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44 Cards in this Set
- Front
- Back
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Insulin questions:
(2) |
1. do you know what insulin is?
2. do you know how to use your pen? |
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how to administer insulin: |
clean your skin with alcohol, pinch skin, insert needle straight in, push plunge, hold ten seconds, remove
- dispense in sharps container or plastic marked with sharps |
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Insulin dosing: |
~~1 unit for every 10 grams |
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important insulin facts:
(3) |
1. rapid insulin can be kept at room temp for 14 days
2. others, fridge for 30 days
3. lose efficacy after that
TEACH BACK METHOD. |
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SE's of insulin:
(2) |
1. hypoglycmia
=> eat candy/drink juice, wait 15 minutes, check sugar - if <70, eat/drink again, check again - hosp. if not getting better
2. wt gain
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how to prevent hypoglycemia:
(2) |
1. do NOT skip meals
2. keep regular track of your sugars |
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Insulin education checklist:
(6) |
1. what insulin is
2. how to administer it
3. SE's (hypoglycemia, wt gain)
4. how to keep track of your sugars
5. teach back
6. suggest 1800-DIABETES |
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Flu Vaccine checklist:
(4) |
1. Did you get one this year? Why not?
2. it lowers chance by 50-80% - milder, shorter than unvaccinated
3. think of the children
4. every October (flu hits November-March) - takes 2 weeks to make AB's |
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before getting the vaccine, tell the doc if:
(2) |
1. egg allergy
2. hx GBS |
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flu vaccine priority: babies, elderly, chronic conditions, preg, and:
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healthcare workers |
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who *shouldn't* get it?
(2) |
1. people with life-threatening allergies to flu shot in the past
2. imm-comp/preg (e.g. shouldn't get nasal) |
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mechanisms of flu vaccine administration:
(3) |
1. shot to the arm
2. intradermal for 18-64 y/o's scared of needles (much smaller needle)
3. nasal spray for 2-49 y/o - *recommended for 2-8 y/o* - not for preg, imm-comp |
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SE's of flu vaccine:
(2) |
1. redness/soreness/swelling at injection site
2. *a few* get body aches, HA's, low-grade fever for 1-2 days |
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NO evidence that flu vaccine increases risk of: |
birth defects or miscarriage |
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Thimerisol =
(then 3) |
mercury derivative
- NOT used in childhood vaccines any longer
- part of *some* but not all vaccines
- not enough to cause mercury poisoning |
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Med Rec checklist:
(6) |
1. ask pt what each med is for, how they take it, and for what
2. look at all meds and list WITH THEM
3. any SE's? any allergies?
4. OTC/HS/MV/eye drops/creams/inhalers?
5. smoking/alcohol/drugs?
6 anything else we haven't talked about? |
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3 critical keys to Med Rec success: |
1. make sure meds and doses are appropriate - they will try to catch you here
2. explain why they're taking this one - then use teach-back
3. put everything down in writing |
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2 key questions for Adult Diet: |
1. what does your diet consist of now?
2. what is ONE THING that you think you can change? |
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Adult Diet checklist:
(6) |
1. fruits and veggies to 5 servings per day - pulptastic 24 must-see diagrams
2. convert white grains to whole grains - rice, pasta, bread
3. dec. fat to about 33% of your daily calories - sat fat down to 7%
4. **dec. sugars** - start by switching from regular sodas to diet sodas
5. dec. sodium <4000 mg to start
6. inc. Calcium to 3 cups of skim milk |
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Inhalers checklist:
(4) |
1. if not used in >2 weeks, shake for 5 seconds, spray into air, then repeat x3
2. clean x1 per week - run warm water through moutpiece and let it air-dry overnight
3. 30-day prescription ~~ 2 puffs per day - if using rarely, write down how often, get a new one in 3 mths
4. clean DPI by wiping mouthpiece with dry cloth |
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see Keep to study administration of both kinds of inhalers: |
don't sleep on this |
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key questions for Vaccines:
(3) |
1. what do you know about vaccines?
2. who do you trust when it comes to learning about vaccines?
3. do you have any concerns about vaccines?
