Reference no: EM132842281

The purpose of this project is to amend the organizational business strategy and raising the awareness and reputation of the Kingswood Health Centre by introducing a medical team IVR telephone system. The goal of this project is to fundamentally ensure the level of customer service is improved upon and an increase in customers / patients who fall within the catchment area, to register and patronize the medical centre. If the proposed alternative isn't accepted, alternatives such as increasing the number of staffs could be considered as well. The KHC provide clinical and non-clinical services such as family planning, maternity and midwifery, a variety of minor injuries/ ailments and lots more. The current gap in service quality is the institutions' ability to cater for the large number of households within its boundary in relation to the number of available staff. Another problem KHC faces is the potential criticism from the public relating to its attitude to customers /patients' reasons of contacting which may seem unreasonable to the staff. The IVR will absolutely eliminate this gap and restore the relationship that should exist between the institution and its customers.

1 What is the Bernheim effect and the reverse Bernheim effect?

2 Kindly explain why the left side of the heart is more prone to disease.

3 1. Is it always necessary to examine the cardiovascular system of a patient in the 45° incline of the head end? Other than convenience for examining the jugular venous pressure (JVP), does this position have any other advantage? 2. If the JVP is not visible when the patient is in the upright position, can one presume it is not raised?

4 The mitral area (of auscultation) normally corresponds with the apex beat. When the heart is dilated and the apex beat is shifted laterally, will the mitral area follow the apex beat to its new location or remain at the place where the apex beat is normally situated?

5 Please explain in detail how to measure the pulsus paradoxus using a sphygmomanometer.

6 What is the difference between dicrotic pulse and pulsus bisferiens?

7 1. Why does the radial pulse become more prominent when the hand is lifted overhead? 2. Please explain the mechanism of a collapsing pulse. Which is the best artery to elicit it: radial, brachial or carotid?

8 What is the mechanism of Durozier's sign?

9 What effects do the aortic stenosis, aortic regurgitation and coarctation of the aorta have on systolic and diastolic blood pressure, and why do they produce these effects?

10 In the section headed 'Pulsus bisferiens' (K&C 7e, p. 691) what do 'percussion wave' and 'tidal wave' mean? An illustration here would be helpful.