Pain/Fever/Nutrition In Adults

Question 1

Acute vs chronic pain

Answer 1

Chronic is greater than 6 months

Question 2

What medications can be given for post operative patients

Answer 2

Start with non optiates with adjuvant therapy can add opiate after that as a prn

Question 3

What should be given for breakthrough pain in cancer patients

Answer 3

Fentanyl patch

Question 4

What can be given for bone pain in cancer patients

Answer 4

Oral bisphosphonates

Question 5

What is a major complication of pressure ulcers

Answer 5

Osteo and sepsis

Question 6

Causes of fevers

Answer 6

Infections, serotonin syndrome, precedex, PE, MI, succinylcholine, procanimide, ABX

Question 7

What indicates a non-infectious fever in post op

Answer 7

Insidious onset, refractory to Tylenol, typically correlated to atelectasis, give IVF first

Question 8

What is the absolute contraindication to succinylcholine

Answer 8

Hyperkalemia

Question 9

Malignant hyperthermia treatment

Answer 9

Dantrolene, O2

Question 10

Normal albumin

Answer 10

3.5-5

Question 11

What albumin level does edema typically occur

Answer 11

<2.7

Question 12

When to consider a peg

Answer 12

Nutritional support >6 weeks

Question 13

What are the signs of refeeding syndrome

Answer 13

Hypophosphatemia, hypokalemia, hypocalcemia, hypomagnesemia

Question 14

Complications of TPN

Answer 14

Pneumothorax, air embolus, sepsis, hyperglycemia, hypertriglyceridemia, HHNK

Question 15

Describe the WHO 3 step ladder approach to pain management

Answer 15

Step one (Mild): ASA, acetominophen, NSAIDs, or Adjuvant. Step Two(Mod): Codeine, Hydrocoodone, oxycodone, tramadol, adjuvants. Step 3 (severe): Morphine, Hydromorphone, methadone, fentanyl, adjuvants

Question 16

What is a reliable factor in determining the development of pressure ulcers

Answer 16

Hypoalbuminemia

Question 17

What is neuroleptic malignant syndrome caused by

Answer 17

Increase in antipsychotics.

Question 18

How can you determine if a fever is drug induced

Answer 18

Minimally effected by Tylenol

Question 19

Normal WBC count

Answer 19

5-10k

Question 20

A patient with a WBC >30K is indicative of what

Answer 20

Non-infectious causes

Question 21

What is the initial treatment in a post op fever

Answer 21

Hydration and lung expansion

Question 22

Calorie calculation for the normal adult

Answer 22

25-30 kcal/kg/day

Question 23

How to position a patient if you suspect and air embolus?

Answer 23

Left lateral decubitus

Question 24

S/s of compartment syndrome, diagnostics, and treatment

Answer 24

S/s: Severe ischemic pain, tense swelling, parasthesias,
Diagnostics: Stryker tonometer intracompartmental pressure >30. Delta pressure <30.
Tx: fasciotomy

Question 25

Normal compartment pressure

Answer 25

0-8 mmhg

Question 26

What is the compartment delta pressure

Answer 26

Difference between the diastolic blood pressure and compartment pressure. DBP-ICP
<30 indicates need for fasciotomy

Question 27

What kind of pain is a used by a mastectomy incision

Answer 27

Neuropathic

Question 28

Outpatient cellulitis is most often caused by

Answer 28

Strep pyogenese