final final Flashcards
ABCDs what does the D stand for
decreased mental status
flasgow coma scale <13
stroke-like sxs
stoke mimics
seizures confusional states syncope toxins subdural super low neoplasms
surgical acute abdomen
Bowel obstruction: incarcerated hernia, malignance, volvucs (cecal or sigmoid) small bowel-adehesion or incarcerated hernia
peritonitis: appendicitis, cholecytsisits, diverticulitis
perfed viscus: diverticulitis, duodenal or gastric ulcer, large bowel obstruction with perforation
vascular:
aortic dissection, gastrointestinal hemorrhage, mesenteric ischemia/infarction, ruptured or symptomatic abdominal aortic aneurysm
meds that cause acute abdomen
NSAIDS- assoc with hemorrhage
Warfarin/pradaxa: GIB or thrombotic
steroids- immunosupression
beta blockers: blunts tachy
transmission of norovirus
food and water borne
close person to person contact
contact with contaminated surfaces
aerosolized vomit
risk factors for hep C
IVDU Hemophiliacs clotting factors before 87 hemodialysis medical workers with needle sticks children of HCV women
underlying issues with FTT
ANY PRESCRIPTION
Psychotropics, Anticholinergics, Antidepressants
OTC
alternative nutritional supplements
definition of incontinence
Urgency: compelling sudden need to void
Urgency incontinence leakage preceded by or associated with urgency
Stress incontinence: leakage with sneezing or some forceful movement
what is a outlet obstruction PVR
Postvoid Residual (PVR) if it is over 200 suggest detrusor weakness or outlet obstruction
can exclude hydroneprhosis
overflow management
if obstruction is present treat underlying cause
reduce or stop drugs that impair detrusor contractility and increase urethral tone; treat constipation
bethanechol chloride is generally ineffective
intermitten clean catheterization
bladder emptying may improve with double void
last resort is protective garments
keigels are important for
Effective for urge and stress UI by strengthening pelvic muscles
when should we use catheters
Short-term decompression of acute urinary retention
Chronic retention not manageable surgically/medically
Patients with wounds that must be kept clean of urine
Very ill patients who cannot tolerate garment changes
Patients who request catheterization despite informed consent regarding risks
Who abuses geriatric?
Primarily adult children,
and then spouses, other relatives and lastly grandchildren
Life prognosis
Overestimate by a factor of 5!!!
eligibility for hospice Dementia
Dementia -
bed bound mute non-ambulatory asp PNA wt loss
and at least one of following occurring in the past year: pyelonephritis, sepsis, pressure ulcers, fever after antibiotics, dysphagia. (answer is was ambulatory)
