Question

The questions asked “What would you say to the patient” please answer like make a communication to avoid offending patient. I dont want an explaination. WHAT WOULD YOU TELL/SAY TO PATIENT. The last two experts explained what’s the questions mean...all I want are What/ How would you say to patient about these situations without offend them.

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CRITICAL THINKING J points each A patient asks you what their BMI is. After you tell them it is 36, they ask "What does that mean? What would you tell them, in your own words? 1. You are palpating a patient's radial artery to count their pulse, and you notice the pulse is incredibly sporadic and irregular. What would you say to the patient? 2. 3. Your patien t informs you that she has had a double mastectomy. How would this affect how you took her blood pressure? 27|Page

Answer 1

Ans)1) I will firstly explain patient that:

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women.

Formula: Weight (kg) / Height (meter) ²

Patient's BMI is 36.

I will tell patient that BMI 36 is obese as categories are:

underweight: under 18.5 kg/m²,

normal weight: 18.5 to 25 kg/m²

overweight: 25 to 30 kg/m²

obese: over 30 kg/m²

I will provide health teaching to patient for healthy BMI ratio:

- To reduce weight.

- Eat green leafy vegetables & fruits.

- Regular exercise

- Avoid saturated & trans fat.

- Drink 4 litres of water per day.

2) While checking patient's radial pulse, pulse is sporadic & irregular.

I will check the radial pulse for 1 min & inform patient that it is normal as patient anxiety level may increase. Will inform Doctor also to check once.

As if the pulse is sporadic or irregular, it's a good idea to verify the rate by listening over the heart. This is because certain rhythm disturbances do not allow adequate ventricular filling with each beat. The resultant systole may generate a rather small stroke volume whose impulse is not palpable in the periphery.

3) Patient says that she had double mastectomy ( surgical removal of both breasts)

I will tell the patient that performing procedures like blood collection or BP on the both sides as double mastectomy carries a risk of secondary lymphedema in both extremity if the lymph nodes have been removed.

I will firstly explain No BP, blood collection, IV line & writing this on belts will put on both wrists of the patient, also will tell her that it's for her safety.

I will say to her that to avoid risk of secondary lymphoedema by taking through brachial artery, I will take Blood pressure measurement on legs which is achieved with an appropriate-sized cuff, applied at the midthigh, and by listening over the popliteal artery.

This will affect blood pressure readings as normally the systolic blood pressure in the legs o.e. popliteal artery is usually 10% to 20% higher than the brachial artery pressure.