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//-->We dedicate this text to PA students:past, present, and future.You inspire us with your curiosity, motivation,and commitment to patient care.We hope that this project will contribute toyour education, and that you will use it to contribute tothe lives and well-being of your patients.1600 John F. Kennedy Blvd.Ste 1800Philadelphia, PA 19103-2899PHYSICIAN ASSISTANT: A GUIDE TO CLINICAL PRACTICEISBN: 978-1-4160-4485-7Copyright © 2008, 2003, 1999, 1994 by Saunders, an imprint of Elsevier Inc.All rights reserved.No part of this publication may be reproduced or transmitted in anyform or by any means, electronic or mechanical, including photocopying, recording,or any information storage and retrieval system, without permission in writing from thepublisher. Permissions may be sought directly from Elsevier’s Rights Department:phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333;e-mail: healthpermissions@elsevier.com. You may also complete your request on-line viathe Elsevier website at http://www.elsevier.com/permissions.NoticeKnowledge and best practice in this field are constantly changing. As new research andexperience broaden our knowledge, changes in practice, treatment and drug therapy maybecome necessary or appropriate. Readers are advised to check the most current informationprovided (i) on procedures featured or (ii) by the manufacturer of each product to beadministered, to verify the recommended dose or formula, the method and duration ofadministration, and contraindications. It is the responsibility of the practitioner, relying ontheir own experience and knowledge of the patient, to make diagnoses, to determine dosagesand the best treatment for each individual patient, and to take all appropriate safetyprecautions. To the fullest extent of the law, neither the Publisher nor the Editors assume anyliability for any injury and/or damage to persons or property arising out of or related to anyuse of the material contained in this book.The PublisherLibrary of Congress Cataloging-in-Publication DataPhysician assistant : a guide to clinical practice / [edited by] Ruth Ballwegº[et al.]. — 4th ed.p. ; cm.Includes bibliographical references and index.ISBN 987–1–4160–4485–71. Physicians’ assistants. 2. Clinical competence. I. Ballweg, Ruth.[DNLM: 1. Physician Assistants—United States. 2. Clinical Competence—United States.3. Delivery of Health Care—methods—United States. 4. Professional Role—United States.W 21.5 P5775 2008]R697.P45P48 2008610. 73¢72069—dc222007041274Acquisitions Editors:Rolla Couchman, Druanne MartinDevelopmental Editor:John IngramPublishing Services Manager:Linda Van PeltDesign Direction:Gene HarrisCover Designer:Gene HarrisMarketing Managers:William Veltre, Helena MutakPrinted in CanadaLast digit is the print number: 98765432 1ContributorsDiane Dixon Abercrombie, PA-C, MA, MMScAssistant Professor and Academic CoordinatorDepartment of Physician Assistant StudiesUniversity of South AlabamaMobile, AlabamaJ. Dennis Blessing, PhD, PA-CAssociate Dean for South Texas ProgramsSchool of Allied Health SciencesProfessor and ChairDepartment of Physician Assistant StudiesThe University of Texas Health Science Center atAntonioSan Antonio, TexasLinda G. Allison, MD, MPHProfessor and ChairDepartment of Physician Assistant StudiesLe Moyne CollegeSyracuse, New YorkWallace D. Boeve, EdD, MSPA, PA-CProgram DirectorPhysician Assistant StudiesGrand Valley State UniversityGrand Rapids, MichiganDavid P. Asprey, PhD, PA-CAssociate Professor and Program DirectorPhysician Assistant ProgramThe University of Iowa Carver College of MedicinePhysician AssistantDepartment of Pediatric CardiologyUniversity of Iowa Children’s HospitalIowa City, IowaAnthony Brenneman, MPAS, PA-CClinical Assistant Professor and Director ofClinical EducationPhysician Assistant ProgramThe University of Iowa Carver College of MedicineIowa City, IowaPatrick C. Auth, PhD, PA-CProgram DirectorHahnemann Physician Assistant ProgramDrexel UniversityPhiladelphia, PennsylvaniaDarwin Brown, MPH, PA-CAssistant ProfessorPhysician Assistant ProgramUniversity of NebraskaOmaha, NebraskaRuth Ballweg, MPA, PA-CAssociate ProfessorDirector, MEDEX NorthwestDivision of Physician Assistant StudiesUniversity of Washington School of MedicineSeattle, WashingtonDavid R. Buck†Geraldine A. Buck, MHS, PA-CAssociate Professor and DirectorAdvanced Physician Assistant ProgramCollege of Nursing and Health ProfessionsDrexel UniversityPhiladelphia, PennsylvaniaDiana P. Barr, BAAssociate DirectorHealth Information Management DepartmentThe