario. Students will be expected to provide questions that are content and scenario appropriate. Every student will participate and teacher will observe and provide feedback as necessary.

Additional Resources: Healthcare Communications Quiz – Appendix 1-1

Adaptations for Diverse Learners: Bi-lingual modifications will be made as necessary. Sign language may also be explained to accommodate the many diversity that could be encountered.

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Lesson #3 – SOAP NotesTeacher: Mr. CliffordGrade Level: 9-12Lesson Title: SOAP Notes

Overview: Students will be introduced to the process of patient care most commonly used in the medical field. The SOAP note utility will be explained and the students will participate in a group activity where they will analyze a medical case for elements of the SOAP note. An academic controversy discussion will follow to conclude class.

Connection to the Curriculum: English skills will be essential for this lesson as SOAP notes need to be written in a clear and concise manner that will be easy to interpret. Simple mathematic calculations will be discussed as numerical observations play a part in most doctor visits.

Connection to the Standards: Health Occupations: 3.3

Multiple Intelligences/Modalities: Logical, Linguistic, Interpersonal, and Bodily Kinesthetic

Technology: Computer with PowerPoint and projector

Time: 90 minutes

Objectives:Students shall:-Be able to identify the correct processes used to document patient information.-Demonstrate competency in writing a SOAP note from given information.-Apply the proper skills for effective communication in the medical workplace.-Differentiate between proper care techniques and those that are ineffective.

Suggested Procedure:

Opening: Begin class with a short demonstration. Teacher will have asked a student before class to assist in the demonstration. Teachers plays doctor, student plays patients. Teacher begins demonstration by doing things in the wrong manner, concerning a doctor’s visit. Teacher continues disorderly conduct and mismanagement of patient stats. Teacher stops and asks class if this is how a doctor’s visit functions and proceeds with a short discussion.

Development: The SOAP note utility is introduced to the students as a way of patient assessment, planning, implementation, and evaluation that is universally understood by all in the medical field. Students will receive handouts that accompany the short lecture and PowerPoint presentation describing each portion of the SOAP note and what

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information can be found there. Emphasis will be on the importance of following the template so that communication is clear.

Closing: Another role-play demonstration with teacher acting as the doctor and student as the patient. Teacher will go through the accepted method of documenting patient information and then providing the necessary care. Teacher will walk the students through each portion and student comments and questions will be addressed as the process moves along.

Student Assessment: Students will be grouped together (4 to a group). Each group will be given a medical case to examine. Groups will read through each medical case and identify the portions of the SOAP note. Portions identified will be written down. Teacher will circulate, providing guidance and answering any questions. Once each group has finished, they will present their finding to the class.

Extending the Lesson: Remainder of the class period will consist of an academic controversy discussion based on the following scenario: “You have witnessed on several occasions, a co-worker who has altered patient information at the request of the patient for varying reasons. You know this has happened and know that it is wrong, but have no concrete proof. What do you do?” Students will be placed into groups of 4 to discuss the options surrounding this scenario. Pros and cons will be thought of and then each group will present the information to each other and a conversation will follow. Teacher will ensure that personal attacks and inappropriate actions do not occur. Teacher will facilitate discussion and provide prompting questions as necessary, while also assuring that all students are involved in the discussion.

Additional Resources: SOAP Note worksheets – Appendix 2-1

Adaptations for Diverse Learners: Group discussion, academic controversy discussion, lecture, PowerPoint.

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Lesson #4 – Tools of the TradeTeacher: Mr. CliffordGrade Level: 9-12Lesson Title: Tools of the Trade

Overview: Students will be introduced to some of the more common medical tools that are found in a typical doctor’s office. Students will learn the use of the tool and how to handle it properly. Students will also be able to demonstrate competency in using some of the tools. A short research assignment will allows students to explore medical equipment and tools in the diagnostic, therapeutic, and informational system fields.

Connection to the Curriculum: Science

Connection to the Standards: Health Occupations 3.2, 3.4

Multiple Intelligences/Modalities: Logical, Naturalist, Bodily Kinesthetic, and Interpersonal

Technology: Appropriate medical tools

Time: 90 minutes

Objectives:Student shall:-Recognize common healthcare tools-Demonstrate competency in using basic healthcare tools-Identify other tools commonly used in a healthcare setting-List vital signs as appropriate

Suggested Procedure:

Opening: Have the following journal topic posted on the board – “Think back to any of your previous experiences in a doctor’s office and list any tool that you can remember and what its function was.” Please do your best to list at least 5 tools. Give ample time to complete the journal and then ask for a few students to share with the class.

Development: After journal sharing, students will proceed to the lab, where medical tools and equipment will be spread throughout on the lab tables (stethoscope, blood-pressure cuff, otoscope, ophthalmoscope, patella hammer, thermometer, traditional scale). Students and teacher will go from table to table discussing each tool and the proper use for it. Descriptions of each tool:-Stethoscope: Used for listening to the lungs and the heart-Blood-pressure cuff: Used for measuring blood pressure along with a stethoscope. Automated versions are also available.

