Question

Mark, a 15-year-old patient, has come into the office after taking a bad spill from his skateboard. Before you begin taking his vital signs, he explains that he is frightened to tell his parents about the accident, because they may forbid him from skateboarding. How would you approach taking his vital signs? What notes will you pass on to the physician

Answer 1

A healthcare provider should take vital signs and assess a 15-year-old patient's physical and cognitive health, respecting privacy and addressing fears about informing parents. Sensory deficits should be documented and notes should be accurately passed to the physician for possible further diagnostics or preventive therapy.

Step-by-step explanation:

When approaching the vital signs of a 15-year-old patient like Mark who has fallen off his skateboard, it is important to create a calming environment and reassure the patient. Despite Mark’s fear of parental repercussions, a healthcare provider must prioritize his health and assess signs of injury or distress thoroughly. This involves observation of the patient's physical and cognitive functions and evaluating any sensory deficits, as well as their mental status. Documentation should specify any findings such as paralysis, weakness, or sensory deficits, while maintaining patient privacy. For example, noting the presence of pins and needles sensations or difficulty in feeling nuances of touch, which could indicate nerve or spinal cord issues.

Given Mark’s age, considerations around patient privacy and the involvement of his parents must also be addressed appropriately. Adolescent patients like Mark may require a balance between parental involvement and patient confidentiality, especially in non-emergency, non-life-threatening situations where the risk does not outweigh the need for privacy. With Mark’s expressed concerns, it is important to empathize and determine the best approach according to healthcare laws and regulations regarding the rights of minor patients. In emergency situations or when the patient's ability to make decisions is compromised, laws generally allow for parental notification and involvement.

It is crucial to pass accurate notes to the physician detailing the physical assessment, the patient's symptoms, mental status, and concerns for potential underlying conditions like blood clots, given Mark's symptoms. Notes may lead to further diagnostic steps such as a CT scan or specific therapies, like aspirin, to prevent complications, as indicated by the symptoms presented.