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10 Cards in this Set

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Medically Complex Patients
Patients who have several comorbid
conditions often with cardiopulmonary
overlay that significantly compromises their ability to function
Comorbidities
COPD ARF CRF
Pneumonia/ Double pneumoonia
CHF
DM
HTN
ESRD
Disease Pathogenesis
Acute Illness if often caught early
lead to lesser problems or minimal Impairments.
example- TIA, angina,
Disease Pathogenesis
When the problems of acute Illness
are not resolved it may lead to
chronic state.
Example - acute Airway diseases
acute renal failure
Disease Pathogenesis
Chronic Illness puts our body in a DEMAND state means needing
attention/monitoring/maintainance
Frequent Labs
Frequent consults
Frequent Therapy /Interventions
Frequent Hospitalisations
Poly pharmacy may be required
One drug to offset the Adverse effects of the other.
For example Cancer and chemo patients are often on Morphine
and Ondasetron
Disease Pathogenesis
A disease may have its own way of
Onset
Duration
Course- Remission/Relapse/Exacerbation
Acute =subacute= chronic = end -stage/terminal
Disease Management
Chronic Illness = Demand state=
May need Skilled Nursing
Skilled Rehab
Special challenges in tx
Low tolerance
Low Motivation
Refusals
Little -documented/measurable outcomes
Medically Complex Patient - Management
Very ill or critical patients don't make too
great of a Progress.
Hence Documentation of Improvement
is done in small increments
pt will decrease his fall risk by 50 %by following safety precautions 50% of the time
pt will attempt to walk the length of the( parelell bars/bed to bathroom) x 3 reps
with minimal assist
Medically complex Patient - Management
Need to Understand the disease process
Incubation period (If Infectious)
Mode of onset
Duration of illness
complications
treatment recieved
Past status/current status
current difficulties/ problems/impairments
prognosis /goals/outcomes
The ERA of Managed care
Case management is the best way
to deal with the management of the
medically complex;