Admit the Patient Flashcards
- Distinguish which patients require admission to a health care facility
- Significant potential for deterioration of clinical course (ex. ICU, intubation, frequent vitals)
- Urgent surgery/invasive procedure
- Short-term IV Tx (ex. abx) or blood transfusions
- Inability to take care of themselves (ex. end stage COPD)
- Unstable patient needing critical care
define types of admissions
planned
emergency
direct admission
- Planned: no immediate threat, planned elective procedure (Labor induction, Hip replacement, TAH-BSO)
- Emergency: unplanned, most likely through the ED. They have been stabilized in ED and decision from ED to admit(Chest Pain, Trauma)
•Direct Admission: Usually from a PCP office, or hospital to hospital, avoiding the ER (Nausea, vomiting, neutropenic patients)
Identify the most common types of admissions to a health care facility
planned
emergency
direct admission
Planned: no immediate threat, planned elective procedure
- Labor induction
- Hip replacement
- TAH-BSO
Emergency: unplanned, most likely admitted from ED
- Chest pain (ex. afib)
- Trauma
- Pneumonia
Direct admission: usually from a PCP or hospital (avoid ED)
- Nausea/vomiting
- Febrile neutropenia
Reasons a patient might need hospital-level care:
- Anticipated clinical course with significant potential for deterioration, which entails the need for monitoring
- Need for urgent surgery or other invasive procedures
- Need for short-term IV drug treatment (VANCO for MRSA infection), blood transfusions etc.
•Inability to take care of themselves
Obviously, an _unstable patien_t who needs critical care
Discuss criteria for Severe immune response syndrome (SIRS) and determine if a patient meets criteria
- Fever >38 C or <36 C
- RR >24
- HR >90
- Leukocytosis >12,000, leukopenia <4,000 or >10% bands
- Distinguish SIRS from Sepsis criteria and determine if a patient meets SEPSIS criteria based on guidelines.
Sepsis: SIRS + proven or suspected microbial cause
A sepsis diagnosis requires:
- the presence of infection (which can be proven or suspected)
- and 2 or more of the following criteria:
define acronym for hospital admission
ADC VAN DIMALS
admission
diagnosis
condition & code status
vitals
Activity
nursing
Diet
IV Fluids
Medications
Allergy
Labs
Special
when ordering meds it is important to always include
something for pain
something for nausea
something for anxiety
something for bowels
DVT prophlyaxis
formulate a plan for the syncopal pt
formulate a plan for the hip fx pt
formulate a plan for the chest pain pt
talk about admission process more in depth
common causes of Emergency admissions
•Chest Pain, Trauma)
common causes of Planned admissions
•Labor induction
Hip replacement
TAH-BSO)
common causes of Direct Admissions
Nausea, vomiting
neutropenic patients
