Week 12 Flashcards
which patients are clinically determined higher risk for CVD?
diabetes >60y/o diabetes with microalbulineamia ABTSI >74 CKD previous dx of familial hypercholesteraemia serum cholesterol >7.5 SBP >180 DBP> 110
what are the lifestyle modifications given to low risk CVD patients?
at least 30 min of moderate exercise most days
smoking cessation
reduce was it circumference to 94 for men and 80 cm for women
BMI less than 25kg/m2
<4g/day of salt
no more than 2 SD/day of alcohol
what is the aim for lipid therapy?
total cholesterol <4 HDL >1 LDL <2 TG <2 nonHLD chol <2.5
high risk: lipid lowering recipients?
CHD or peripheral vascular disease which has become symptomatic
DM
family hx of CHD which has become symptomatic by the age of 55 in 2+ 1st degree relatives OR by the age of 45 in 1+ 1st degree relatives
5 palliative care principles?
focus on QOL whole person approach care encopasses dying per and those that matter to them patient autonomy and chouce open and sensitive community
4 common medications used in palliative carE?
nausea
pain
agitation
resp secretions
some points about palliative care?
provide relief from pain
not to prolong life
provide support for the patient and the family
incorporate spiritual and psychological aspects into care
team approach to address the needs of the patient and family
enhance QOL
application early in the course of illness
ARP?
acute resuscitation plan
- queensland health document for hospital
provides consistent documentation of clinical recommendations to withhold/ withdraw life sustaining measures, CPR and assisted ventilation
not a legal document but aims to guide clinicians if patient were to lose mental capacity
AHD?
advanced health directive
- clunk legal document
document that states your wishes and directions regarding your future health care for various medical conditions
may wish to happy AHD when you are unable to decide for yourself or you may want to only apply it when you are terminally ill
enduring power of attorney?
for welfare and finances
act on someones behalf regarding legal and financial matters
state of choice document?
value based document that records a patients wishes/ choices for their health care into the future
not a legal document but promotes EOL care discussion
consent order of priority?
patient has mental capacity and directs care
valid AHD
guardian appointed by tribunal
attorney appointed under most enduring document
statuary health directive
adult guardian
informed consent?
competence and capacity
voluntariness
disclosure of info
understanding and accepting info
what patients need in palliative care?
mental capacity advanced care planning will ARP EPoA AHD
6 steps in verification of death?
no breath sounds 2 min no breathing effort/ breath felt no carotid pulse ho heart sound 2 min fixed dilated pupils no respones to noxious stimuli re-check patient identification
FLIP?
identify the problem analyze the problem design solutions plan your program evaluate
evaluation in flip?
SMART- specific, measurable, achievable, relevant, timely
outcome evaluation - did you achieve your goals
impact evaluation - did you active your objective
process evaluation - did your strategies work?
type of genetic mutation in PID?
recessive mutations of single genes
many are subclinical
what is the most common PID?
selective IgA deficiency
what is the most common clinical manifestation in IgA deficiency?
autoimmune diseases
examples of some encapsulated extracellular bacteria
these are the most virulent Escherichia coli (in some strains) Neisseria meningitidis. Haemophilus influenzae. streptococcus pneumonia
what kind of pathogen is mycobacterium TB?
intracellular
what immune deficiencies results in mycobacterium?
(IC bacteria)
T cell def
NKC def
IL12