Below is a summary of Taylor’s electronic health record (EHR) during his visit. As a physician, you are responsible for examining Taylor, ordering tests and procedures and diagnosing his condition. Using Virtual Physical Exam (VPE), Taylor’s EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Taylor’s healthcare team.

1. Internet Research: You order a cholesterol test and a fasting blood glucose test. What can you tell Taylor about these tests and how the results will impact his health?
   
   Review Taylor’s EHR: What are Taylor’s test results for his Lipid Profile (cholesterol, LDL, HLD and triglycerides) and fasting blood glucose tests?



2. Review VPE: Dr. Waring performs a funduscopic exam on Taylor’s eyes. What does Taylor’s funduscopic examination reveal?



3. Internet Research: You tell Taylor that because of his family history of diabetes and obesity, he is more likely to have type 2 diabetes. What are the common symptoms of type 2 diabetes?
   
   On Your Own: How can Taylor improve his health status?



4. Internet Research: How does type 2 diabetes affect the nervous system?
   
   Internet Research: How does type 2 diabetes affect the arteries?
   
   Internet Research: Why is the cut on Taylor’s finger not healing in a normal fashion?

Below is a summary of Taylor’s electronic health record (EHR) during his visit. As a nurse, in addition to getting Taylor prepared for the tests and procedures ordered by the physician, you are responsible for obtaining, reading and monitoring his vital signs. Using Virtual Physical Exam (VPE), Taylor’s EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Taylor’s healthcare team.

1. Review Taylor’s EHR: The physician needs to quickly assess Taylor’s symptoms and current vital signs. As the nurse, it is your job to record this information in the patient’s chart. You record Taylor’s blood pressure and his pulse rate in his EHR. What are these numbers?
   
   Internet Research: What do these numbers indicate regarding Taylor’s health?



2. Internet Research: What does BMI measure?
   
   Review VPE: According to VPE, what is Taylor’s BMI?
   
   Internet Research: Why is Taylor’s BMI of concern?



3. Internet Research: Why is it important to know Taylor’s family medical history, including his father’s diabetes? Explain.



4. Internet Research: You review Taylor’s EHR and notice that Taylor’s fasting blood glucose and cholesterol are high. What is the best recommendation you can make to Taylor to help him lower these results without medication(s)?

Below is a summary of Taylor’s electronic health record (EHR) during his visit. As a laboratory or radiology technologist, you are responsible for obtaining and providing test results to assist the physician in diagnosing Taylor’s condition. Using Virtual Physical Exam (VPE), Taylor’s EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Taylor’s healthcare team.

1. Internet Research: Dr. Waring orders two tests for Taylor, a blood glucose test and a cholesterol test. Explain how each procedure is performed and the information each test will provide.
• Fasting blood glucose:
• Cholesterol:



2. Review Taylor’s EHR: What is the result of his fasting blood glucose test?
   
   Internet Research: What is the normal range for this test?



3. Review VPE: What are the results of Taylor’s cholesterol test? A cholesterol test includes total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL) and triglycerides.
   
   Internet Research: What are the normal ranges for these tests?
   
   Internet Research: How do the results affect Dr. Waring’s diagnosis?



4. Internet Research: What is the best recommendation a physician can give to Taylor to help him lower his fasting blood glucose and cholesterol, without medication(s)?

Below is a summary of Taylor’s electronic health record (EHR) during his visit. As a pharmacist, you are responsible for ensuring that Taylor receives the proper medications ordered by the physician. You are also responsible for reviewing any adverse interactions Taylor might have with his current medications, as well as knowing what medications to prescribe to diabetes patients. Using Virtual Physical Exam (VPE), Taylor’s EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Taylor’s healthcare team.

1. Review Taylor’s EHR: What are the results of Taylor’s cholesterol test?
   
   Internet Research: What options, other than medication, does Taylor have to help control his cholesterol levels? Be sure to take Taylor’s age into consideration when making this suggestion.



2. Review Taylor’s EHR: You also notice Taylor has an allergy to a medication. What is Taylor allergic to?
   
   Review Taylor’s EHR: How could this impact the physician’s decision to treat the cut that is not healing?



3. Internet Research: You know that a well-balanced diet and exercise are the best prescription for Taylor. However, based on his fasting blood glucose results, found in VPE, you assume that he will be diagnosed with type 2 diabetes and that an oral diabetic medication is also needed.
   Make a chart that provides the physician with the drug class information for: Metformin, Rosiglitazone and Acarbose. Include information to describe the ‘Action’ (How it works), ‘Possible Side Effects’ and ‘Brand Names’ for each medication.
   
   Internet Research: Which medication do you recommend?

Below is a summary of Taylor’s electronic health record (EHR) during his visit. As a medical and health services manager, you are responsible for making sure he receives excellent care. You will also figure Taylor’s bill, consisting of his tests, procedures, room charges, supplies and medications. Using his EHR, Virtual Physical Exam (VPE) and Internet research, fill out the billing statement and be prepared to share this information with the rest of Taylor’s healthcare team.

• MHSM – Bill
• MHSM – Bill Reference
• Taylor’s EHR – PCP (link below)
• Virtual Physical Exam (link below)

1. Since Taylor is a minor, his bill will be sent to his parents. Use the blank copy of Taylor’s Bill to calculate his costs. In his EHR, look for the number of times a test is administered, number of days a cost is incurred or the units per day a medication is administered. You may need to do additional Internet research. Some helpful sites are www.pharmacychecker.com, www.fairhealthconsumer.org and www.healthcarebluebook.com.

Below is a summary of Taylor’s electronic health record (EHR) during his visit. As a health coach, your job is to recommend lifestyle changes to alleviate symptoms, prevent symptoms from recurring and decrease the need for future care or hospitalization. You will also provide the education Taylor needs to understand his diagnosis and the risk factors that may have caused his condition. Using Virtual Physical Exam (VPE), Taylor’s EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Taylor’s healthcare team.

1. Internet Research: The most important aspect of Taylor’s condition is education. Explain how the following problems could affect his future health.
• High blood pressure:
• High Cholesterol:
• Exercise:
• Blood sugar levels:



2. Internet Research: You also discuss with Taylor and his family the dangers of his high glucose readings, as found in his EHR. You explain that a high glucose reading could lead to a diagnosis of type 2 diabetes; which is a serious condition. You want to stress to Taylor’s family that diabetes management is more than just taking medication and that Taylor must begin monitoring several areas of his health. What other areas will Taylor have to monitor?



3. On Your Own: As a health coach, you will assist Taylor and his family in creating a plan to help him manage his diet and exercise in order to improve his health and reverse his medical conditions. Set four S.M.A.R.T. goals for Taylor in the areas of weight management, exercise, diet and suggestions for controlling his type 2 diabetes.



View Taylor’s EHR – PCP Chart   Virtual Physical Exam
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S.M.A.R.T.: Specific, Measurable, Attainable, Realistic or relevant, Time-based.

(“SMART Criteria.” Wikipedia. Wikimedia Foundation, 09 Oct. 2014. Web. 10 Sept. 2014.)