1.
coffee ground -> vital sign -> okey -> 1. NG 2. lab:CBC( check HB),BUN,Cr 3. PPI
-> no okey -> call R
2.
Af
work up:EKG, electrolyte, thyroid function
amiodarone :150 mg f/u + ekg monitor
survey sympathic increase underlyine, like pain...
6Amp in D5W 250 glass bottle run 16 cc /hr 前六小時
3.
Vomitting
4.
dizzing
5.
dyspnea
6.hyperglycemia 350 FBS
(1) under insule treatment patient and totally use 30u
1500/30=50
350 -150=200
200 => 4U
(2) new onset
: 0-80: orange juice, milk, and call a doctor
: 80-200: 2U regular
: 201-250: 4U regular
: 251-300: 6U regular
: 301-350: 8U regular
: >400:10U regular and call a doctor
survey inf. etc...
7.
Intermittent claudication
CILOSTAZOL TAB 50MG
overactive bladder
VESICARE TAB 5MG
after load
-
pre load
-ACEI
8. wheezing
5D/D: asthma, fuild overload,MI,PE,anSHOCK,HF
(1) vital sign => hypo or not !!!!!!! -> yes, r/o :MI,PE,shock
(2) drug history=> antibiotic, constract, procedure, beta-block r/o: shock
(3) I/O, history r/o fluid, asthma
(4) order: O2 mask, combivent,gas, x-ray,lasix half,CBC DC
(5)
JVP,heart murmur -> heart failure
(6)
fever => PE, infection, MI
(7)
focal wheezing => tumor, sputum .foreign body , aspiration
-> over 30 => emergency treatment
1.check vital sign
if ↓ BP -> AMI, Pulmonary embolism, analphylactic shock
if bate-block use -> check asama history
if fever -> PE,infection,MI
pathophysiology: acute PE -> find the reason
1.pneumonia 2. MI 3. PE 4.COPD AE 5.asama => diffuse wheezing
focal wheezing => tumor, sputum .foreign body , aspiration
2. chest,
3. heart sound -> heart failure (JVP,edema,s3,s4)
4. LAB:GAS,CBC DC,
5. CXR, EKG
6. treatment:
bronchospsam:solucortef,albuterol
PE:lasix 20~80mg, MI:NTG 1g subligure,O2
9. Renal/ureteral stone:
diagnosis:clinical symptom, U/A(microscopic hematuria),KUB
work up: ca, ua, U/A,KUB
treatment: hydration, pain control (pethidine Q6H/PRN),alpha-blocker
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