Altered Mental Status
Associated with factors such as fever, infection, dehydration, electrolyte disturbances, hypoglycemia, hypoxemia. Return to neuro status baseline with treatment of underlying cause
metabolic encephalopathy
Hx of ischemic heart disease; EF 30%; home meds: Coreg, Lasix; has been sleeping in his chair last 5 days due to coughing, shortness of breath, and feet swelling
Acute on Chronic Systolic Heart Failure
After study, providers should always link a definitive diagnosis to the presenting symptoms to support the POA indicator of Yes
True
Symptoms that align with myocardial ischemia resulting from CAD; provisional diagnosis until further evaluation allows for more specific identification, such as NSTEMI, unstable angina, or other cardiac or non-cardiac causes.
Acute Coronary Syndrome
Type of A-fib where on-going management is focused solely on rate control without further attempts at rhythm control, as determined by agreement between patient and clinician (CC).
Permanent
Agitation, anxiety, and confusion that appear in individuals with dementia, typically during the late afternoon or evening. Return to neuro status baseline next morning.
Sundowning
Hx of drug and alcohol abuse, found down at home; CXR RLL infiltrate; started on IV Zosyn.
aspiration pneumonia
Reporting options that distinguish pre-existing comorbidities from hospital acquired conditions.
What are present on admission indicators
Due to CAD, generally identified by characteristic EKG findings. Treatment: immediate reperfusion therapy such as coronary stenting (PCI) or fibrinolysis, CABG, antithrombotic, or heparin-like medications, beta-blockers, and ACE inhibitors.
Type 1 STEMI
Type of A-fib where episodes are intermittent and resolve either spontaneously or with intervention within 7 days of onset (Non-CC).
Paroxsysmal
Caused by high blood ammonia in advanced liver disease leading to mental and neurological impairment. Treated with Lactulose.
hepatic encephalopathy
Abnormally irregular heart rate with no cardiac output; CPR and defibrillation in ER.
Vfib
This indicates the provider cannot clinically determine whether a condition was present on admission. Payment is made for HAC diagnoses.
W or clinically undetermined
Due to CAD, indicated by elevated troponins. May present with mild symptoms or limited evidence of acute myocardial ischemia when compared to STEMI. Treatment includes NTG, ASA, B-blockers, ACE inhibitors, heparin-like drugs, and antithrombotic agents
Type 1 NSTEMI
Type of A-fib that remains uninterrupted for more than 12 months (CC).
Long-Standing Persistent
Occurs as part of severe sepsis and represents a specific form of metabolic encephalopathy.
Septic encephalopathy
Hx Pulmonary Fibrosis; continuous home O2 at 2l/min; PaO2 54 on room air.
Chronic Hypoxic Respiratory Failure
FREE
FREE
Elevated troponins not due to CAD, occurs primarily due to an imbalance between oxygen supply and demand. Some causes: severe anemia, Afib, sepsis, heart failure, and sustained tachyarrhythmias. Treatment directed at underlying cause.
Type 2 MI
Type of A-fib that is continuous and does not terminate within 7 days despite efforts to restore sinus rhythm, including electrical cardioversion or pharmacologic therapy (CC).
Persistent
State of altered consciousness that varies from reduced responsiveness (obtundation) to unconsciousness with limited responsiveness, up to complete unresponsiveness
Coma
Hx acute heart failure, AFib; troponin elevated; no s/s acute MI; cardioversion and eventually taken to cath lab for ablation.
Non-Ischemic Myocardial Injury
This indicator means documentation is insufficient to determine whether a condition was/was not present on admission and should only be used in limited circumstances. Payment is not made for HAC diagnoses.
U or unknown
FREE
FREE
A-fib of any type that has persisted for more than three months (CC).
Chronic