CCS 2 Flashcards

1
Q

Stroke-TIA orders

A
Head-CT
CBC
BMP
ECG
cardiac monitor
carotid doppler
Blood glucose
Echo
lipid 
HBA1C
MRI head
MRA brain
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2
Q

Stroke-TIA therapy

A

IV access
ASA
Consider CEA
Counseling

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3
Q

Stroke-TIA steps

A
Exam
STAT orders (CBC, CT-head, BMP, ECG)
ASA as soon as CT head negative
Transfer patient to ward
Ward orders
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4
Q

Stroke-TIA ward orders

A

diabetic diet, glucose q8h, STAT imaging (MRA, etc.)

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5
Q

PID workup

A
HCG
Gram stain, cervix
Gonorrhea culture
Chlamydia culture
UA
Urine culture
CBC
BMP
RPR
HIV
Pap smear
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6
Q

PID therapy

A
IV access
IVF
IV clinda + IV gentamicin inpatient, outpatient CTX + doxy for 14 days
Phenergan IV
Acetaminophen IV
Morphine IV
NPO 
bedrest
Counseling
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7
Q

bleeding diathesis orders in kid

A
CBC
BMP
Bleeding time
PT/PTT
LFTs
Factor VIII, IX, XI
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8
Q

hemophilia therapy

A
Factor replacement
No ASA
Counseling
Genetics consult
Admit to ward
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9
Q

hemophilia monitoring

A

PTT

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10
Q

ACS emergency orders

A
Pulse ox
O2
Cardiac monitor
Continuous BP
12 lead
IV access
**ASA
nitroglycerin
IV access
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11
Q

ACS workup

A
12 lead
Troponin
CXR
CBC
BMP
LFT's
lipids
PT-PTT-INR
Echo
cardiology consult
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12
Q

ACS therap

A
MONA-BASH
ASA
Nitro
**Heparin
metoprolol
Eptifibatide
Statin
Cardiology consult
Cath
NPO
Bedrest
Counseling
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13
Q

croup workup + emergency orders

A

EMERGENCY orders STAT (oxygen, pulse ox)
STAT CBC
BMP
Neck x-ray STAT

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14
Q

croup therapy

A

Humidified air
Epinephrine, inhaled
Dexamethasone oral
Counsel patient

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15
Q

asthma exacerbation emergency orders

A
Pulse ox q 1 hour
Oxygen
IV access
Head elevation
Cardiac monitor
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16
Q

Asthma exacerbation workup

A
peak flow (PEFR)
ABG
ECG
CXR
CBC
BMP
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17
Q

asthma exacerbation therapy

A
Oxygen  
Albuterol
Iptratropium bromide
steroids
Counseling
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18
Q

asthma monitoring

A

pulse ox
Peak flow q 1 hour
IF not responding, admit

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19
Q

meds that can cause constipation

A

CCB’s, opioids, anticholinergics, iron replacement

20
Q

constipation workup

A
CBC
BMP
Serum mag
serum phos
TSH
FOBT
colonoscopy
HBA1C
21
Q

constipation therapy

A
High fiber diet
**metamucil
oral hydration
low salt diet
low fat diet
Exercise program
Patient counseling

*don’t start second line therapies first

22
Q

constipation first line and second line

A

Initial measures:
Fiber + fluids
Bulk forming laxatives (psyllium/metamucil, methylcellulose)
IF refractory:
Softeners (docusate), osmolar agents (lactulose, sorbitol, mag citrate), stimulants (senna, bisacodyl)
Disimpaction
GI referral for colonic transit, anorectal manometry

23
Q

physical exam + location also for acute appendicitis

A

rectal

*transfer immediately to ER after exam, then admit to ward before surgery

24
Q

appendicitis workup in kids

A
CBC
BMP
LFTs
FOBT
UA
coags
abdominal US (CT only if US equivocal or child is obese)
25
Q

appendicitis therapy

A
NPO
IV access
NS
morphine IV
zofran
cefoxitin IV
surgery consult
laparoscopy
26
Q

septic arthritis workup

A
CBC 
BMP
Blood cultures
coags
X-ray knee
synovial fluid analysis
synovial fluid gram stain 
and culture and sensitivity
Synovial fluid crystals
27
Q

septic arthritis therapy

A
IV access
IV NS
NPO
morphine iV
IV CTX + vanc
STAT Ortho consult + arthroscopy if inadequate drainage
Counseling
*admit to ward
28
Q

most common cause of abnormal uterine bleeding in non-pregnant adolescent females

A

dysfunctional uterine bleeding (anovulation and unopposed stimulation of endometrium by estrogen. HPO axis is underdeveloped)

29
Q

dysfunctional uterine bleeding workup

A
qualitative urine HCG
serum TSH
serum prolactin
CBC 
coags
30
Q

dysfunctional uterine bleeding therapy

A

OCP
Iron sulfate
Reassurance
Counseling (med compliance, safe sex, regular exercise)
*rule out pregnancy before starting therapy

31
Q

emergency orders for pericarditis

A
pulse ox
oxygen
cardiac monitor
BP monitor
12 lead ECG
IV access
32
Q

pericarditis orders

A

ECG + CXR first

CBC
BMP
Troponin
ESR
Blood cultures
ECHO
33
Q

blunt abdominal trauma emergency orders

EMERGENCY TRAUMA ORDERS

A
C-spine immobilization
IV access
IV NS
Pulse ox
oxygen
BP monitor
cardiac monitor
34
Q

Blood abdominal trauma workup

A
CBC
BMP
LFTs
Serum amylase
Serum lipase
UA
ABG
coags
type and cross
blood ethanol
Utox
Urine HCG
12 lead ECG
Spine + chest X-ray 
abdominal CT
UOP
35
Q

blunt abdominal trauma therapy

A
NPO
General surgery
Foley
IV morphine
IV zofran
Counseling (no contact sports)
36
Q

blunt abdominal trauma monitoring

A

serial exams

H&H q6h

37
Q

Blunt abdominal trauma timing

A

Initial ABCDE
C-spine immobilization before exam
Surgery consult immediately following exam

38
Q

cellulitis orders

A

CBC with diff
BMP
x-ray
Blood cultures

39
Q

cellulitis therapy

A
IV access
IV NS
Leg elevation
Clindamycin IV
Percocet  oral
40
Q

gout workup

A
CBC
BMP
Coags
ESR
Serum uric acid
X-ray of joint
synovial fluid analysis
41
Q

gout therapy

A
Indomethacin
Counseling (low protein diet, no alcohol, no smoking, medication compliance)
42
Q

PCP pneumonia workup

A
Pulse ox
CBC
BMP
ABG (to determine need for steroids)
Serum LDH
Serum PCP stain
CXR
Blood G6PD
HIV elisa + western blot + viral load + CD4 count
43
Q

PCP therapy

A
Empiric bactrim after CXR
STeroids if PO2 less than 70 or A-a gradient over 35
O2
Influenza vaccine + pneumococcal
HAART
Counseling
Pulse ox
44
Q

general cancer workup

A
CBC
BMP
LFTs
UA
FOBT
Abdominal + chest CT
Serum iron
TIBC
Ferritin
Coags
type and cross
45
Q

general emergency orders

A
IV access
pulse ox
Oxygen
BP monitor 
cardiac monitor 
ECG
46
Q

acute abdomen-perforated ulcer workup

A
CBC
BMP
LFTs
lipase, amylase
abdominal or CXR
Coags
type and cross
47
Q

perofrated ulcers order

A
NPO
Bedrest
NG tube
NS
morphine
zofran
PPI
IV ampicillin-sulbactam
surgery consult
laparoscopy