It is Shocking
name the stages of shock
refractory- irreversible despite ongoing treatment
AML
signs and symptoms
fever and bleeding
HIV
-treatment (and purpose)
-education
-HIV vs AIDS symptoms
ART therapy- suppress viral load /monitor CD4-T level for infection risks
Use condoms
HIV- flu like symptoms then usually more aggressive fungal or bacterial infections
AIDS- Kaposi sarcoma, cachexia,
IgE allergy response
immediate wheezing and itching
Treatment of back pain-
what is the priority treatment?
Physical Therapy
other modalities are helpful, but not ultimately best treatment to resolve back pain
How to treat
Septic Shock
Hypovolemic shock
Cardiogenic shock - watch for which s/s
Neurogenic shock- s/s?
septic- IV, labs, cultures, antibiotics (Oral or IV antibiotics?)
Hypovolemic- treat reason- IV access and replacement
Cardiogenic- monitor cardiac levels and CP symptoms
Neurogenic shock- bradycardia and dry skin
What is gout
treatment
uric acid build up typically erythema in big toe
treatment- acute is NSAID or colchicine, long term treatment is allopurinol
list anemia and tx
pernicious
sickle cell anemia
pernicious- B12 lifelong replacement (no intrisic factor)
sickled RBC- fluid, pain control
what is the priority assessment in an acute burn?
urinary output
RA VS OA
RA OA
joint pain relieved with exercise joint pain with exercise
symmetrical joint inflammation asymmetrical involvement
erythema nodes
A patient comes in to the ED and barely able to speak due to stridor. Her friend is yelling saying she cant breathe even though they gave her the epi injection. She has periorbital edema, BP 100/50, P 110, R 30, sat 90% RA.
What is your priority treatment?
Epinephrine -
expected vs concerning side effects of epi
Does cancer suck?
yes
no wrong answer
A patient came into the ED after his vape pen exploded and he got a severe burn over 50 percent of his lower body. He weighs 154 lbs. Aggressive fluid replacement is ordered at 2 mL x kg x %TBSA over 24 hours. Half of the total during first 8 hours. The remaining half is given over the next 16 hours. what rate per hour should the IV be set first 8 hours?
70 kg adult with a 50 % TBSA burn, the total fluid needed is 2 x 70 x 50=7000 mL in 24 hours. The first 8-hour requirement would be 3500 mL. 3500 divided by 8 hours = 437.5ml/hr or 438hr for 8 hours
Osteoporosis
how to dx
definition
education to reduce risks
DEXA
decreased bone density
quit smoking, calcium/D intake, weight baring exercise
What is your favorite Christmas cookie?
ALL
steps if allergic reaction
blood type and blood compatability
STOP INFUSION if allergic reaction noted
compatibitily- blood type AB can get A or B blood
What is the preferred fluid replacement choice for IV replacement with burns?
LR
Total hip arthroplasty education
pillow between legs during sleep
raised toilet seat
do not cross legs
DIC vs HIT
signs and symptoms
DIC- spontaneous bleeding
HIT- drop of platelets
Are you ready for the final?
yes
patient has a cast on arm, what education will you give?
watch for tingling in fingers/ distal
check pulse
do not rub fingers