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CDM II > Hospitalist Medicine I > Flashcards

Hospitalist Medicine I Flashcards

1
Q

closed vs open ICU

A

Open ICU rural- hospitalist runs ICU
Closed ICU- Pulmonologist runs ICU

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2
Q

2 MC procedures done by hospitalists?

A

Thoracentesis
Paracentesis

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3
Q

Why was the hospitalist role made (2)?

A

Resident work hour restrictions
Increase safety

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4
Q

H&P note or Progress note?
Admitting pts

A

H&P note

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5
Q

H&P note or Progress note?
Hand off

A

Progress note

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6
Q

Time when Handoff may need t be more meticulous

A

Night shift handoff

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7
Q

Acronym for admisison orders?

A

“ADC VANDALISM”
Admit to
Dx
Condition
VS
Allergies
Nursing orders
Diet- imp for pt
Activity
Labs- BMP & CBC QD AM
IVOp fluids- fine teeter/totter
Special Studies- Misc Rn orders
Medications

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8
Q

Most important part of d/c or pts? (tells the pt exactly what happens next?

A

DC summary:
including follow up

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9
Q

What documentation tells the story of the hospital course?

A

DC summary

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10
Q

How often does hospitalist assess VS, LAbs, imaging & consults?

A

Daily

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11
Q

ICU or Floor?
Ventilator, BiPAP

A

ICU

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12
Q

ICU or floor:
Central lines, pressors, drips

A

ICU

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13
Q

ICU or Floor?
Nursing needs:
(insulin drip, heparin drip, eye drop administration)

A

ICU

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14
Q

ICU or Floor?
Risk of decompensation
(e.g. threatened airway)

A

ICU

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15
Q

Hyper/hypoglycemia
Hyperglycemia (>400) without anion gap? ICU, PCU, Floor?

A

Floor

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16
Q

Hyper/hypoglycemia
DKA but pH > 7.2 and resolving anion gap

A

PCU

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17
Q

Hyper/hypoglycemia
DKA with multi-organ dysfunction, pH < 7.2

A

ICU

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18
Q

Nursing pt ratio? ICU, PCU, Floor?

A

Floor: 1:4+
PCU: 1:3+
ICU: 1:1 or 1:2

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19
Q

Hospitalists are captains of the ship why? (4)

A

Admit pts
Coord consults
d/c pts`
arrange OP f/u

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20
Q

Lab Draws (Floor, PCU, ICU)?

A

Floor: Daily, BID
PCU: Q2h
ICU: <Q2h

21
Q

ICU or Floor?
Chronic hemodialysis/ non-emergent

A

Floor

22
Q

ICU or floor?
Emergent dialysis, CRRT, K > 6.0 with EKG changes, any K > 7.0

A

ICU

23
Q

ICU or Floor?
Stable hemodynamics (HR 50-130, SBP 85-200, RR 10-30)

A

Floor

24
Q

ICU or FLoor?
Hemodynamically unstable; hypertensive emergency; IV antihypertensives

A

ICU

25
Q

ICU or Floor?
Chronic stable NPPV overnight (CPAP for OSA)

A

Floor

26
Q

ICU or Floor?
NIPPV (BiPAP, CPAP); intubated; impending respiratory failure; threatened airway

A

ICU

27
Q

How to determine inpatient or observation?

A

2 midnight rule

28
Q

Always have at least __ DDx

A

3

29
Q

Dont forget to ask about

A

CODE STATUS

30
Q

Daily life of a PA: 4 thing to do during shift

A

*Daily (at least) re-evaluation of patients
*Adjustment of treatment plan
*Communication with consultants
*Discharge planning / longer-term plan

31
Q

Do hospitalist notes need to be done before handoff?

A

you bet

32
Q

Who:
Home health, Outpt IV ABX setup, durable medical equipment, transfer to outside hospital/SNF/placement

A

Case Manager

33
Q

Who:
takes care of
Homelessness
Uninsured helps pts get insurance
Undocumented
Substance abuse DH inpt addiciton team
Adjustment to illness counseling
Complex social issues Legal issues/guardianship

A

Social Worker

34
Q

Who:
Medical necessity review
Inpatient vs. OBS

A

Utilization management

35
Q

Who:
Assess/improve ADLs, mobility
Cognitive screens, MOCA

A

OT

36
Q

Who:
Ventilator and NIPPV management
Home oxygen evaluations
Nebulizers, chest PT (Physiotherapy)
OSA screens
Sometimes intubate

A

RT

37
Q

Who:
*Patient assessment
*Medication administration
*Care coordination
*Front line for patient/family interaction
*Discharge logistics and education

A

RN

38
Q

Who:
*Confirmation of all inpatient med orders
Med reconciliation
*Clarification of orders with providers
*Preparation of medications
*RRT/MET/code involvement

A

Pharmacy

39
Q

What will the consultant contribute (3)?

A

*Procedures
*Advice on workup
*Advice on treatment

40
Q

Any ___ findings on a head CT warrant a PE and neurosurg consult

A

New

41
Q

___ communication is key to prevent bad patient outcomes

A

clear

42
Q

If a pt is on O2, what is a good question to ask?

A

What is their baseline O2 requirement?

43
Q

What position helps pts with COVID lungs

A

Prone “swimming”

44
Q

Can you do heated high flow on the floor?

A

yes

45
Q

DIscharge details
Collaboration withattending goes in:

A

discharge summary

46
Q

Discharge Details
*Follow up scheduled- f/u w/____

A

PCP! within a week

47
Q

Discharge Details
*Coordinating DC meds- see if pts need ___

A

refills on home meds

48
Q

Discharge Details
make sure you add:

A

STRICT PRECAUTIONS
ie would care (supplies, packing, whether you can get the area wet).

49
Q

Calc serum anion gap
Normal?

A

Serum anion gap
= Na - (Cl + HCO3)

4-12

CDM II (6 decks)

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