Geri and Combative Pts

Question 1

What scoring system can you use to admit seniors for social admits that are weak admits to the hospitalists?

Answer 1

ISAR - ID of Seniors at Risk

1. Do you need help on regular basis?
2. Need more help than usual since injury?
3. Been hospitalized in last 6mo?
4. Do you see well?
5. Problems w/memory?
6. Take > 3meds a day?

Score > 2 ADMIT

Question 2

What are the 6 ADLs?

Answer 2

Bathing
Dressing
Toileting
Transferring
Continence
Feeding

BDTTFC

Question 3

Older patient presenting with NEW kidney stone pain should be evaluated for what?

Answer 3

Ruptured AAA

Question 4

How does the IDSA define suspected infection in the LTC community?

Answer 4

Fever + change in baseline

Question 5

How to treat pain in Geri pts with renal disease?

Answer 5

0.5mg Dilaudid then check 15 minutes later and ask if they want more pain meds

All the other common pain meds accumulate in kidneys (including morphine)

Question 6

Difference bw Versed and Ativan for restraint?

Answer 6

V - 5 IM, faster onset of action and only lasts 2 hours

A - 2 IM, takes 15-30 to work and lasts 6-8 hours, NO active metabolites

Question 7

Dose of Ziprasidone? Used for what pts?

Bran name?

Answer 7

20mg IM
Known psych disorder

Geodon

Question 8

Which antipsychotics have the highest incidence of EPS?

Highest incidence of sedation, HoTN, antiACh?

Answer 8

High potency (Haldol)

Low potency (Thioridazine)