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-Otoscope: Used for looking into the ear canal.-Ophthalmoscope: Used to look into eyes.-Patella Hammer: Used to test reflexes of the patella tendon-Thermometer: Measuring temperature-Traditional Scale: Measuring weight using the balance system.

Closing: Have students return to their desks put away all notebooks and other items.

Student Assessment: Students will now be placed into groups of 4, with males and females separated for obvious reasons. Each group member will receive a vital statistics sheet. Groups will receive a blood pressure cuff, stethoscope, and a thermometer. Group members will measure and record the following for each of the other group members: Blood pressure, pulse, and temperature. Teacher will circulate to each group to provide assistance and answer any questions that may come up. Students will be expected to act professionally and conduct themselves in the appropriate manner. The student measuring the statistics will also be required to practice the introduction methods learned in the previous class and will treat this as an actual patient visit.

Extending the Lesson: For take home work, students will be asked to research one medical tool or piece of equipment in the following fields: diagnostic, therapeutic, and informational. Each tool or piece of equipment must be named, given a brief description, and explained what its use is. Research should be about a page in length, and students should expect to share their findings with the class. Use of the Internet is expected, and description of the assignment is rather vague to encourage research.

Additional Resources: Vital Statistics Sheet – Appendix 3-1

Adaptations for Diverse Learners: Some learners may learn better from using a computer program that describes each tool at an even deeper level.

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Lesson #5 – 1st Hospital Job ShadowsTeacher: Mr. CliffordGrade Level: 9-12Lesson Title: 1st Hospital Job Shadows

Overview: Students have been exposed to much information about the tools and processes that take place in a healthcare setting. In coordination with the local hospital, students are given the opportunity to observe healthcare professionals in that setting. This experience will provide relevancy to what has been learned in the classroom and will let students see what takes place on a daily basis in a healthcare setting.

Connection to the Curriculum: Science

Connection to the Standards: Health Occupations 3.1, 3.2, 3.3, 3.4

Multiple Intelligences/Modalities: Linguistic, Logical, Spatial, Bodily Kinesthetic, Interpersonal, Intrapersonal, Naturalist.

Technology: N/A

Time: 2-hour field trip

Objectives:Student shall:-Recognize specific procedures in an actual healthcare setting-Appraise a healthcare setting based on observations -Summarize his/her observations from a job shadow

Suggested Procedure:

Opening: Students will meet in front of the school to be taken by bus to the hospital for the first day of job shadowing. Students will meet with teacher and hospital administrator in the conference room to go over general rules and shadowing assignments. Students will not be required to take notes during the shadowing. After orientation, students will go to their assigned positions and proceed with shadowing.

Development: Students will be observing medical professionals and assisting as needed and appropriate. Students will abide by all rules and practice the techniques that they have learned in class. This hands on time will be valuable to the students.

Closing: Students will return to the conference room and will proceed back to the school. In the coming shadowing assignments, there will be no orientation and shadowing will take place within the 90 minutes of class time.

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Student Assessment: Students will be required to fill out an observation report for each visit to the hospital. Being mindful to the confidentiality laws, students will document the time they were there, what they observed, what they did, and what they are looking forward to in their next visit. The report will be a minimum of 1 page and must be turned in for the student to continue the shadowing process.

Extending the Lesson: During each shadow, students will have opportunities to ask questions to their assigned healthcare professional. Before each shadow, students need to come up with two questions that they will ask. They will be responsible for sharing with the teacher and then writing a brief summarization about the answer they were given. As always, students must abide by confidentiality laws.

Additional Resources: N/A

Adaptations for Diverse Learners: ESL modifications will be made as necessary and professionals will be found to accommodate the learners.

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Healthcare Communications QuizPlease read all questions thoroughly and thoughtfully and provide your best answer in the space

provided.

1)What is the acronym for the law that governs patient confidentiality?

2)When encountering a patient, what is the first thing that you should do?

3)What is one negative consequence that can come about because of a failure to properly communicate?

4)If you encounter a special needs patient whom you can not understand, should you guess what they are trying to convey or ask for assistance? Explain your answer assuming ideal conditions.

5)You walk into a room and find a patient whom you personally dislike and have trouble with in the past. Thoughtfully explain how you should conduct yourself in this situation.

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Writing Medical SOAP Notes

S: S is for . Included in this section: -why is patient here-any symptoms that the reports-any other items that the patient makes known

O: O is for . Included in this section: -Any observations by you or other medical staff-vital statistics-physical measurements- Sypmtoms

A: A is for . Included in this section:-test results, such as x-rays, etc.-any diagnoses of diseases or other conditions-Anything that could explain patients condition

P: P is for the . Included in this section:-any action for treatment-medications or prescribed-Any follow up visits or referrals to another provider

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Patient # 1Case PresentationSamuel Dexter is a 52-year-old African-American man who is both a husband and father. He is moderately obese (BMI of 32), and has smoked two packs of cigarettes a day for the past 38 years. He awakes one morning with weakness on his right side. He is a bit confused, sees double, and his speech is slurred. When he attempts to walk to the bathroom, he stumbles a few times and falls once. His wife suspects that he has suffered a stroke and calls 911. Emergency personnel arrive within minutes of her call and transport Samuel to the emergency room of the nearest hospital.

