May 26th 2021 Flashcards
69M insomnia, retired pilot 4ya, uses promethazine PRN, bed at 21:30, up at 0700, takes 2 hours to sleep due to restless legs, denies snoring, 8ya, gambling, non-smoker, vegan, cycles. 4 hx about legs
- how long has the leg discomfort been happening?
- feelings of restlessness?
- any numbness/tingling
- weakness in legs?
acronym for restless legs?
f,e,c,b,j
URGE urge to move legs rest induces symptoms gets better with activity evening and night-time worsening
69M insomnia, retired pilot 4ya, uses promethazine PRN, bed at 21:30, up at 0700, takes 2 hours to sleep due to restless legs, denies snoring, 8ya, gambling, non-smoker, vegan, cycles. 4 non-pharm strategies
- mental distraction, crosswords
- regular stretching before sleep
- warm bath during symptoms
- keep legs cooler than body for sleep
- avoid sleep deprivation
- cease promethazine
- reduce alcohol
69M insomnia, retired pilot 4ya, uses promethazine PRN, bed at 21:30, up at 0700, takes 2 hours to sleep due to restless legs, denies snoring, 8ya, gambling, non-smoker, vegan, cycles. 1 single pharma
- gabapentin 100mg, PO, nocte
- pregabalin 75mg, PO, nocte
16F with mum, mum insisting on depot, 5 factors why parents attend child’s appointment
- adolescent nervous, want parents to talk
- overprotective
- parents believes they are minor, legally need to
- parents not aware of doctor’s legal, moral, ethical duty to confidentiality
- parents may not have established trust with doctor
- adolescent may require assistance
16F with mum, mum insisting on depot, 3 factors why must see on own
- information may not be accurate if mum is present
- may not be able to assess Gillick competency
- need to ensure she is not being coerced in anyway
- promote access to healthcare
- reinforce autonomy
16F with mum, mum insisting on depot, 3 actions
- do not prescribe depot, no consent from Carlotta
- print out contraception to give to Carlotta
- give information to mum and adolescent re: right to confidential consultation
