- - Se tolera la decision del padre de no vacunar a su hijo hasta que ejemplo pt

necesite vacuna de tetano pq se espeto algo ya aqui es urgente.

- - In patients with divorced parents, only parents with custody may give consent for
medical care. Parents with joint custody are each able to consent,= consent from
only one parent is all that is necessary to proceed with treating the minor, especially
when the decision is clearly in the child's best interests. In all cases, treatment is
ideally discussed with both parents to reach an agreement that will help the child
and facilitate cooperation between the treatment team and the parents.

-When caring for an unemancipated minor, informed consent from one parent or
guardian is considered legally sufficient to justify proceeding with therapy. Physicians
should also provide care in urgent situations without waiting for parental consent

- No se necesita permino de los padres para intubar un menor, blood transfusion,

surgery de emergencia

-Un colega hizo un procedimieento y a causa de eso pt tiene un problema, pt te

pregunta pq tiene ese problem= The patient's condition may be related to her recent
angiography, but I will discuss it with her regular physician before giving a definitive
answer.

-Physicians should consider admitting a mistake, especially under the following

circumstances:
Actual patient harm
Clear or potential clinical significance
An unwanted treatment, device, or substance reaching the patient
An unanticipated outcome
An unexpected safety event

-Communication failures between physicians during patient handoffs are a large

contributor to medical errors and adverse patient outcomes
-Most effectively improve communication of relevant information during patient
transfers? Implementing a signout checklist

-Pt que necesita cesarean y quiere parir vaginal: Respect the patient's decision, and
proceed with vaginal delivery
The mother is considered to have ultimate rights over her unborn child, assuming she
has capacity. When a mother refuses a procedure or treatment that is in the best
interest of the fetus, the physician should provide counseling and education as to why
the procedure is necessary. If the mother continues to refuse a procedure that would
prevent irreversible harm to the fetus, the hospital ethics committee should be
consulted, but the mother should not be coerced or otherwise forced into accepting any
form of treatment she does not want.
-Pt con cancer y no quiere q nadie sepa, su esposa q es su health care proxy te
pregunta de su salud= Inform the wife that it would not be appropriate to discuss the
patient's information..Medical information should be shared with family members
only with the patient's permission

-Si otro medico te pregunta sobre la salud de un pt tuyo pq quiere saber: It would be
inappropriate for me to discuss this with you.
Confidential patient information should be disclosed only to fellow health care workers
who are directly involved in the patient's care. Physicians should avoid discussing a
patient's medical condition in public areas where comments might be overheard.
Inappropriate inquiries from colleagues curious about a patient's medical condition
should be politely but firmly rebuffed.

-Si tratas a pt y el te autoriza a que hables con el dueno de su compania ya que ha

faltado mucho= "I can confirm that the patient is currently hospitalized, and I anticipate
he will be able to return to work."
The Health Insurance Portability and Accountability Act protects health information by
requiring verbal or written authorization for release of information. Hospitals and
physicians' offices frequently have additional policies requiring written forms for release
of information and procedures to verify the identity of phone callers. It is important that
health care providers be familiar with these rules and disclose only the minimum
necessary information.

El hijo de una pt tuya te dice que no le digas a su mama sobre el dianostico de ella
cancer.. "Is there a specific reason why you do not want your mother to know the
diagnosis?"
In general, a patient has the right to know a diagnosis. If family members ask for
information to be withheld, it is imperative for the physician to understand their
reasoning. Occasionally, it is in the patient's best interest to withhold especially
distressing news (eg, if a severely depressed patient might become suicidal). Therefore,
it is best to clarify the situation with the concerned family members first before deciding
how best to proceed.

-Pt q le haces examines y sale HIV + y ella no quiere q se lo digan a su esposo pq le

pego cuernosEncourage the patient to tell her husband but tell her that you are
required to inform the local health department
The health department (and not the physician) typically makes contact with all of the
patient's sexual partners and informs them of being at risk for the disease, without
giving any identifying information about the partner who placed them at risk.
Patient confidentiality should not be maintained if it endangers the health and welfare of
others.

-Enfermedades q se reportan al health department: HIV, tuberculosis,sifilis,gonorrhea

-Patient's husband requests a copy of all medical records associated with her wife
hospital stay. Which of the following is the most appropriate course of action? Inform the
husband that the patient must request a copy of her medical records. Medico tiene 30
dias

-Pt estable, sin cita q quiere ser atendido a las malas despues de tus horas de
oficina="Although I understand your concern, we should address it tomorrow because it
is not an emergency."
This question addresses the importance of maintaining professional conduct when
dealing with patients of all types, ranging from hostile to seductive. Several actions
suggest that this patient could have boundary issues. These include:
Arrival at unscheduled times and/or at closing time (when others are less likely
to be available)
Insistence on seeing the same physician for each visit (for mild conditions) and
in private
Frequent return visits for nonspecific complaints
Health complaints that necessitate examination of private areas or undressing,
despite recent normal findings
To maintain a therapeutic distance, the physician should have the receptionist politely
inform the woman that patients are seen only when they have scheduled appointments
during normal office hours and with the presence of another staff member.

- Pt molesta y no quiere q la atiendas= "May I ask what is upsetting you so that I can
help you as best I can?"
When dealing with an angry patient, the most appropriate response is to remain
nondefensive, acknowledge that the patient is upset, and begin the discussion with an
open-ended question.

-Una drug company esta regalando un flash drive= Do not take the flash drive as only
small gifts that directly benefit patients are acceptable
Accepting gifts from interested third parties can influence a physician's practice in subtle
or subconscious ways. Only nonmonetary gifts that are of minimal value and that
directly benefit the patient, such as unbiased educational material or drug samples,
should be considered.

-In the absence of an advance directive, a life-saving blood transfusion can be given to
a Jehovah's Witness who lacks decision-making capacity
The Health Care Consent Act has been applied to Jehovah's Witnesses to allow
transfusion to preserve a patient's life in an emergency when no blood refusal card is
present.

- Pt con meningitis x meningococo y no quiere ser hospitalizado- Hospitalize and

isolate the patient against his wishes Patients have the right to refuse treatment
except when doing so poses a serious threat to public health. In these cases, the
physician is justified in restricting individual liberties until the public's health is no
longer at risk.
-Nino con leukemia y papas no quieren darle la quimio- obtener una orden de la corte
pues esto le salvara la vida pero no es una emergencia para actuar sin la corte
If parents refuse to consent to treatment of their child for a non-emergency but fatal
medical condition, the physician should seek a court order mandating treatment.