Discussion: Clinical Challenges for the NP Case Study One: Dismissing the non-co
ID: 248347 • Letter: D
Question
Discussion: Clinical Challenges for the NP
Case Study One: Dismissing the non-compliant patient.
Gwen. a 52 year old Caucasian LPN. recently joined your practice as a new patient. She currently has a BMI of 32. B/P of 142/88. Pulse is 89. Respiratory
rate is 22. Pulse Ox is 96% on Room Air. She is taking Lisinopril 1omg po daily (when she can remember). Metformin 100omg po BID and refuses lab work.
Her physical exam is unremarkable and foot exam is normal. She refuses all vaccinations including Prevnar and Influenza. Gwen’s last mammogram and pap
smear were “years ago.”
ANSWER ALL THE FOLLOWING QUESTIONS IN SEPARATE PARAGRAPHS
1.Identify and briefly summarize the case study you selected
2.Explain any legal implications for standard of care related to the case study you selected
3.Identify and explain the key components of a malpractice policy related to the case study you selected
4-Explain the collaborative agreements and knowledge the rules for your state(GA) in regards to NP practice the case study you selected
Explanation / Answer
ANSWER 1) The case study is about a 52 year old Caucasian LPN named Gwen. She is a diabetic and hypertensive would is on oral medication of Lisinoprile 10 mg PO daily and Metformin 1 gm PO BID. Her vital signs upon examination is found to be B/P of 142/88, Pulse is 89, Respiratory rate is 22. Pulse ox is 96% on room air. Gwen's last mammogram was a year ago. She refuses all vaccinations and the laboratory work.
ANSWER 2) Gwen is a non compliant patient who refuses treatment without realizing the seriousness of her condition. The care providers are accountable for the treatment and care of Gwen. Her non-compliant attitude will result in further health issues. This can lay a legal implication on the care provider that an adequate refusal consent by the patient for non compliance to treatment is not taken and the lack of documentation that the potential risk of their attitude was explained to the patient clearly. In many cases, its seen that during treatment the patient refuses to cooperate and after been sick they complaint that nothing was being done for them to improve their condition, no one explained the urgency of the interventions etc.
ANSWER 3) The malpractice suit involved this case is that patient is advised to undergo lab test but she is refusing. The care providers can be charged for malpractice stating that he/she didn't explain the prognosis of the case and that the laboratory test were important for treatment.
ANSWER 4) According to manage a non compliant patient, the law says that an adequate documentation of the refusal in the form of a refusal consent or a form stating that the potential risk of the disease was explained should be taken and patient with their own consent is refusing for treatment or procedures. The law also permits the physician to terminate such patients with a dismissal letter that will include the recommended treatment and risk associated with not receiving the treatment. It also says that :