hi viddi and shad , i need your help - rickie

[ArchivalUser]

Can you help me how to do these two cases
FATHER KEEP SOME LAB RESULTS OF HIS CHILD CONSULT INTERPRETATION
I/V DRUG DIAGNOSED WITH HIV . HOW TO TELL THE PATIENT AND HOW TO WRITE NOTES IN THIS CASES.
ANY SUGGESTIONS WELCOMED.

[ArchivalUser]

i am assuming the 1st Q means that the father has brought in some lab results and wants you to interpret them...
in that case.. you can say "Alright Mr.X. you have given me the results of the tests conducted..since this is the 1st time you are consulting with me..i need a littel info on the health of your child adn his condition before i can decide on the treatment regimen required for your son/daughter. may i ask you a few Qs on what prompted you to visit a doc initially.. ask Hx,.. well.. Mr.X thank you for the info.. i have a few possibilities in mind..we have the lab results of certain tests in hand..but i need to augment my knowledge of your son's condition with a P/E.. if you could bring yoru son in we will evaluate him further and go over these results .. is that o with you?? if he expresses anger.. i understand teh difficulty Mr.X.. but the health of your son is imp and it is better to have complete picture of the condition before we treat it.. you are in good hands.. please bring your son in and we will move quickly from there.. ok??

[ArchivalUser]

frankly i think you will get a case of refill where the guy is already on Rx for HIV but not a newly diagnosed fella... the trouble is that if you are breaking the news for teh 1st time you cant hit him with "hey man any symptoms like cough,etc etc".. you can only show sympathy ,cousel a bit and arrange follow up.. but nevertheless... i am going thru the 1st time couselling.. if your Q was about HIV refill ..please clarify...that is what will probably be on teh exam.. and you need to go over his medication and symptomatology...
anyone..tell em if i am wrong here...


greetings etc etc..
i understand you were recently underwent some test.. there is a problem with one of them.. it is your HIV test... pause.. it came back positive.. it means you have been infected with HIV, a virus whihc could lead to aids.. (pat on shoulder..if he appears overwhelmed.. say i am sorry.. i understand how difficult this must be for you)... do you understand what HIV is?? it is not a death sentence..and many people have plenty of time to consider a range of options... we have excellent counsellors here who can help you out... they will conduct tests and give you the appropriate medication to suppress the virus and see that the risk of dveloping AIDs is reduced... your resutls will be kept entirely confidential..
do youlive alone?? with your partner??
menwhile i would like to remind you that the virus can be transmitted by unprotected sex or by sharing of needles... i would advise you to bring your partner in on this... so you can both decide how best to use protection...
do you have an Q or concerns for me...

[ArchivalUser]

Thanks very much viddi , so nice of you, my question was to deliver the news that your hiv test came positive.
Viddi ,how to write patient notes in both cases , i heard these cases can come .
is they give some diffirent performa, for conselleing or same , because here we don,t need to put ant diff. diagnosis or physical exam.

[ArchivalUser]

i am waiting for your reply .
I NEED YOUR HELP IN ONE MORE CASE BAR FIGHT . WHAT TO ASK AND HOW TO DO COUNSELLING.

[ArchivalUser]

the case abt the child is obviously no problem.. you leave out the P/E.. leave it blank i mean.. write Hx and put in the DD yfor chest pain in that child and your own labs..

as for the 1st time HIV ... if it turns up on teh exam.. you need to go ahead and tell him that you need a littel info to assess his current health condition.. and ask abt symptomatology regd AIDS (you know the Qs am sure ..similar to HIV refill except nothing abt medication since he is not on any yet)... go out and write down the history.. conduct a P/E focusing on mouth, lungs, any swellings (lymph nodes), heart.. write that down
labs- CD4 count, viral load adn any other tests based on his symptoms.. eg difficulty swallowing- upper GI endo,barium swallow, chest pain -accordingly


does this answer your Q??

[ArchivalUser]

just go back a couple of pages in the forum.. mirt asked abt bar fight.. and thereis a reply.. just 2 pages away...

[ArchivalUser]

Thanks vidhi, sorry to bother you,
palpitation case what to ask .

[ArchivalUser]

i notice that you are concern about your results.yes i am so ...
as you remmeber when we discussed about safe sex in last visit my greatest concern in my mind was hiv.unfurtunately the results confirm my fear that you are infected by hiv.show empathy...i understand your concern it must be difficult.....but you are not alone we are here to help you .we have excellent conselor and support group in this hospital they can help you to cope with this problem....
Do you know about the mechanism of AIDS?
The HIV virus acts upon and weakens the body™s immune system, as a result of which the body becomes prone to infections. There are some steps that can be taken to reduce the chance of these infections. First of all, I would highly suggest that you get vaccinated against a few common diseases, it is also important that you visit me at the slightest doubt of an infection so that appropriate steps can be taken to prevent the infection from spreading in your body. I cannot stress more on the importance of regular health check-ups so that we can keep an eye on your health together.all right mr.xyz i would like to explain to you our plan to monitor of hiv infected people.two blood test are routinly used
1)cd4 cell count which assessof the status of the immune system.it show us that you are at risk of unusual infection or not?
2)viral load test that measure the amount of the virus,so we can check the progresion of the diseases and also help us to monitor the effective ness of your medication.do you have any question about that?
all right mr.xyz It is very important you inform your sexual partners about your HIV status.i know that it could feel very uncomfortable to reveal your medical condition.it is better let them know the truth may have gotten infected with hiv also .may be they need test and treatment too.i could help you inform them. you need to use condom regularly in order to prevent spread of the disease to them. It is also important that you drink bottled water to prevent infections.in the end i have a good news for you regarding multiple medication on market that decline in death ,better prognosis and longer life span than in the past.
Do you have any other questions or concerns?