yellowsea
Forum Newbie
Topics: 5
Posts: 13
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1. "about pain management. ONE TIME or CONTINUE?"
I use morphine iv on most of my patients who are in acute pain. Use Iv acetaminophen on patients who are under respiratory distress and children.
is it correct? Should i use IV ONE TIME or CONTIUEOUS? Intussesception case from UW, the pain management use IV morphine ONE TIME, the rest use IV morphine continueous.
2."complete bed rest patient."
Under what circumstances, we should give patient bathroom privilage?
Is it appropriate that we always give foley catheter to complete bed rest patient who can't go to bathroom?
3. "Case ends in ICU"
I had a practice case about AAA rupture from UW, this case ended even before i sent him to laparotomy, this patient was still in ICU. should we order screen test, life style modification or post surgery care during the last 5 mins?
4. "Case ends in ward"
my HSV encephalitis case from UW ended when the patient was still in the ward. During the last 5 mins, should i switch IV drug to PO ones, or order counceling? At that time, the patient impoved and still need more time on iv drugs.
Thank you very very much
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| ripplefire
Forum Senior
Topics: 31
Posts: 219
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1: bit difficult to answer this question, especially whether it should be continuous or one time, quite subjective. even if we select continuous, it means that it will be given automatically when ever the pt needs it. it can also mean that it will be given at fixed intervals. but since there is no option to give it as and when required, we can have the benefit of doubt that when we select continuous we actually mean to give when required. as for the use of morphine in children, if it can be used in intussesception then why not in other cases. as for respiratory depression, is there another alternative?
2: pt whose vitals are not stable, pt who is in ICU........these cases need complete bed rest
3:we can order them,but when we are asked the 'time' to order these counselings, select a date which is 1-2 days later. by then he would have been discharged from the ICU atleast
4: be on the safe side when it comes to drugs, let the pt remain on iv drugs. as for counseling, u can do what u did in the above question
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| yellowsea
Forum Newbie
Topics: 5
Posts: 13
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Thank you ripplefire, i still have some questions.
thank you again
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| floreat4
Forum Newbie
Topics: 1
Posts: 2
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even I think how can we know that if we clicked iv one time or continous...we did right,
usmle world...too does not give back the performance result on ccs....
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