- Aug 2018
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pharmd.umc.edu pharmd.umc.edu
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bod
say why you chose a crystalloid over colloid
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iscontinuation
may want to consider electrolytes (k and mag) and thiamine for aws.
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bolus
i would take out bolus
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pharmd.umc.edu pharmd.umc.edu
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Monitoring The
how often do you monitor. monitoring for LR?
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.
is there a specific scoring system?
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250
how often do you monitor for this and what do you do if these values are not met?
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6 His
how often do you monitor for this and what do you do if these values are not met?
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ciprofloxacin
I don't see how this sentence is relevant
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can
delete
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509
round to 500 mL/hr or 250
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Acetaminophen
what about the bactrim
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1 He
dont need this sentence
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pharmd.umc.edu pharmd.umc.edu
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Adverse Event Monitoring.
remember to establish when you need to monitor and what to do if patient is experiencing AE
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Perform
when?
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Therapeutic Monitoring
remember to establish when you need to monitor and what to do if patient is not meeting therapeutic goals.
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luids helped
fluids helped what?
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frequently
how frequently
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ACG
what does this stand for write it out to establish the abbreviation
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Althou
move this sentence next to where you talk about mero
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issues going on
sounds unprofessional
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days
also consider adding potassium, and mag
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Discontinue
good
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106
? usually 140 or 180 in hospital setting
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pharmd.umc.edu pharmd.umc.edu
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Monitoring Some
include what to do if they experience symptoms and when to monitor for them
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imipenem
again, what if fever doesn't decrease? consider checking susceptibility
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decrease
what if levels do not normalize? i
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decreased
compared to what? NS? say specifically why you chose LR over NS
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po
spell out
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IV
may want to spell out intravenously and every 6 hours
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The
probably don't need this sentece or you can say magnesium sulfate in 100 ml of NS in the previous sentence
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erum potassium
serum potassium is not a medication. choose KCl or KPhos may want to write 40 meq kphos infused over 6 hours then recheck levels
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Tylenol
dc bactrim? associated with pancreatitis
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106
may be low? usual inpatient goals are either 140 or 180
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electrolytes
which electrolytes? hypomagnesia etc.
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pharmd.umc.edu pharmd.umc.edu
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epinephrine
consider adding time periods to monitor for all. daily?
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hour
Is that all, probably need to continue fluid replacement for longer than an hour to assure hydration
consider adding KPhos
Add thiamine for alch withdrawl
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Tylenol
double check about tylenol and pancreatits?
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New
may want to hit on duration. how long will he get AB? fluid? diazapam.
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ringer
intravenously (could say at a rate of 500 mL/hr)
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Rationale
great rationale
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reassess fluid
consider adjusting fluid rate or switching to normal saline
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Discontinue Bactrim
good
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infection
bacterial infection and susceptibility of meropenem
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xpectatio
consider saying normalize lab values (if you need more space). may want to include: expectations would be to effectively treat pancreatitis (etc) with minimal adverse effects. g
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pharmd.umc.edu pharmd.umc.edu
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on-Phar
Great job overall!! :)
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St
lowercase s, this sentence could also go in non-pharm
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isease
great job here!
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iving. 2
consider adding how it would help the people around her by not having to take care of her, she could remain independent
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at bedtime
be more specific: take one tablet by mouth at bedtime
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forgetfulness
create realistic expectations. this will not cure her, but prevent progression of disease
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Monito
when do you monitor for all of these things? at follow up appointment? and what do you do if any of these SEs occurs? D/c med or switch to another maybe
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50 ng/m
when should this serum level be taken?
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AD
write out: or establish the abbreviation. while some abbreviations are acceptable; just to be sure with your graders i would write everything out, or establish the abbreviation the first time you write the word in the plan
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nhibito
if you are going to use ChEI for the remainder of the plan; put (ChEI) here to establish the abbreviation
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Therapy
expect to take this for the rest of her life
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ADL
spell out
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pharmd.umc.edu pharmd.umc.edu
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65 years old
overall great job!
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e
consider adding more about what to expect as far as memory. clarify that it may not improve memory, but prevent it from deteriorating
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suboptimal
define suboptimal response for the 4-6 w follow up?. is there as specific MMSE score, or are they just looking for a decline in score?
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po
write by mouth
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prolong
great job on this section!
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diphenhydramine
antihistamine contraindicated with cholinesterase inhibitors
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pharmd.umc.edu pharmd.umc.edu
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ricep
did you specifically what the brand name: consider donepezil (generic)
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diphenhydramin
good
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ituation
consider adding non pharm about word puzzles, and exercise
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MMSE score
this is more therapeutic than AE
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cost efficien
if you could find primary lit that says donepezil is safer (less AEs) or more effective that would strengthen your rationale
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.
consider adding avoiding the need to outside help, staying independent
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pharmd.umc.edu pharmd.umc.edu
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.
Great job! good luck with everything!
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Alzheimer
add more about how this will help alleviate her specific symptoms or keep them from getting worse
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desirable effects
What are the desirable effects? be specific. little to no decline is MMSE? no worsening of symptoms
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One
consider adding why a cholinesterase inhibitor was chosen over namenda: one sentence explaining that they are first line
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17.7%
good rationale!
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(generic)
Add formulation: one tablet
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time
consider adding; help her stay independent, or prevent the need for a care facility, or care from family
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Diphenhydramine
consider adding why antihistamines are not appropriate, especially in dementia, not just because BEERs
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Alleviating
slowing?
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paying bills
look at word agreement, exp: loses and paying add forgets to pay bills
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near misses
explain more. what is a near miss?
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