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Nellie Curtis, age 83, has been a member of a large manage-care plan since its inception i 1985. She became a member as part of her husband’s employee benefits package when his employer converted shortly after his retirement. She has always had her prescriptions filled at the clinic pharmacy run by her plan. On this occasion, she enters the pharmacy to pick up refills for two of her medication, a diuertic and a digitalis glycoside.
PA: Hello Nellie! I bet you are having a good day today.
Nellie: Not really, but why are you so sure?
PA: Because with all this rain we’ve been having it’s going to be good for the crops and making the grass green.
Nellie: Well, I guess so.
PA: Here are your medicines. Let’s see, you take one of each once a day, except the little white ones is every other day. Right?
Nellie: Yes, I think you’ve got it
PA: You have been on this stuff a long time, haven’t you?
Nellie: Yes, about a decade
PA: You’re not having any problems with them, are you?
Nellie: Well, I must not be, I’m still around, aren’t I?. Say, why all the questions?
PA: It’s our new policy to talk to people. There is a law that says we need to talk more to customers
Nellie: Well, it’s about time!
PA: Well Nellie, Y’all have a good one
Summarize your thoughts and answer all the following questions:
1. How could the PA have better prepared for this elderly patient for a therapeutic encounter?
2. How should the PA have established a more respectful relationship?
3. How could the PA have assessed and responded to any of Mrs. Curtis’ needs related to sight, hearing or memory loss?
4. What simple sentences could the PA have used to ensure that Mrs. Curtis’ understanding of how and why she takes her medicine?
5. Some of the PA’s comments appeared to be a leading, restrictive, and judgemental in nature. Rewrite the dialogue to let Mrs. Curtis respond with items that are important to her.