George is a 49-year old recently retired engineer with a history of irritable bowel syndrome that causes frequent diarrhea and rectal bleeding. His wife is a schoolteacher. It is mid-December when he comes to the hospital complaining about "not feeling good". You conclude he is having a reoccurrence of his intestinal problem.
George is a 49-year old recently retired engineer with a history of irritable bowel syndrome that causes frequent diarrhea and rectal bleeding. His wife is a schoolteacher. It is mid-December when he comes to the hospital complaining about "not feeling good". You conclude he is having a reoccurrence of his intestinal problem.
What questions would you ask yourself to check your assumptions?
Which other sources of data might be appropriate to access in his case?
How would you demonstrate that you are using critical thinking attitude?
How would you apply Socratic questioning? Deductive reasoning? Inductive reasoning?
What are the key areas of information to obtain regarding his past history?
Which physiological systems are the most important for data collection?
Solved by verified expertInductive reasoning uses patterns to arrive at a conclusion.
Deductive reasoning uses facts, rules, definitions or properties to arrive at a conclusion.
What questions would you ask yourself to check your assumptions?
- Signs and symptoms experienced.
- When the pain started and the nature of pain.
- Previous medical history whether he had bacterial infection in the gastroenteritis.
- Any other underlying condition.
- Triggering factors such as certain food, stress,anxiety or drugs
- Family history, Any chronic history in the family.
- Social Support from the family to incase of emotional stress.
- history any smoking or alcohol intake
Which physiological systems are the most important for data collection
- Digestive system
- Cardiovascular system
- Endocrine system
- Immune system
- Nervous system
- Renal system
Which other sources of data might be appropriate to access in his case?
- Physical examination; Signs of dehydration such as sunken eyes, skin turgor,blood pressure, pulse rate, temperature, weight.
- Interview patient and take history on past and present illness, sources of food.
- Observe his behaviour if anxious or depressed and physical appearance.
- Previous medical records.
- Laboratory investigations i.e stool for ova and cyst, occult blood.
- Blood urea and electrolytes to rule out renal function.
- Whole blood cells count to know hemoglobin levels, check infection, platelets.
- Colonoscopy to check colitis.
How would you demonstrate that you are using critical thinking attitude?
Explain to the patient that Irritable bowel syndrome is a disorder that people live with, having few episodes of exacerbation as far as you know the triggering factors such as food, stress or emotional conflicts.
How would you apply Socratic questioning?
- To explain when the pain started, what could have triggered the pain.
- To describe the pain what worsens or relieves.
- Whom do you stay with?
- Describe how the stool is considering color, frequency, volume,urgency.
- Any other problem in the body i.e. fatigue, fever.
- Explain about his feeding habits and the favourite food
Deductive reasoning?
It is known that exacerbation of irritable bowel syndrome is associated with anxiety and emotional stress. It is a disorder of motility of the entire gastrointestinal tract that produces abdominal pain, constipation or diarrhea.
Inductive reasoning?
It affects women more than men
Patients who only have irritable bowel symptoms almost never have inflammatory bowel disease but once on remission of IBD, 30% to 40% of patients show signs of IBS.
What questions would you ask yourself to check your assumptions?
- What are the symptoms? Severity and duration.
- what are the Bowel patterns
- Any bloating or gas before bowel movement
- Pain description, what reliefs pain onset, radiation or aggravating factors.
- Patients diet, feeding habits, commonly used food..
- Whom are you staying with at home.
What are the key areas of information to obtain regarding his past history?
- Medical encounter
- Support of individuals.
- Events that might have taken place.
- Health status prior to the presenting problem.
- Family history.
- Personal situation and review of all body systems.
