1. Step 6
1.1. Review session 1
1.1.1. Summary of step 5
1.1.1.1. how to make goodcommunication with difficultpeople.
1.1.1.1.1. respect
1.1.1.1.2. treat him normally
1.1.1.1.3. not being racist
1.1.1.1.4. gain pationt trust
1.1.1.2. what type of infection causes this symptoms
1.1.1.2.1. hebatitic
1.1.1.2.2. infected from sex working
1.1.1.2.3. STD's
1.1.1.3. effect of herion and alcohol in pregnancy
1.1.1.4. normal symptoms of pregnancy (early stage )
1.2. Report new knowledge
2. Step 7
2.1. Inquiry plan and info gathering
2.1.1. History of presenting complain
2.1.1.1. young women
2.1.1.2. pregnant
2.1.1.3. daughter at risk
2.1.1.4. + - difficult patient
2.1.2. Previous medical / surgical history
2.1.2.1. EXPOSURE to hepatitis C
2.1.2.2. past hepatitis B
2.1.3. Drug history / allergy
2.1.3.1. binzodizepan
2.1.3.1.1. dependant
2.1.3.2. heroin
2.1.4. Family history
2.1.5. Social / occupational history
2.1.6. Physical examination
2.1.6.1. DOMISTIC VIOLANCE
2.1.6.2. needle exposure
2.1.6.3. fatigue
2.1.6.4. brosses
2.1.6.5. some scratch marks in left shoulder
2.1.7. tests results
2.1.7.1. hepatitis B
2.1.7.1.1. antigen -
2.1.7.1.2. antibody +
2.1.7.2. hepatits C
2.1.7.2.1. ANTIBODY +
2.1.7.3. heroin +
2.1.7.4. benzodizepan +
3. Step 8
3.1. Diagnostic decision
3.1.1. pregnant, heroin and benzodiazpen depndent, exposed to hepatitis C + domestic violance
3.2. Mechanism
3.2.1. pregnant
3.2.2. heroin and benzosiazpin dependent
3.2.3. used to be sex work
3.2.4. not good at pills
3.2.5. exposed to hepatitis c
3.2.6. previous history of hepatitis B
3.2.7. living with her boy friend ( violent)
3.3. Presentation
3.3.1. marks
3.3.2. brosses
3.3.3. vomiting
3.3.4. fatigue
3.3.5. needle marks
3.3.6. lost of apitite
3.3.7. pregnant
3.3.8. with a child
3.4. Supporting data
3.4.1. + heroin
3.4.2. + benzodiazipin
3.4.3. antibody hepatitis C +
3.4.4. hepatitis B antisurface +
3.4.5. hepatitis B antigen -
3.4.6. normal liver fonction
3.4.7. + pregnancy test