Upon examination by the emergency room physician, Samuel is found to have right hemiparesis and diminished pinprick and two-point discrimination on the right side of his head and arm. His deep tendon reflexes are brisk on the right and there is a positive Babinski reflex on the right. He has difficulty articulating answers to the questions he is asked, speaking only a few words and frequently responding with just a verb or a noun. His ability to respond to complicated verbal commands, whether spoken or written, is not impaired. In addition, his systemic blood pressure was found to be 160/100. A serum lipid profile was performed and the results are shown in the table below.

Make you notes in the appropriate areas below:

S:

O:

A:

P:

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Case Written By: David F. Dean, Department of Biology, Spring Hill College Copyright 2005 by the National Center for Case Study Teaching in Science.

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Patient # 2Case PresentationAmanda Richards is a 20-year-old junior in college. She is majoring in biology and hopes someday to be a pediatrician. Beginning about a month ago, Amanda noticed that she was waking up once, sometimes twice a night, by the need to go to the bathroom. More recently, she has noticed that she needs to go to the bathroom during her school day much more frequently than before, sometimes as often as once every hour. At first Amanda thought that her increased frequency of urination was due to the coffee she drank, but when she reduced her coffee consumption to one cup in the morning, she still needed to go to the bathroom just as often. In addition, Amanda was buying bottled water by the case, and she found herself never without a beverage in her hand or nearby. She also noticed that her urine seemed pale and colorless.When Amanda told her mother of her problem, her mother became very concerned and arranged for Amanda to see the family physician. Her physician found no abnormalities on physical examination. However, a blood chemistry profile revealed Amanda’s plasma sodium level to be 149 mEq/L, plasma osmolality was 308 mOsm/L, and her fasting plasma glucose was 85 mg/dl. An analysis of Amanda’s urine showed a urine osmolality of 200 mOsm/L. The urine sample was negative for the presence of glucose. An extensive history revealed that no other member of the family had ever displayed Amanda’s symptoms. Amanda had no history of traumatic head injury and an MRI of her brain was normal. Next, a two-hour water deprivation test was performed on Amanda. After two hours of not being able to drink water, the osmolality of her plasma and urine were measured a second time. This time her urine osmolality was unchanged; however, the osmolality of her plasma increased to 315 mOsm/L. She was then injected with a drug called DDAVP. One hour after the injection, the osmolality of her plasma decreased to 290 mOsm/L and the osmolality of her urine increased to 425 mOsm/L. Based upon the results above, Amanda’s medical history, and the results of theMRI, a diagnosis of idiopathic pituitary diabetes insipidus was made.

Make you notes in the appropriate areas below:

S:

O:

A:

P:Case Written By: David F. Dean, Department of Biology, Spring Hill College

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Copyright 2005 by the National Center for Case Study Teaching in Science

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Patient # 3Case PresentationJason Hendrix is a 21-year-old senior at the University of Delaware, majoring in economics. While on spring break in Florida, Jason was involved in a one vehicle motorcycle accident. In the accident, Jason was thrown from his bike to the pavement, landing on his back. A police officer witnessed the accident and immediately called for medical assistance. Emergency personnel arrived within minutes, and upon recognizing the seriousness of Jason’s back injury, immobilized his neck and secured him to a rigid board prior to transporting him to the emergency room of the nearest hospital.

When he arrived at the hospital, Jason was conscious and complained of pain in his lower back. Upon examination by the emergency room personnel, Jason was found to have numerous abrasions and contusions, and loss of both sensation and motor control of his legs. After he was stabilized, a complete neurological exam was performed to assess and localize Jason’s injury. The neurological exam revealed the following: Jason demonstrated normal or near normal strength in flexing and extending his elbows, extending his wrists, and when flexing his middle finger and abducting his little finger on both hands. However, he exhibited no movement when medical personnel tested his ability to flex his hips, extend his knees, and dorsiflex his ankles. Stretch reflexes involving the biceps, brachioradialis, and triceps muscles were found to be normal, while those involving the patella and ankle were absent. In addition, Jason was found to have normal sensitivity to pin prick and light touch in areas of his body above the level of his inguinal (groin) region, but not below that region of the body.

Make you notes in the appropriate areas below:

S:

O:

A:

P:

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Case Written By: David F. Dean, Department of Biology, Spring Hill College Copyright 2005 by the National Center for Case Study Teaching in Science.

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Vital Statistics SheetPatient Name:

Blood Pressure:

Pulse Rate:

Temperature:

Vital Statistics SheetPatient Name:

Blood Pressure:

Pulse Rate:

Temperature:

Vital Statistics SheetPatient Name:

Blood Pressure:

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Pulse Rate:

Temperature:

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References-Dean, David F. Department of Biology, Spring Hill College. Case Studies.

-Nevada State Standards in Health Occupations.

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