CRITICAL THINKING APPLICATIONS

Lora Rose Liao

Friday November 01, 2019
CMA-2

1. Dr. Song mentions a patient’s nervous system function to Mai. The patient hears this
conversation and later asks Mai, “What does my nervous system do?” How should Mai
answer this question? What resources could she use to help explain the nervous system
to the patient?
a. Mai should say the following: the nervous system, with the brain as its center,
coordinates and controls all bodily activities. When the brain ceases functioning,
the body dies. The nervous system is divided into two primary parts: the central
and peripheral nervous systems.” She should explain that the central nervous
system includes the brain and spinal cord. And its functions include receiving and
processing information, and regulating all bodily activities. Then she should
explain what the peripheral nervous system does which is the following: the
peripheral nervous system (PNS) includes the 12 pairs of cranial nerves
extending from the brain and the 31 pairs of peripheral spinal nerves extending
outward from the spinal cord. Then she should mention that the function of the
peripheral nervous system is to transmit nerve signals to and from the central
nervous system. She should also research the system further and print out the
website she used to gather the information.
2. Mai answers the phone at the clinic. The caller is a patient, an anxious woman who is
desperately trying to say something but appears unable to do so. Mai thinks the patient
is trying to say something like “Help.” Mai checks the number on the caller ID display,
looks it up in the office computer, and finds that it belongs to a 50-year-old patient who
came in 2 days earlier because of frequent, severe headaches and hypertension. How
should Mai handle this situation? Be sure to think about what she should do, why she
should do it, and what might happen if she does nothing.
a. Mai should keep the woman patient on the line and quickly dial 911. She should
then reassure her that everything is going to be okay and that help is on the way.
When on the phone with 911, she should say that the patient called in and
acknowledge that patient is still on the line. She should also mention that the
patient came in two days prior to this situation, and was complaining of having
“frequent, severe headaches and hypertension.” Mai should also notify the
physician on what is going on to ensure that he/she knows about it and isn’t left
out of the equation.
3. Mr. Jackson, a 75-year-old patient with dementia, is coming in for his first visit. He does
not respond to verbal commands and is unable to answer direct questions. How can Mai
get him into the examination room and into a patient gown while preserving his dignity?
a. Mai should use nonverbal communication to help (eg pointing at a picture of
someone you are talking about).
4. Mai is putting together information on head injuries for the family of a patient who
recently suffered a minor concussion. The family should watch for what symptoms?
When should the family seek additional medical care? What resources could Mai use to
develop the pamphlet?
a. The family should watch for:
i. Persistent headache
ii. Vertigo (dizziness)
iii. Inability to concentrate
iv. Repeated problems with memory
v. Nausea or vomiting (especially if vomiting is projectile)
vi. Unusual anger, irritability, anxiety, or depression
vii. Sleep disorders
viii. Seizures
b. The family should seek additional medical care if any of the above symptoms
occur.
c. Mai should look up government approved websites on the subject to ensure that
the information she gives out is accurate.
Dr. Song said he would approve the pamphlet after Mai completed it, but he was called
away on an emergency before he saw it. A patient sees it behind the desk and asks to
take one. Should Mai let him? Why or why not?
a. Mai should not let him take the pamphlet because Dr. Song clearly said that he
would approve it once she finished. If she gives out the pamphlet without Dr.
Song approving of her work, she could end up possibly being accused of giving
out false information. She could be sent to jail for that.
5. A 34-year-old man has just found out that he has a brain tumor, and Mai is to schedule
him for surgery next week. Before he leaves the office, he says he wants to talk to Mai
Privately. They go into an examination room, and he says, “Tell me the truth’ this is
cancer, and I’m going to die, right?” How should Mai respond to this frightened patient?
a. Mai should say the following: “Yes, you have cancer, but no you are not going to
die because this surgery is going to help prevent it from getting any worse. Just
know that as long as you keep fighting, you have a better chance of going into
remission. We were all brought into this world for a reason, and a cancer like this
cannot beat us to the ground. You will look back on this day and this
conversation a year from now and think ‘wow am I ever lucky to be alive’
because people like you are born to fight the worst of the worst, and aim for the
best of the best.”
6. Dr. Song wants to perform a lumbar puncture on a 10-year-old girl who he suspects has
bacterial meningitis. Her mother agreed to the procedure, but while Mai is preparing the
girl, the mother changes her mind. She is afraid that inserting a needle into her
daughter’s spine will paralyze the girl. What should Mai do in this situation?
a. Mai should stop the procedure altogether and pull the physician (Dr. Song) if he’s
available, and state what has just happened and why the mother doesn’t want to
go through with the procedure. Mai should ask Dr. Song if there might be an
alternative to this procedure, because she’s not 100% sure if such a thing exists.
But Mai should definitely not proceed without receiving further instructions from
the physician and consulting the mother first.