Test your clinical skills in this week’s 5-question quiz.

Test your clinical skills in this week’s 5-question quiz.

Test your clinical skills in this week’s 5-question quiz.

A 62-year-old woman presented with a rash and intermittent pain of the right upper quadrant. The reticular, brown hyperpigmentation was also seen on her right flank and around the umbilicus. The patient reported that she often applied heating pads to these areas for pain relief.

To reduce discomfort when administering potassium in a peripheral line, mix in 2 mL of a 1% lidocaine solution. This may also work with other painful IV medications, but first check with the pharmacy for drug interactions.

This simple technique can quickly reduce leg edema. Instruct the patient to place a chair on a bed as shown, lay a pillow on the back of the chair, then lie down with legs elevated on the pillowcovered chair back. (Do not use in patients with congestive heart failure; volume overload and pulmonary edema may result.)

Lend a stethoscope to hard-of-hearing patients who are not wearing a hearing aid. Speak directly into the stethoscope diaphragm, and the patient may hear well enough to communicate with you. Be sure to clean the stethoscope's ear tips before and after the patient uses it.

Instead of throwing away the label from an injectable medication, peel it off and tape it to the patient’s chart. The nursing staff will not have to write the drug information on the chart because the label contains the name, unit dose, and lot number.

ABSTRACT: Exercise can be an effective way to stabilize or slow the degenerative process of osteoarthritis-provided convenient, safe, and enjoyable activities are selected and achievable goals are set. Implement an osteoarthritis exercise plan in phases, and progress gradually from one phase to the next; this will help both you and your patient anticipate difficulties and gauge progress. The first phase-the initial evaluation-includes gathering baseline data, targeting an area of the body to focus on first, and identifying potential contraindications to activities. Subsequent phases include range of motion exercises (stretching), isometric and isotonic strengthening exercises, and recreational or functional activities. Encourage patients to continue stretching exercises throughout the program.

Persistent pain is common in older adults but tends to be underrecognized and undertreated. Up to 50% of community-dwelling older persons have significant painand up to 80% of nursing home residents have substantial pain that is undertreated.

A 63-year-old woman seeks evaluation of a persistent, rough, red area on the dorsum of her left index finger. The lesion has been present for several months. The patient’s manicurist is convinced it is a wart.

A 13-year-old boy presents with swelling of the left eyelids that started 12 hours earlier; the eyelashes are matted with yellow discharge. He does not wear contact lenses or eyeglasses and denies ocular trauma or foreign bodies. He has been nauseated and has vomited once; his mother attributes these symptoms to an antibiotic that was prescribed 5 days earlier for a sinus infection. Medical history is noncontributory; there is no family history of ocular problems.

A bright, active 10-year-old boy has been experiencing recurrent bouts of abdominal pain with nausea and occasional vomiting for 3 years. Although he has had 1 or 2 attacks at school, the pain usually occurs at home—frequently on weekends. His mother has been unable to correlate these episodes with particular foods or activities. She notes that her son has experienced motion sickness during long auto trips and during a family holiday in the mountains of Colorado.

To suggest today that condoms are “obsolete” sounds heretical and like a topic ripe for heated debate. Here, HIV/AIDS blogger Dr. Rodger MacArthur lays out the science for your review.

I’ve been in practice for 20 years and have never lost a patient to suicide. But I have lost colleagues, friends, and lovers – ALL male physicians—to suicide. I have a long list of answers to the question, “Why?” Maybe the most fundamental answer is that doctors are human..

My first patient had so many things wrong; he left before I could examine his heart and lungs, ask about chest pain, or reconcile his medication list. After his visit, veteran clinic staff noted they hadn’t seen Jim for years and were surprised he had come in at all. I felt the totality of my medical education had been squandered. They kindly reminded me it had just begun.