unit 3: the DM office visit Flashcards
frequency of HGB A1C
at least every six months for those reaching goals… more for those not reaching goals
AKA AT LEAST TWICE A YEAR
frequency of fundoscopic eye exam
EVERY office visit
*document last yearly dilated eye exam in ROS
frequency of foot exam
EVERY visit inspect and assess sensation w monofilament or turning fork
*comprehensive exam ANNUALLY
frequency of lipid levels
at least yearly, more if not at goal
*document latest in soap note
frequency of avg FBG
EVERY visit under objective findings
frequency of DM education?
assess every visit. are they attending sessions? how long ago was last session?
physical exam includes:
- compliance w meds
- exercise habits
- s/s depression
- social support
- eye exam
- oral cavity exam (doc last dental under ROS)
- heart
- carotid bruits
- lungs
- abd
- extremities
- peripheral vascular system
- foot exam
MI techniques
what stage of readiness is this pt at? how can you help them move forward?
frequency of urine albumin/creatinine ratio
YEARLY, document last one or order another if needed
assess smoking status
document and encourage cessation
assess what in women?
birth control use, esp if on ACE-Inhibs (why?) BP?
assess what in men?
erectile dysfunction & treat as appropriate
health promotion topics?
mammography, colonoscopy per age recc’s
immunization reccs?
pneumococcal per ADA guidelines
nemonic for office visit:
GLUCOSE BAD
- G = glycemic control
- L = lipids, know guidelines for ordering a statin
- U = urine screen for microalbuminuria
- C = cigarettes, smoking cessation
- O = opthalmologic exam
- S = sex, birth control & ED
- E = extremities, feet
- B = BP, goal <140/90, order an ACE-Inhib
- A = asa therapy, use as secondary prevention for CVD
- D = dental, recc q6m visits
