Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CDM 1 > Patient Assessment > Flashcards

Patient Assessment Flashcards

1
Q

4 roles of a pharmacist

A

Procurement of the medication
Dispensing of the medication
Patient Education
Monitoring for effectiveness and safety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Social determinants of heath

A

are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Some examples of social determinants of health

A

Economic stability, Neighborhood and Physical Environment, Education, Food, community and social context, health care system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Health outcomes

A

Mortality, morbidity, life expectancy, health care expenditures, health status, functional limitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Prejudice

A

A preconceived opinion that is not based on reason or actual experience

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bigotry

A

Intolerance toward those who hold different opinions or are different from oneself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Discrimination

A

The unjust or prejudicial treatment of different categories of people or things, especially on the grounds of race, age, or sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Racism

A

Prejudice, discrimination, or antagonism directed against a person or people on the basis of their membership of a particular racial or ethnic group, typically one that is a minority or marginalized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Implicit bias

A

Implicit bias refers to the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What equations are available for creatinine clearance calculations?

A

Cockcroft-gault, Jellife, Schwartz, Salazar Corcoran

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Calculating GFR

A

MDRD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MDRD Formula

A

eGRF –> 175 x (Scr)^-1.154 x (age)^-0.203 x 0.742 [female] x 1.212 [black]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Effects of implicit bias

A

Interpersonal interactions

  • diagnoses
  • pain management

Internal Dynamics

  • communication
  • collaboration
  • performance reviews
  • compensation/promotion

Cost/waste
-$310 billion per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Caring for patients with minoritized ethnicities

A

Keep an open mind

if you don’t know, ASK

Look beyond race as a risk factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does a pharmacist add value

A

Medication experts

Preventing errors

Easily accessible for patients and others

Diagnose in certain situations

Immunizations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Goals of providing pharmacy service

A

Cure a disease
Eliminate or reduce symptoms/side effects
Stop/slow progression of a disease
Prevent a disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Providing pharmacy service involves 3 major functions

A

Identifying potential and actual problems

Resolving actual problems

preventing potential problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pharmacist services that add value

A 
Medication reconciliation
Medication Therapy Management (MTM)
Comprehensive Medication Management (CMM)
Transition of Care
Chronic disease state management
Renal dosing
Antibiotic stewardship
Medication assessment
Drug information
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Transition of Care

A

The situation where a patient leaves the care of a particular unit or health care facility and moves to another facility or setting, including to his or her own home.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Poorly coordinated transitions of care are caused by

A

Medication Discrepancies
Readmissions
Adverse Events
Higher costs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

medical Reconciliation

A

The process of comparing a patient’s medication orders to all of the medications that the patient has been taking…to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions.

Step 1: review patient chart/profile
Step 2: contact outpatient pharmacy/mail order/SNF/ provider office
Step 3: Interview Patient
Step 4: Communicate to others (verbal/written)

22
Q

Medical Adherence

A

The extent to which a patient takes medications as prescribed/directed

23
Q

Health Literacy

A

degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

24
Q

JCPP Pharmacist Patient Care Process

A 
Collect 
Assess
Plan
Implement
Follow up: Monitor and Evaluate
25
Q

Collect

A 
Medical terms/abbreviations
Medical history
Medication reconciliation
Lab results
Patient lifestyle habits/preferences/beliefs 
Socioeconomic factors
26
Q

Assess

A 
Clinical Data Interpretation
Risk factors
Patient specific outcomes
Cultural factors
Health literacy
Access to medications
Preventative Health
Identify problems
Develop prioritized problem list
27
Q

Plan

A

Address problems and make recommendations to optimize therapy practicing evidence based medicine
Identify goals of therapy to achieve clinical outcomes

28
Q

Implement

A

Communicate/Document plan with others
Initiate, modify, DC med therapy
Pt education and self-management training
Preventive care strategies

29
Q

Follow up

A

Monitor Clinical endpoints
Monitor outcomes of care/care goals
Re-evaluate at each encounter

30
Q

Quest Scholar-Mac

A

Quickly and accurately assess the patient
Ask about current complaint (SCHOLAR)
Symptoms: What are the main & associated symptoms?
Characteristics: What are the symptoms like?
History: What has been done so far? Has this happened in the past?
Onset: When did it start?
Location: Where is the problem?
Aggravating factor: What makes it worse?
Remitting factors: What makes it better?
Other Medications and products?
Allergies?
Coexisting conditions?

