問題一覧
1
List things to check every time working up a patient
1. Med Rec 2. Major Labs Abnormalties 3. Drugs and significant adverse effects checks 4. Med Recs 5. Allergies 6. CrCl adjustments and correction 7. Diet 8. Lines 9. Wounds 10. Drains + UOP 11. Airway 12. DDI Checks 13. GI care: Px, BM, Diet 14. DVT Px: SCCs 15. Outpatjent meds review
2
Why should Med Rec be done every time patient is admitted impatient?
To make sure patient is taking right medication and on the correct dose.
3
Which population groups required CrCl corrections in ICU?
1. Quadriplegic aka Paralyzed patients = 0.80 2. Underweight patient due to smaller muscle mass = 0.69 3. Overweight patient = 0.3 or 0.4 4. Female patient = 0.85
4
What is the Pharamcist role if patient is order NPO diet in ICU?
Check all medications to make sure correct routes is order
5
Prefer IV Line used to administered Vasopressors?
All Vasopressors are administered via the Central Line
6
When should you recommend Ascorbic acid aka Vitamin C in ICU?
Recommended Ascorbic acid in patients with wounds and burns for healing
7
Why is Peridex commonly prescribed in ICU?
Prescribed in when patient is intubated to prevent infection
8
Why is Mineral Oil Prescibed in ICU when patient is paralyzed?
Used in during NMB (Paralysis) to avoid drying eyes
9
Why is thiamine commonly prescribed in ICU?
Thiamine is recommended to prevent Wernickes Encephalopathy in cirrhosis or liver impairment
10
Why is Folic Acid commonly prescribed in ICU?
Folic acid is often depleted in liver failure or impairment
11
Who needs GI Prophylaxis in ICU?
1. NPO order 2. GI bleed 2. GI Ulceration 3. GI dysfunction or disorder 4. Liver impairment 5. Coagulopathy
12
What should I do if patient is brought in with drug overdose or toxicity (example Acetaminophen overdose)?
Call Poison control for guideline recommendations
13
Patient Interview
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14
Why is it important to do Outpatient med review for patient with plan discharged?
To recommended guideline directed therapy that patient can benefit from.
15
Why is it important to assess patient allergies when working up patient?
To determine if true allergies or intolerance
16
Tip for Insulin dosing in ICU renal impaired patients
Try not adjust since renal failure effects glucose metabolism which may be due to the increase BG
17
Tip about Psych meds in Impatient management
Never dose adjust until MD and Neurologist agree you don’t want to cause harm
18
Tip about DDI in Pharmacy
ALWAYS notified MD for potential major DDI (ceategory C-D)
19
Tip about documentation in pharmacy
ALWAYS, I mean always document and cover your ass
20
Tips about GI Care impatient?
1. Always check if patient is eating 2. Always check if patient is pooping 3. Always check for need for GI prophylaxis