53 Matching Annotations
  1. Aug 2018
    1. Monitoring

      You discussed side effects of LR"s and the BZD, but what side effects should we monitor for meropenem?

    2. If presents

      Not sure what you are trying to say here with these two words.

    3. WBC

      What should/would you recommend if the patient does not respond ideally to your fluid and antibiotic regimen?

    4. segmented

      Would say neutrophils (segmented 44-65%, bands 0-5%) just for additional clarity.

    5. electrolyte

      Will Lactated Ringer's completely correct all electrolyte imbalances?

    6. CIWA

      Good job mentioning this and how to use it!

    7. 20 ml

      I would check this number out with the package insert. I have seen 100 mL normal saline minibag snaps commonly used for meropenem in the hospital.

    8. Therapy

      Are there any other therapy options that may be beneficial in patients with a history of alcohol use/alcohol withdrawal?<br> Hint: What are major complications that can be seen in patients with chronic alcohol use?

    9. pancreas

      Is that the only reason why Bactrim DS should not be continued? What drugs can induce acute pancreatitis?

    10. OTC

      Are you sure about all of these being continued?

    11. will

      You have told me how treatment will help his current S/S, but you haven't told me how it will directly impact the patient's life. (ie. quality of life, work, etc.)

    12. alieving

      Check spelling on this

    1. carbopenems

      Check spelling on this

    2. meropenem just

      Typo - "meropenem is just"

    3. q8hrs

      What does MH's renal function look like? Based on your findings, is this an appropriate dosing interval?

    4. Pepcid

      Is Pepcid okay to use in patients with acute pancreatitis and if so, what route is best for this patient at this time?

    5. life

      Good job mentioning quality of life!

    6. Goals

      If you get close to the 1 page limit, you can consider taking the numerical values out of this section since they would fit better in the Therapeutic Monitoring section.

    1. physician

      He is in the hospital already, so he may or may not be able to recognize and communicate these issues to his doctors. So, it is up to you to determine how frequently someone should be checking these things for him and what changes should be made if they occur.

    2. adjusted

      Is there a certain number/cutoff that you could mention?

    3. renal

      Good! But, what lab value do we use to monitor renal function?

    4. Monitoring

      Be sure to mention how frequently all of these should be monitored.

    5. opioid

      Was he previously taking the Tylenol ES for his HAs? Do we use opioids for HAs? Also, would we want to start an opioid in someone who already has a history of substance abuse (ie. alcohol)?

    6. output

      If you mention this, they may expect you to mention what is considered normal urine output for a patient in this setting.

    7. Alcohol

      Like that you mentioned this assessment, but how would I use it in modifying MH's care? What would the score mean?

    8. Monitoring

      Be sure to mention how frequently all of these should be monitored. Also be sure to include critical values (ie. the range for WBC, the range for the specific electrolytes you want to monitor, etc.)

    9. pancreatic

      Typo

    10. 8 to 12

      Pick one: either 8 or 12 How long will MH be on the meropenem?

    11. 50 tablets

      50 tablets?? I would rethink this wording :)

    12. multivitamin

      Route?

    13. Ringer

      Route?

    14. Therapy

      Be sure to use the correct format for the drug names. --> Correct naming format (Brand + generic unless using specifically generic version and will write generic name (generic) ex: lisinopril (generic) or Januvia (sitagliptin).

    15. malabsorption

      Is the patient on Pepcid?

    16. References

      Make sure to include in-text citations!

    1. work

      Never hurts to mention "improved quality of life"

    2. lorazepam

      How frequently would you monitor for this?

    3. 50

      How frequently should you monitor for WBC and temp changes?

    4. Monitoring

      What is your plan if the patient does not respond ideally to your current recommendations?

    5. given

      What route?

    6. should

      Typo - do not need the word "should" here.

    7. doses

      Are there any other concerns in patients who present with alcohol withdrawal? What medications could be used to address these concerns? If you find anything, be sure to add to your rationale section.

    8. electrolytes

      Will the LR's cause his electrolytes to normalize without using any additional agents?

    9. Therapy

      Be sure to use the correct format for the drug names. --> Correct naming format (Brand + generic unless using specifically generic version and will write generic name (generic) ex: lisinopril (generic) or Januvia (sitagliptin).

    10. Pepcid

      Oral or IV? He is nauseated and vomiting.

    11. normal

      If you start to get close to 1 page, you may consider taking the critical values/actual numbers out of this section since these really fit better in the therapeutic monitoring section.

    1. brand

      Be sure to use the correct format for the drug names. --> Correct naming format (Brand + generic unless using specifically generic version and will write generic name (generic) ex: lisinopril (generic) or Januvia (sitagliptin).

    2. immediately

      What should you do if a critical value is met? In order to answer this question, I would assume that the physician is going to ask the pharmacist what their recommendation would be. Also note that MH is already in the hospital, so MH may or may not be able to recognize and communicate these adverse events to a nurse or doctor.

    3. monitored

      For all adverse events listed, how frequently should MH be monitored?

    4. potassium

      Was potassium replenishment addressed in New Drug Therapy? If so, is that enough to get MH back into the normal range?

    5. who chlordiazepoxide

      who "used" chlordiazepoxide

    6. (

      May need a closing parenthesis since you have an opening one.

    7. resume

      Do any of MH"s current medications have the potential to induce acute pancreatitis? If MH is vomiting, should oral medications be used? Will elevated liver enzymes affect your choice of medications used?

    8. electrolytes

      Is correcting electrolytes/fluids a goal of therapy? Which ones are abnormal?