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Flashcards in final gerit Deck (36):
1

risk factors for hep C

IVDU
Hemophiliacs who received clotting factors before 1987
Received blood/organs before 1992
Hemodialysis
Medical workers who had needle Sticks

2

sxs of hep c

MC symptom = asymptomatic
Nausea, vomiting
Fever, fatigue
Dark urine
Jaundice Fever
Pruritus

3

sxs of CHRONIC hep c

Arthritis
Itching
Numbness
Leads to Hepatocellular carcinoma

4

what diarrhea is characteristic of C diff

3 watery bowel movements daily for 2 or
more days

5

other than diarrhea what sxs do we see associated with C Diff

Fever, nausea, abdominal pain

6

what are the three complciations associated with C diff

■ Colitis
■ Sepsis
■ Death

7

High risk patients for C. diff

hospitilized
Nursing Homes
Assisted Living
RCFE (residential care for elderly)
Community Care Facilities
Less so in prisons
The Elderly
The Ill
Immunocompromised → HIV, Chemo, Chronic steroid use, COPD...etc.

8

Recent ABX use puts you at risk for c.diff, especially if you've recently been on

{the drugs that treat oral, tooth UTI and PNA}

Ampicillin
amoxicillin
Cephalosporin (e.g. Keflex)
Fluoroquinolones (eg Levaquin)

9

sepsis criteria

T >39.4 degrees C (102.9 F), RR>30, P>120
WBC>11
Shaking chills, DM, Major comorbidities, AMS, abd pain, and vomiting

10

MEDS associated with UI

ETOH
Adrenergic antagonists
Antidepressants
Antipsych
CCB
Loop
Narcotics
NSAIDS
Sedative
Thiazolidinediones

11

Neurological

Stroke
Parkinson’s
Normal pressure hydrocephalus
Dementia
Depression

12

detrusor activity can be

age related
idiopathic
secondary to a lesion
due to local irritation
stress related

13

causes of urge UI

interstitial cystitis
spinal cord injury --> impaired detrusor compliance

14

this type of incontinence occurs with increased intra abdominal pressure

stress

15

most common type of UI in older women

Urge and then stress

16

most common types of UI in older men

urge and then outlet obstruction

17

ULS definition of urge/stress UI

 Residual volume: >50 urge/stress.

18

ULS definition of urinary retention

  >250 outlet obstruction ton or detrusor inactivity

19

overflow incontinence is the result of

detrusor under-activity bladder outlet obstruction or both

20

stress UI is due to

impaired pelvic supports
failure of urethral closer

21

which type of incontinence results from trauma

failure of urehtral closure or stress incontinence is due to trauma

can also see outlet obstruction in women who;'ve had surgery for UI

22

peripheral neuropathy can cause what type of incontinence

detrusor underactivity or overflow

23

Frailty for FTTT
what are they and how many do you need

Wt loss
Exhaustion
Weakness
Slow Walking
↓ Physical Activity

(3 out of 5)

24

FTT Neuro

Parkinson, Stroke, MS, ALS

25

Medications:

Psychotropics, Anticholinergics, Antidepressants

26

Physical

Chronic heart dz, lung dz, dysphagia, GI and CA

27

detrusor muscle

Contracts via parasympathetic nerves (S2–S4)

28

storage of urine is under control of

SNS

29

when to cath

Short-term decompression of acute urinary retention
Chronic retention not manageable surgically/medically
Patients with wounds that must be kept clean of urine
Very ill patients who cannot tolerate garment changes
Patients who request catheterization despite informed consent regarding risks

30

risk factors for catheter blockage

alkaline urine

femal gender

poor mobility

calciuria

proteinuria

copious mucin
proteus colonization

preexistant bladder stone

31

CHF criteria for hospice

Class IV failure, EF <20%
2-3 admits to acute care in a year

32

COPD criteria for hospice

O2 dependent(<88% r/a)
poor response to bronchodilators
resting pcO2>50
PO2<55 on oxygen, cor pulmonale
wt loss HR>100

33

Renal Failure criteria for hospice

Cr >8.0, off dialysis

34

Cirrhosis/liver failure criteria for hospice

bed bound, albumin <2.5,
INR >2.5 + (encephalopathy, SBP - spontaneous bacterial peritoniti
refractory ascites
recurrent variceal bleed
hepatorenal syndrome)

35

CHF criteria for hospice

Class IV failure, EF <20%, 2-3 admits to acute care in a year

36

phrase that refers to the changes in health status over time as the patient nears death

Trajectory of death