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CDM II Fall Block > Hospital Med > Flashcards

Hospital Med Flashcards

1
Q

What are the hospitalist procedures?

A

Central lines
Intubation
Paracentesis
Thoracentesis
Lumbar puncture
Ultrasonography
Arthrocentesis- depending on the hospital. Ortho or rheum also involved

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2
Q

What are basics of hospital medicine?

A

Admitting patients
Rounding on admitted pts
Discharing

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3
Q

what should you get when admitting patients

A
  • How does the patient get to the hospital: Ambulance, direct clinic admissions, urgent care, direct hospital admissions
  • Admission orders –> “ADC Vandalism”
  • H&P Note
  • Hand Off
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4
Q

what should you get when rounding pt

A
  • Daily vitals, labs, imaging, and consultants
  • Progress note
  • Hand off
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5
Q

What should you do when discharging pt

A
  • Discharge summary
  • Discharge order
  • Discharge Instructions- including follow up
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6
Q

Admit to floor vs ICU?

A

Ventilator, BiPAP
Central line, pressors, drips
Nursing needs
Risk of decomp

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7
Q

Hyperglycemia (>400) without anion gap, ICU or floor?

A

Floor

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8
Q

DKA but pH > 7.2 and resolving anion gap, floor or ICU?

A

PCU

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9
Q

DKA with multi-organ dysfunction, pH < 7.2, ICU or floor?

A

ICU

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10
Q

If pt needs lab draw earlier than every 2h, where do they go?

A

ICU

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11
Q

What are the vitals for floor?

A

Stable hemodynamics (HR 50-130, SBP 85-200, RR 10-30)

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12
Q

What are the vitals for ICU?

A

Hemodynamically unstable; hypertensive emergency; IV antihypertensives

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13
Q

for renal failure, they are Chronic hemodialysis/ non-emergent

A

floor

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14
Q

Renal failure, Emergent dialysis, CRRT, K > 6.0 with EKG changes, any K > 7.0

A

ICU

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15
Q

Resp, Chronic stable NPPV overnight (CPAP for OSA)
floor or ICU?

A

Floor

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16
Q

NIPPV (BiPAP, CPAP); intubated; impending respiratory failure; threatened airway. ICU or floor?

A

ICU

17
Q

Whats the impt or obs rule?

A
  • Two-midnight rule
  • “Complex medical judgment”
  • “Generally, a patient is considered an inpatient … with the expectation that he or she will require hospital care that is expected to span at least two midnights”
  • “However, the decision to admit a patient is a complex medical judgment which can be made only after the physician has considered a number of factors
18
Q

whats important to get during admit?

A

code status

19
Q

What should you do during discussion for code status

A
  • Normal statement
  • Education/explanation
  • Further steps if pt interested
  • Most have forms
20
Q

What happens during the hospital stay

A
  • Daily (at least) re-evaluation of patients
  • Adjustment of treatment plan
  • Communication with consultants
  • Discharge planning / longer-term plan
21
Q

whats do case managers do?

A

Arranging logistics/finances of:
- Home health
- Outpatient IV antibiotics
- Wound vacs, durable medical equipment
- Transfer to outside hospital
- SNF or LTAC referrals/placement

22
Q

What do social workers do?

A
  • Homelessness
  • Uninsured
  • Undocumented
  • Substance abuse
  • Adjustment to illness counseling
  • Complex social issues Legal issues/guardianship
  • Utilization Management
  • Medical necessity review
  • Inpatient vs. OBS
23
Q

Team based - OT

A

Occupational Therapist
- Assess/improve ADLs, mobility
- Cognitive screens, MOCA
- “Just because you’re walking around doesn’t mean you’re safe to go home”

24
Q

Team based - Resp therapist

A

Respiratory Therapist
- Ventilator and NIPPV management
- Home oxygen evaluations
- Nebulizers, chest PT
- OSA screens
- Sometimes intubate (hospital-dependent)

25
Q

Team based - RN

A

RN
- Patient assessment
- Medication administration
- Care coordination
- Front line for patient/family interaction
- Discharge logistics and education

26
Q

Team based care - Pharmacy

A
  • confirm of all inpt order
  • Clarify orders with providers
  • Prep meds
  • RRT/MET/code involvement
27
Q

Team based care - Consults

A

-

28
Q

What are the discharge detail include?

A

Discharge summary
Follow up scheduled
Discharge Order
Coordinating DC meds

CDM II Fall Block (9 decks)

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