week 3 Flashcards
lasting power of attorney
legal document that lets an individual appoint one or more people to help make decisions or to make decisions in the future event of the patient lacing capacity
2 types of lasting power of attorney
1) health + welfare
2) property + financial affairs
advanced statement
written statement by the patient, setting out preferences, wishes, beliefs regarding future care
not legally binding
advance decision OR advance decision to refuse treatment
a decision a patient with capacity can make to refuse specific treatments in the future
legally binding
electrolyte imbalance caused by omeprazole
hyponatraemia
NSAIDs and electrolyte imbalance
NSAIDs can cause renal damage therefore at risk of causing electrolyte imbalance
U+E that can cause acute confusion
- uraemia
- hyponatraemia
bone profile results causing acute confusion
- hypercalcaemia
- hypocalcaemia
3 medications that can cause hyponatraemia
- omeprazole
- citalopram
- ramipril
causes of
- hyponatraemia
- dehydrated patient
- urinary Na > 20 mmol/l
Renal Na loss
- addisons disease
- renal failure
- diuretic excess
- osmolar diuresis
causes of
- hyponatraemia
- dehydrated patient
- urinary Na < 20 mmol/L
loss of Na elsewhere (not through urine)
- diarrhoea
- vomiting
- fistulae
- burns
- SBO
- trauma
- CF
- heat exposure
cause of
- hyponatraemia
- patient not dehydrated
- patient is oedematous
- neophrotic syndrome
- cardiac failure
- cirrhosis
- renal failure
cause of
- hyponatraemia
- patient not oedematous or dehydrated
- urine osmolarity > 500 mmol/kg
SiADH
cause of
- hyponatraemia
- patient not dehydrated
- normal urine osmolarity
- water overloaded
- severe hypothyroidism
- glucocorticoid insufficiency
definition of diarrhoea
- acute
- chronic
abnormal passage of loose stools more than 3 times a day
- less than 4 weeks
- longer than 4 weeks
drugs that can cause acute diarrhoea
- allopurinol
- abx
- digoxin
- metformin
- NSAIDs
- PPIs
- SSRIs
- statins
- thyroxine
red flags for diarrhoea
- blood
- persistent vomiting
- weight loss
- nocturnal symptoms
q’s in hx when suspecting an underlying cause of infective diarrhoea
- food poisoning
- travel abroad
- contact with another person with diarrhoea
signs of dehydration
- reduced skin turgor
- nausea
- light headedness
- tiredness
- dizziness
- confusion
- oliguria
indication (2) for emergency hosp admission following diarrhoea
- vomiting and inability to retain oral fluids
- features of severe dehydration + shock
complications of diarrhoea
- dehydration
- electrolyte imbalance
- IBS
- infection spreading
how long will it take for most infective diarrhoea to pass
2-4 days
how long does diarrhoea caused by campylobacter + salmonella last
2-7 days
investigation of choice when looking for an infective cause of diarrhoea
stool sample
- culture
- sensitivity
- ova
- cysts
- parasites
