100% CORRECT VERIFIED AND DETAILED ANSWERS
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Tx of infectious Post-op fever - CorrectAnswer-#1 Supportive fluid therapy andAPAP #2
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fy Treat underlying source fy fy
#3 Gram stain and C & S all invasive lines or catheters as indicated.
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What is the best intervention for fever of unknown origin? - CorrectAnswer-Nothing until the
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fy diagnosis is confirmed. fy fy
Major syndromes causing fever - S/S of each and TX - Correct Answer-Serotonin
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fy syndrome - SSRI use, clonus, hyperreflexia, ataxia, mental status changes, restlessness,
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confusion, agitation, coma, seizure, diaphoresis, hyperthermia, mydriasis, labile bp
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- tx: dantrolene sodium, clonazepam for rigor, cooling blankets
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Malignant Hyperthermia - happens in the OR; after succinylcholine IV then fry brain to 104 F.
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fy IVF, pack them with ice then send to PACU with Dantrolene
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Neuroleptic Malignant Syndrome - associated with dopamine antagonists - bradykinesia,
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fy "lead-pipe" muscle rigidity fy fy
- on anti psychotic; IVF priority to flush toxins out, and this is true to every toxic
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Other rando causes of fever to consider - Correct Answer-Temporal arteritis - high ESR,
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fy normal WBC, fever as high as 104!!! - HA, scalp tenderness, visual complaints. - 15% of all
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fy cases of FUO in pts > 65 years fy fy fy fy fy fy fy
,Pt w/ vise-like, tight, generalized HA that is most intense in the neck or back of the head, w/
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no focal symptoms and that lasts for several hours. What is it / what do you do? - Correct
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Answer-Tension HA. No dx for this. Manage w/ OTC analgesics and relaxation.
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Female w/ unilateral episodic HA that is dull or throbbing, builds up gradually and lasts for
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fy several hours. Has some field defects, visual hallucinations such as stars, sparks, and
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zigzag lights,APHASIA, numbness, tingling, clumsiness and weakess, also n/v, and
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fy photophobia and phonophobia. What is it / what do you do? - Correct Answer-Classic
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fy Migraine (migraine with aura) (NOT COMMON MIGRAINE). This is r/t dilation and
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fy pulsation of branches of external carotid and follows the trigeminal nerve pathway.
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If new or different than previous HA's -- Head CT!!!
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,BMP, CBC, VDRL, ESR, and anything else indicated by hx and physical exam
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If Migraine confirmed, then....
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#1 avoid triggers
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#2 relax/manage stress
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#3 Prophylactic therapy isATTACKS > 2-3x PER MONTH (Elevil - monitor QT interval;
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fy Depakote, Inderal Tofranol, Catapres, Veramapil, Topamax, Neurontin, Methysergide, fy fy fy fy fy fy fy
fy Magnesium).
InACUTEATTACK: rest, takeASAright away (some relief), Sumitriptan 6mg SQ or 25mg
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fy PO at onset (STANDARD ABORTIVE TX), SQ may be repeated.
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Middle-aged male w/ unilateral, periorbital HA, no family hx of HA or migraine, but possible fy fy fy fy fy fy fy fy fy fy fy fy fy fy
fy ETOH use. Describes pain as "severe" and reports suicidal thoughts when the pain comes
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fy on. Also causes him nasal congestion, rhinorrhea, and eye redness. What is it / what do
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you do? - CorrectAnswer-Cluster HA. No diagnostics. Eye will be red, and he will have
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fy rhinorrhea.
PO meds ineffective. fy fy
Give 100% o2 (so about 12-15L on non-rebreather for about 15 min). Subq
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fy Sumitriptan 6mg fy
Inhalation Ergostat fy
Albumin level for protein malnutrition /Albumin level for edema? - CorrectAnswer-<
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3.5 / < 2.7 (will see falling out hair, ridged nails, muscle wasting, dry mucous membranes,
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, fy slow healing). fy
Nutritional considerations for the acutely ill: - CorrectAnswer-In times of physiological
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fy stress, pts caloric needs double from baseline d/t their hypercatabolic state
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Goal of nutritional therapy is to sustain pts existing weight, even if pt is obese
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Typical caloric requirement is to sustain existing weight is 30-35kcal/kg or body weight
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fy daily, so hospital patients will require 60-70 kcal/kg daily
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Pt getting feedings with duo tube, ND tube, NG tube, or PEG what should you watch out for?
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fy - Correct Answer-Complications of Enteral nutrition support related to the solution.
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-aspiration
-diarrhea
-emesis
-GI bleeding (didn't know that, d/t PEG?)
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-mechanical obstruction of tube fy fy fy
-hypernatremia (know this!!) fy fy
-dehydration (know this!!) fy fy