Planning Management Flashcards
What does HONK stand for?
Hyperglycaemia (usually >35mmol/L)
HO (hyperosmolar: osmolality over 340mmol/L (calculated by (x2 Na + x2 K) + urea + glucose)
NK (nonketotic, i.e. no ketones in blood or urine).
HONK management is the same as DKA management (see Fig.
4.11), except half the rate of fluids is required
Treatment of hypoglycaemia
If the patient is able to eat then give a sugar-rich snack, e.g. orange juice and biscuits.
However, if unable to eat (i.e. drowsy/vomiting)
give IV glucose via a cannula, e.g. 100mL 20% glucose
If unable to eat and no cannula give IM glucagon 1mg
Oxygen management of COPD patients who are not critically unwell
Prior to availability of blood gases, use a 28% Venturi mask at 4 l/min and aim for an oxygen saturation of 88-92% for patients with risk factors for hypercapnia but no prior history of respiratory acidosis
adjust target range to 94-98% if the pCO2 is normal
Contraindication of arachis oil?
Nut allergy
Contraindication of ispaghula husk? (bulking agent)
Faecal impaction
Colonic atony
Contraindication of bisacodyl?
Acute abdomen
Contraindication of phosphate enema?
Acute abdomen
Contraindication for all laxatives
Bowel obstruction
When should systemic steroids be tapered?
received more than 40mg prednisolone daily for more than one week
received more than 3 weeks treatment
recently received repeated courses