Dementia Flashcards
managment of symptoms of dementia
Engage person in activities that are interesting and meaningful
Trial of analgesia
Consider treatment with antipsychotic if behaviour severe (not in Dementia with Lewy Bodies)
palliative care when appropriate
Speech pathologist for assessment of swallowing and feeding
Describe advanced care planning
- Plan for the medical treatment they would prefer if they became too ill in the future to express their wishes
- ## complete legally binding document called an advance health directive or living will - patient’s intentions for their future healthcare
PEPSI-COLA
Physical needs Emotional needs Personal/religious needs Social support Information/communication between professionals/patient/carers Control - choice, dignity, place of death Out of hours needs Late - terminal care Afterward - bereavement care
Diagnostic work up for dementia
GPCOG cognitive testing Screen for comorbid depression CTB Pharmacological review - hypnotics, sedatives, analgesics and antipsychotics FBE EUC LFT Serum b12/folate TSH BGL Ca Urine mcs
Travel history upon return
Where? When? Urban or rural? Purpose of travel? Special activities - mountaineering, scuba diving, caving Risk exposures - sexual - consumption of poor quality food and water - ticks or other insect bites - swim in lakes - contact with wildlife What vaccinations did you receive Malaria prophylaxis details Did you/anyone become ill while away
Examination of lump
Location Size Consistency Tenderness Mobile or tethered
Treatment for acromioclavicular joint separation
Rest the shoulder for 48 hours
Ice the shoulder for 15 mins every 2 hours for 48 hours
Paracetamol
Supportive shoulder strapping of the left shoulder to stabilise the joint
Referral for physiotherapy to maintain left shoulder function
Short term use a sling to provide pain relief
Over 75 yo health check (17)
BP, rate, rhythm SNAP, BMI Review medication Assess continence Assess psychological function including mood and cognition check immunisation status - tetanus, influenza, pneumococcus Assess physical function - activities of daily living and falls in last 3 months Social function - availability/adequacy of paid/unpaid help/caring for another person Fitness to drive Foot care Hearing Vision Sleeping patterns Need for community services Home safety Mobility Oral health
2 month national immunisation schedule (3)
Infanrix hexa /diphtheria, tetanus, acellular pertussis, hepatitis B, polio, Haemophilus influenzas B vaccinations
Preventer 13/pneumococcal vaccination
Rotaries/rotavirus vaccination
Medications for etOH abuse (3)
Disulfram
Naltrexone
Acamprosate
What is necessary for a patient to give consent?
Freely given without duress
Given by someone who is legally capable (competent) of consenting
Specific and cover the intervention or procedure to be performed
Informed
Capacity is present if the patient can:
- an ability to comprehend and retain information
Weigh that information in the balance to arrive at a choice
Screening principles
- It should be an important health problem with a recognisable latent or early symptomatic stage
- Test should be simple,safe, precise and validated, acceptable
- Treatment should be available that leads to better outcomes
4; evidence of improved mortality, morbidity or QoL as a result of screening and the benefits of screening should outweigh the harm
Healthy pregnancy environment
Toxoplasmosis - avoid cat litter, garden soil, raw/undercooked meat and unpasteurised milk, wash all fruit and vegetables
Cytomegalovirus, parvovirus B19 - frequent handwashing, using gloves when changing nappies
Listeriosis - avoid pate, soft cheeses, prepackaged salads, deli meats and chilled/smoked seafood. Wash all fruit and veg
Fish limit those high in mercury
