Test 27 Flashcards
Atelectasis
Postoperative atelectasis is common 2-5 days following thoracoabdominal surgery and typically presents with hypoxemia or respiratory difficulty. Patients without respiratory secretions can be managed with continuous positive airway pressure, whereas those with secretions are best managed with aggressive pulmonary hygiene, include chest physiotherapy and suctioning.
Hazard ratio
The null value for HR is 1.
Diabetes mellitus
The thiazolidinedione medications can result in fluid retention via PPAR-gamma agonist effects on the renal collecting tubule resulting in sodium reabsorption. This effect is usually seen in patients with underlying heart failure.
Delirium
Delirium can be the only finding of an acute medical condition in older demented individuals. Use of psychotropic medications as a first line therapy for behavioral problems is not recommended.
Focused history, PE and basic laboratory work-up should be performed early in the initial evaluation of delirium in any patient.
Psychical and chemical restraints should be used judiciously in a combative and disruptive patient. These help prevent injuries and falls, and allow for the continuation of medical therapy. Always give haloperidol (antipsychotics) before you apply restraints.
Esophageal cancer
Esophageal adenocarcinoma is found primarily in the lower esophagus and is associated with chronic gastroesophageal reflux and Barrett’s esophagus. Squamous cell carcinoma is often seen in patients who use alcohol and tobacco chronically and is usually located in the upper esophagus.
Pulmonary embolism
Anticoagulation with heparin or a low molecular weight heparin followed by oral warfarin is the tx of choice for a patient with pulmonary embolism. An IVC filter is recommended in patients with complications of anticoagulation, contraindications to anticoagulation, or failure of anticoagulation.
Adjustment disorders
Adjustment disorder involves sx causing marked distress and functional impairment that develop within 3 months in response to a stressor. It is important to identify adjustment disorders that occur in response to a medical dx as counseling and/or psychotherapy can improve sx and promote a return to functioning.