Establish that the patient is an appropriate candidate for therapy (particularly OTC)
No severe symptoms
No symptoms that persist or return repeatedly without an identifiable cause
No self-treating to avoid medical care

Suggest appropriate therapy strategies
Medication (OTC and/or Rx)
General care measures (non-drug)

31
Q

SOAP

A

Subjective:
Related to the identified problem and associated symptoms as described by the patients themselves (or caregivers)
Descriptive information that the patient provides or that describes how the patient appears and acts.
Cannot be reliably reproduced

Objective:
Observations made and information acquired by a healthcare practitioner determined to be relevant to the identified problem(s)
Results of tests, procedures, and assessments that can be repeated by other health care professionals under similar circumstances to obtain the same information (vital signs, labs, most of the PE, etc…)

Assessment:
Practitioners clinical opinion or judgment about the problem(s) based on S/O data, as well as practitioner’s previous experiences
Look for actual or potential problems
Include rationale for therapy recommendation(s)

Plan:
Course of action deemed appropriate for each problem given the data available
Concise
Do NOT include rationale for recommendation

32
Q

JCPP: Step 1: Collect

A

Collect and organize necessary subjective and objective information in order to understand the relevant medical/ medication history and clinical status of the patient

33
Q

3 Main data sources

A

Patient
Community Pharmacy records
Medical Record

34
Q

JCPP: Step 2: Assess

A

The pharmacist assesses information collected and analyzes clinical effects of pt’s therapy in context of overall health goals to identify and prioritize problems and achieve optimal care.

35
Q

What is a “problem”

A
  1. Every patient’s disease state
    - -> Could be controlled or not
  2. Preventative Health
    - -> Immunizations, screenings etc…
  3. Drug Related Problems (DRPs)
36
Q

Developing a problem list

A

Once clinical data is gathered, a prioritized problem list is developed
A problem is defined as a patient concern, a health professional concern or both
Problems may be diseases, patient complaints, abnormal laboratory values, social concerns, financial concerns, or drug related problems
Multiple approaches to identify/reconcile problems:
Patient Assessment Concept Map
QuEST SCHOLAR-MAC

37
Q

Medication Errors

A

any mistake at any stage of the medication use process

38
Q

Adverse Drug Events

A

result of an injury to a drug-related intervention, regardless of whether an error has occurred

39
Q

Medication Errors vs Adverse drug Events

A

All MEs can be prevented
ADEs: preventable, non-preventable or potential
MEs: result from any step of medication0use process

40
Q

Drug Related Problems

A

event or circumstance involving a pt’s drug treatment that actually, or potentially interferes with achievement of optimal outcome

41
Q

Why do DRPs happen

A

Systems problems
Clinical inertia:
–> Chronic diseases, many asymptomatic (e.g. diabetes, hypertension, osteoporosis)
–> “recognition of a problem, but failure to act”
Lack of Professional training/experience
Work environment
–> # interruptions, etc…
–> Staffing issues
Poor communication among health care workers

42
Q

Potential DRP situations

A 
Any new drug therapy
Same drug, altered dose
Pt required to split tablet
Irregular administration schedule
e.g. qwk, TIW, qmonth
Multiple prescribers
Multiple pharmacies
Use of herbal products, dietary supplements or vitamins
43
Q

Consequences of DRPs

A 
Revisit with MD
Additional drug treatment to combat DRP
Urgent care visit
ER visit
Hospital admission
Long term care facility/rehab admission
Death
Pt no longer accesses health care system
44
Q

Detecting DRP

A

Key information necessary to detect DRPs:
Chief complaint
Patient PMH
Current medications
Medications prior to admission
Renal function (Clcr)
Hepatic function
Monitoring parameters necessary to determine is patient is optimally treated
e.g. BP if pt has HTN, A1C if DM, lipid panel with hyperlipidemia, INR if on warfarin, other drug levels

45
Q

Resolving DRPs

A

Alternatives and assessment:
Assess all reasonable drug and non-drug therapy which could benefit this pt and resolve the DRP
Weigh the pros and cons of each option
Evidence based medicine
Pt factors (adherence, side effects, cost, etc…)
What monitoring parameters will need to be addressed?
Indicate the best therapy option

46
Q

Patient care process step 3: plan

A

The pharmacist develops an individualized patient-centered
care plan, in collaboration with other health care professionals
and the patient or caregiver that is evidence-based and cost-
effective.

47
Q

Plan should include

A
  1. recommended therapy
  2. drug/food to avoid
  3. further tests and follow-up
  4. goals
  5. therapeutic monitoring parameters
  6. toxic monitoring parameters
  7. patient education
48
Q

Patient Care Process Step 4: Implement

A

The pharmacist implements care plan in collaboration with other
health care professionals and pt or caregiver

49
Q

PATIENT CARE PROCESS STEP 5: FOLLOW-UP: MONITOR AND EVALUATE

A

The pharmacist monitors and evaluates the effectiveness of the
care plan and modifies the plan in collaboration with other health
care professionals and the patient or caregiver as needed.

50
Q

therapeutic monitoring parameters

A

S/sx for progression/resolution of disease state
Tests to monitor disease progression/resolution (and frequency)
Establish endpoints for therapy (when should you discontinue or
change therapy)
Appropriate therapeutic serum drug concentrations
Appropriate alterations in lab values (eg, INR w/ warfarin)

51
Q

Toxic monitoring parameters

A

Adverse events of medications and how you would monitor them (eg,

nephrotoxicity = BUN, Scr)

Potential Drug-Drug interactions

Plan to deal with commonly encountered side effects that require therapy

CDM 1 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions