Why did you choose Spastic Colon as the primary dx?
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Attached you will see my discussion where I Spastic Colon as the primary diagnosis.
Running head: PARTNER VIOLENCE.
Date of Submission
“Discuss the questions that would be important to include when interviewing a patient with this issue.”
Below are some of the questions that would be significant to include when interviewing a patient who is undergoing intimate partner violence.
“Do you feel safe when you are at home?”
“All relationships sometimes have disagreements. What happens when you and your partner have a disagreement?”
“Partner violence is a common issue in most relationships, and there are various forms of violence; thus, I often ask all my patients about it. Is there anyone who is hurting you or has ever hurt you physically or sexually in the past? Or is there anyone who is threatening you?
“Have you ever been forced by your partner to do something that you do not want to do or prevented you from doing something that you want to do?”
“How is the money issue handled in your relationship?”
“I normally observe the same kind of symptoms you have in people who are being hurt at home or in a relationship. Is this happening to you?”
Asking the patient such questions allows them to share their information regarding how they feel about their safety at home or neighborhood, including whether they are being abused physically or sexually (Choo, Houry, 2015). However, it takes time before a patient discloses such sensitive information. Therefore there are certain measures that should be exercised in order to promote open communication with the patient. This includes developing measures that create a safe setting such as hanging posters on walls such as in the exam rooms and bathrooms containing information regarding the acknowledgment of the different cultures as well as the acknowledgment of varied relationships and backgrounds.
Moreover, open communication can be facilitated by interviewing the patient alone. Thus, it is necessary to ensure that the suspected perpetrator is not present during the interview. This can be achieved bt politely addressing him or her that “I always do this part of the exam just with the patient. You can join us again when we are done.” In case he or she insists on staying, the two can be separated by taking the patient outside the exam room to take a urine sample or other related tests.
“Describe the clinical findings that may be present in a patient with this issue.”
Some of the clinical findings of the patient undergoing intimate partner violence include the typical signs of either physical or sexual abuse, emotional or behavioral problems such as increased anxiety or fear, difficulty in eating or sleeping, increased aggression, including other signs that portray emotional distress.
“Are there any diagnostic studies that should be ordered on this patient? Why?”
There should be some diagnostic studies that should be conducted on the patient. The purpose of those diagnostic studies should be to identify the condition of the patient. This, in turn, influences the recommendations provided to the patient.
“List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.”
The primary diagnosis is spastic colon.
Additionally, the patient should be diagnosed on the following,
Blood pressure and heart problems
Chronic pain syndrome
Dyspareunia and vaginitis
This is because most people who are victimized by their intimate partners experience those conditions.
“Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.”
The first step is to acknowledge the abuse of the patient and share with him/her about the health implications. Moreover, trying to agree with the patient’s decision regarding the situation is also vital. However, it is also important to provide the patient with more information to aid him/her in making decisions. Additionally, it is important to address the patient on safety issues, including the level of risks. This includes providing the patient with ways to gain contact services when needed. This will aid the patient in seeking consultations regarding the issue. Furthermore, it is important for this patient to be regularly seeking medical services to facilitate the process (Zink, Elder, Jacobson, Klostermann, 2004). This will enable the health provider to monitor the recovering process by conducting more diagnoses that define the progress of the patient. In addition, the patient should be advised to seek pharmacologic therapies to aid in the patient’s recovery process.
Zink, T., Elder, N., Jacobson, J., & Klostermann, B. (2004). Medical management of intimate partner violence considering the stages of change: pre-contemplation and contemplation. The Annals of Family Medicine, 2(3), 231-239.
Choo, E. K., & Houry, D. (2015). Managing intimate partner violence in the emergency department. Annals of emergency medicine, 65(4), 447.