University of Texas Medical Branch atGalvestonGalveston, TexasTom ByersFormer Deputy MayorSeattle, Washington†Deceased.vviContributorsJames L. Cary, PA-C, MHASenior PartnerMedical Legal Education and ConsultingCary and Associates, LLCPanama City, FloridaNicole Gara, MAVice PresidentGovernment and Professional AffairsAmerican Academy of Physician AssistantsAlexandria, VirginiaR. Monty Cary, PA-C, MEdSenior PartnerMedical Legal Education and ConsultingCary and Associates, LLCLas Vegas, NevadaF. J. (Gino) Gianola, PALecturerMEDEX NorthwestDivision of Physician Assistant StudiesUniversity of Washington School of MedicineSeattle, WashingtonR. Scott Chavez, PhD, MPA, PA, CCHP-AVice PresidentNational Commission on CorrectionalHealth CareChicago, IllinoisAnita Duhl Glicken, MSWProfessor of PediatricsInterim DirectorChild Health Associate Physician AssistantProgramUniversity of Colorado at Denver Health SciencesCenterAurora, ColoradoJohn L. Chitwood, LTCOL, USAF, BSCAssistant ProfessorInterservice Physician Assistant ProgramSaint Francis UniversityLoretto, PennsylvaniaConstance Goldgar, MS, PA-CAssociate DirectorPhysician Assistant ProgramUniversity of UtahSalt Lake City, UtahDan Crouse, MPAS, PA-CDirector of Academic AffairsUniversity of Utah Physician Assistant ProgramDepartment of Family and Preventive MedicineSalt Lake City, UtahJ. Kirkland Grant, MD, FACOGChairmanDepartment of Obstetrics and GynecologyMesquite Community HospitalMesquite, TexasLinda M. Dale, MSOD, PA-CPhysician AssistantOccupational MedicineWorkCARE, PLLCWenatchee, WashingtonJim Hammond, MA, PA-CProfessor and DirectorPhysician Assistant ProgramJames Madison UniversityHarrisonburg, VirginiaAnn Davis, MS, PA-CDirector of State Government AffairsAmerican Academy of Physician AssistantsAlexandria, VirginiaKenneth R. Harbert, PhD, CHES, PA-CDeanSchool of Physician Assistant StudiesSouth CollegeKnoxville, TennesseeWalter A. Eisenhauer, MMS, MEd, PA-CProfessor and DirectorPhysician Assistant StudiesLock Haven UniversityLock Haven, PennsylvaniaVirginia McCoy Hass, FNP-C, PA-C, MSNFacultyDepartment of Family and Community MedicineFNP/PA ProgramUniversity of California, DavisSacramento, CaliforniaTimothy C. Evans, MD, PhD, FACPAssociate Professor of MedicineDepartment of MedicineUniversity of WashingtonSeattle, WashingtonContributorsviiKy Haverkamp, PA-CLecturerMEDEX NorthwestDivision of Physician Assistant StudiesUniversity of Washington School of MedicinePhysician AssistantFamily PracticeGroup HealthSeattle, WashingtonKathy A. Kemle, MS, PA-CAssistant ProfessorDepartment of Family MedicineMercer University School of MedicinePhysician AssistantDepartment of Family MedicineMedical Center of Central GeorgiaMacon, GeorgiaTimothy J. King, PA-CLawrence Herman, MPA, PA-CAssistant Professor/Senior Clinical CoordinatorDepartment of Physician Assistant StudiesNew York Institute of TechnologyOld Westbury, New YorkFacultySouthwest Georgia Area Health Education CenterAlbany Area Primary Health Care, Inc.Albany, GeorgiaWilliam C. Kohlhepp, DHSc, PA-CL. Jill Jones-Hester, PA-CPhysician AssistantNorth Texas Infectious Disease ConsultantsDallas, TexasAssistant Professor of Physician AssistantEducationDirector, ELMPA ProgramQuinnipiac UniversityHamden, ConnecticutPhysician AssistantOccupational Health PlusHospital of Saint RaphaelNew Haven, ConnecticutRoderick S. Hooker, PhD, PA-CAssociate ProfessorDivision of Rheumatic DiseasesDepartment of MedicineThe University of Texas Southwestern MedicalCenterDirector of Rheumatology ResearchMedical Services, Rheumatology SectionDepartment of Veterans AffairsDallas VA Medical CenterDallas, TexasKristine J. Kucera, PA-C, MPAS, DHSAdjunct Clinical ProfessorPhysician Assistant StudiesThe University of Texas Southwestern MedicalCenterPhysician AssistantTexas Dermatology AssociatesDallas, TexasSteven Johnson, PA-CPhysician AssistantPalo Alto Medical FoundationPalo Alto, CaliforniaDavid H. Kuhns, PA-C, MPHAssistant ProfessorPhysician Assistant ProgramCollege of Health ProfessionsUniversity of New EnglandPortland, MaineBryanne L. Jones, MASenior Research and Legislative AssociateCompassion and ChoicesPortland, OregonBarbara Coombs Lee, PA, FNP, JDPresidentCompassion and ChoicesPortland, OregonP. Eugene Jones, PhD, PA-CEditor-in-ChiefJournal of Physician Assistant EducationProfessor and ChairDepartment of Physician Assistant StudiesThe University of Texas Southwestern MedicalCenterDallas, TexasPaul Lombardo, MPS, RPACProgram ChairDepartment of Physician Assistant EducationUniversity of Stony BrookStony Brook, New York [ Pobierz całość w formacie PDF ]