You are a family nurse practitioner employed in a busy primary care office. the providers in the group include one physician and three nurse practitioners. the back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. she knows almost every patient in the practice, and has an excellent rapport with all of the providers.

mrs. smith was seen today in the office for an annual physical. her last appointment was a year ago for the same reason. during this visit, mrs. smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. you noted the patient's name on the label, and the date on the bottle was 1 week ago. you also noted your name printed on the label as the prescriber. the patient admitted that she called last week concerned about her cough and spoke to stephanie. you do not recall having discussed this patient with stephanie nor do the other providers in the practice.

discussion question:

what are the potential ethical and legal implications for each of the following practice members? :

medical assistant

nurse practitioner

medical director

practice

what strategies would you implement to prevent further episodes of potentially illegal behavior?

what leadership qualities would you apply to effect a positive change in the practice? be thinking about the culture of the practice.

11. two 1 l iv bags are to be administered at 150 ml/hr. how long will the iv last? round to the nearest hundredths

A10-year-old girl suffered from a rare malignancy in her brain and around her spinal cord. she had surgery, and most of the tumor mass was removed, but residual tumor remained in the brain and around the spinal cord. the girl's doctors informed her parents that chemotherapy and radiation were possible treatment options but could cause serious problems such as sepsis, a permanent loss of iq and stature, and even death. the parents wished to proceed with the therapy. while their child was undergoing aggressive chemotherapy and radiation, the parents did independent research and read of several drugs being administered for cancer in other states that were unapproved by the federal drug administration (fda) and were illegal in their home state but were touted by physicians using them as miracle cures." furthermore, one of the girl's doctors released the girl's medical records to another physician to get a "second opinion" without informing the parents. this particular physician is a member of the same country club as the parents. he happens to share facts from the medical records with other members who end up telling the girl's parents. the couple sued their child's physician for failure to disclose alternative treatments, thus depriving them of informed consent. the couples also sued the child's physician for sharing their daughter's records in violation of the girl's privacy. how should the court rule in both cases? did the child's physician involved follow the law? did he act ethically in either situation? explain your answer. under the doctrine of informed consent, should a physician be responsible for informing patients of all treatment options, even if some of the treatments are illegal or not yet proven effective?

List three other drugs used for anxiety or sleep that are not classified as benzodiazepines or barbiturates.