Lectures 1-3 Flashcards
Define medication management services.
Professional activities needed to meet the standard of care which ensures patient medication is individually assessed for
i. Appropriateness
ii. Effectiveness
iii. Safety
iv. Adherence
Describe the 4 elements needed for assessment of patient illness and health problems
Knowledge of characteristic patterns of the signs and symptoms for each disorder
i. PharmD must know drug related problems
ii. Diagnostic criteria for the disorder
iii. Patient History (Subjective data/questions)
iv. Physical Examination (Objective Data)
Bradycardia
Low heart rate
Tachycardia
High heart rate
Standard of care for patient assessment
- Collection of patient specific information (decision making process)
- Assessment of drug-related needs (best meds possible; accessibility)
- Identification of drug therapy problems
- Development of goals of therapy
- Statement of interventions (care plan to resolve/prevent drug therapy prob. & get goal)
- Establishment of a schedule for follow-up evaluations
- Follow-up evaluation
Subjective data
Acquired by interviewing patient
Open ended questions
Questions that require patients to give detailed answers
Close ended questions
Questions that can be answered with a yes or no
Patient oriented
Explores patient feeling, active listening, emotional reaction to disease/symptoms
Provider Oriented
Targeted toward obtaining specific information for making diagnosis, driven by provider, less attention on personal aspects
HPI
History of present illness
Includes chief complaint
Focuses on patient’s presenting symptoms
QuEST
Quickly and accurately assess patient
Establish that the patient is an appropriate self care candidate
Suggest appropriate self-care strategies
Talk with the patient
SCHOLAR MAC
Symptoms (What)
Characteristics (What does it feel like)
History (Whats been done so far)
Onset (when it started)
Location (where)
Aggravating factors (what makes it worse)
Remitting factors (what makes it better(
Medication
Allergies
Conditions
PMH
Past medical history
Childhood illness, immunization stats, medications, allergies, adverse drug reactions, etc.
FH
Family History
Familial patterns of disease from immediate family
e.g: Grandparents, parents, aunts/uncles, etc.
SH
Social History
Sexual history, financial status, housing status, living arrangements, travel, alcohol intake, recreational drug usage, education, etc.
PRAPARE
Protocol for
Responding to and
Assessing
Patients’
Assets
Risks and
Experiences
Functions as validated assessment tool, a process, and core measures for addressing the social determinants of health (SDOH)
ROS
Review of systems
List of questions arranged by organ systems
SOAP
Subjective
Objective
Assessment
Plan
Guides healthcare professional to collect data, evaluate the issues, and develop a treatment plan
Plan
Always make a plan consider the patient’s SH, insurance, and finances
Physical Assessment Techniques
Blood Pressure, Temperature, Pulse, Respiratory rate
(pain can also be included)
Normal temperature
97.7 - 99.5
36.5 - 37.5
Hypothermia
<95
<35
Hyperthermia/Febrile
99.5 - 100.9
37.5 - 38.3
Hyperpyrexia
104 or 106.7
40 or 41
Pulse
60-100 BPM
Radial or Carotid artery
Respiration
Rise and fall = 1
12-20 breaths per minute
Bradypnea
<12 breaths per minute
Tachypnea
Greater than 20 breaths per minute
What do you avoid 30 minutes before blood pressure reading?
Caffeine, Smoking, Exercise, Meals
What do you do during a blood pressure reading?
Go pee, White coat syndrome so chill for 5 minutes, Measure cuff size, Line arm at heart level, No talking, feet flat on floor, palm up, legs uncrossed
How do you take a blood pressure test?
Pump until no radial pulse, go 20-30mmHg above that
Stethoscope on brachial artery
Deflate cuffs at 2mmHg per second
First Korotkoff is systolic
Second is diastolic
Record BP and state which arm, arm with highest BP is used next time
Normal Blood Pressure
Below 120/80
Elevated Blood Pressure
120-129 and less than 80
Hypertension stage 1
130-139 or 80-89
Hypertension stage 2
140/90 or higher
ER levels of blood pressure
Greater than 180/120
