Long Case Management Issues Flashcards
any question: strategy
RICE MotherFucker:
1. review e.g. severity, reasons, previous Ix
2. Ix if need
3. collab with pt/family/school/AH/specialists
4. educate pt/family
5. Mx - non-pharm vs pharm
6. f/u - effectiveness, Cx of meds
health surveillance - role of paeds
- imms
- surveillance: teeth, hearing, vision
- disease specific surveillance
- common paeds issues: sleep, growth, continence
- MHx / transition e.g. puberty, adult services
how to reduce outpatient care burden
- coordinate Ix
- appts same day
- multi-disciplinary clinics
- telehealth if possible
- local service - GP if pissble
things to think about with all chronic conditions
- surveillance
- medications
- outpatient burden
- finances, social, home
- emergency planning
- supports
emergency planning
- CPR training
- emergency plan - update, review info/contacts, distribute appropriately
- ID bracelet
- AV cover
obesity management
RICE MF:
review - risk factors/cause/Cx e.g. steroids/diet/disease
Ix - TFT, BSL/OGTT, LFT
Collab - pt + family, realistic goals, lifestyle changes
(Educate)
Mx
A) lifestyle = simple 6
B) FBT
C) Rx - metformin
D) weight Mx clinic / DT / PT
simple 6 lifestyle changes
- eat together once/day
- water main drink
- B’fast every day
- less snacks
- 60 mins outside
- less screen time
Oral aversion Mx
RICE MF
Review - RF / reasons / Mx options tried, impact, candida
Ix if needed - swallow
Collab - family
Educate - early textures/range, fun, no pressure
Mx - A/H with SP, play therapist, IFM
F/u growth
Needle phobia Mx
RICE MF
Review/collab - reasons with fam/child, RF e.g. MHx
(Ix/educate)
Mx - play therapy, giving emla to put on at home, planning sedation/Ix, long line if really appropriate
Advanced care planning - how to go about it?
- not one off convo, rapport needed
- also may change over time
- parents wishes vs childs wishes
- priorities
aboriginal health Mx
- surveillance e.g. RHD, AOM, scabies
- imms - extra e.g. flu/hep A / pneumococcal
- finances - PBS
- Aboriginal health worker
Bone health Mx
RICE MF
Review - RFs e.g. meds/disease e.g. kidneys, severity e.g. #
Ix - vit D/CMP/ALP/TFT, DEXA for steroids
(collab/educate)
Mx - exercise/diet/sun, Vit D/Ca/PO4, bisphosphonates
Optimise # risk - falls assessment, home, vision
F - surveillance e.g. hip XR yearly
Adherence to medications
RICE MF
Review - reasons/barriers parents vs child views
(Ix)
Collab with child/parent
Educate - understand what happens with sudden cessation? understanding of disease
Mx
1) simplify - frequency, dosage, webster? pill pack?
2) reminders - alarm, next to skincare step, written reminders
3) address barriers - not at school, side effects, $
F/u - Sx, review
Constipation
RICE MF
Review - RF e.g. meds/diseases, diet, severity - urinary/pain, overflow motions causing embarassment, toilets at school
Exam - skin tags
Ix - TFT, coeliac, AXR, ?gastroparesis
Collab with family/educate - discuss current Mx, what they’re aiming for
Mx - stool chart/regular toileting, nappies for overflow, diet/movement/water, Rx
Action plan
Dev Delay
RICE MF
Review: RF, severity (ages/stages, PEDS), d/w school, disease
thorough exam
Ix e.g. disease / severity - Bayley / ID or adaptive e.g. Vineland/WISC, nutritional
Mx - “EARLY intervention will help maximise their potential”
1) ECIS!!! team - school, SP, OT
2) placement in school
3) $ - NDIS
4) MHx parents
5) optimise e.g. sleep/vision/hearing