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why you should get vaccines:
(2) |
1. protect you against many diseases, most of which we actually never see anymore, since we've been vaccinated
2. protect others your disease can harm children and elderly around you - it could be devastating |
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vaccine Safety:
(6) |
1. years of testing are required by law before a vaccine can be used in the public - then it's followed closely for safety and efficacy
2. CAN still get one with mild illness and low-grade fever, like common cold
3. NO link to austism - results withdrawn, financial conflict of interest
4. you have a higher risk of getting GBS when you catch the flu than you do by getting flu vaccine
5. SIDS = coincidence - both around 9 months
6. There's not enough thimerosal to cause mercury poisoning - besides, Thimerosal not used in childhood vaccines anyway |
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7 key questions on Smoking Cessation: |
1. how long have you been smoking?
2. what made you start?
3. how much do you smoke now?
4. ever thought about quitting?
5. scale of 1 to 10, how important is it for you to quit? - why X and not X-2?
6. what's stopping you?
7. 1-10, how confident are you that you can quit? |
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I want you to quit, |
and I'm not even your doctor |
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SE's of quitting = WD symps:
(4) |
1. difficulty sleeping
2. irritability
3. cravings
4. some weight gain
- these dec. over 3-4 weeks |
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steps to quit:
(6) |
1. set a quit date
2. decrease number of cigarettes per day as that day approaches - tell family and friends - avoid triggers like stress
3. use oral substitutes, like sugarless gum or sunflower seeds
4. call 1800 QUIT NOW for support
5. do NOT view relapse as failure - evaluate what happened, learn from it, move on
6. use meds - NRT - not much difference between the different modes, trick is to find one that works best for you - it reduces WD symps
start Chantix 1 week before quit date - call if thoughts of suicide or unusual behavior
start Welbutrin 2 weeks before quit date - can't take if hx of seizures or on antipsychotics
- ask about hx of sez's |
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e-cigs are NOT recommended |
some have cancer-causing agents, others have nicotine in them when they shouldn't |
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5 key questions for Contraception: |
1. sexual activity hx
2. menstrual cycle hx
3. currently smoking? drinking?
4. hx of blood clots?
5. FHx of blood clots or CVD or osteoporosis? |
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diaphragm or cervical cap requires: |
fitting by doctor |
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leave diaphragm/cap in for the next 24 hours |
make sure to store condoms in cool, dry place |
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absolute contraindications to OCP's:
(9) |
1. < 6 wks postpartum
2. smoker >35 (>15 cigarettes per day)
3. HTN (>160/100)
4. hx DVT
5. ischemic heart disease
6. hx of CVA
7. current BC
8. DM with retinopathy/nephropathy/neuropathy
9. severe cirrhosis or liver tumor
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combo OCP's prevent: |
ovulation
- minipills prevent sperm from joining egg |
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other contraceptive options and fun facts:
(6) |
1. Patch - = combo - on for 3 wks, off for 1
2. Depo-Provera shot - PROG every 3 mths - can only use for 2 yrs b/c it weakens bone - infertile up for a year - not good if you want to have kids soon
3. Nuvaring - wear for 3, remove for 1
4. implantable rod - works for 3 years
5. IUD - copper ParaGard works for 12+ yrs - Mirena works for 5 - rec'd for women in monogamous relationships due to risk of PID
6. Permanent - tubal ligation - vasectomy - essure springs in Fallopian tubes |
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fun facts about OCP's:
(2) |
1. shouldn't take if bone strength is an issue
2. need to take it at the same time every day
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SE's of all hormonal contraceptives =
(4) |
1. nausea
2. mood swings
3. wt gain
4. possible blood clots |
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Emergency contraception:
(4) |
- prevents sperm from reaching egg
high-dose OCP's w/in 72 hrs
Plan B = PROG - 2 PO doses, 12 hrs apart
only mifeprestone *after* 72 hrs - 600 mg, one dose - most effective |
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make sure Insulin education includes: |
“clean your skin with alcohol” |
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stand up when: |
using the inhaler
shake, wait one minute in between |
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CKD exacerbations + important point: |
confusion, fatigue, taste different?
do not take NSAIDs - take Tylenol |
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remember _________ for URI symps |
ALLERGIES |
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women's causes of vaginal bleeding:
(3)
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1. hormonal dysregulation ==> meds (OCP’s)
2. fibroids ==> menorrhagia
3. postmenopausal bleeding ==> CA - ask about FHx CRC, ovarian, endometrial, BC |
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for pelvic pain, add: |
DRE if man/prostatitis is a potential Dx |
