Wednesday, March 30, 2016

clinical tips

I will update this regularly for anything I've learned from school, textbooks, &... life!:

- Chronic lithium ingestion can lead to nephrotic diabetes insipidus which is the most common form of renal injury in lithium patients. NP management: ask psychiatrist to lower dose. If therapeutic effects for psych and psychiatrist doesn't want to lower dose => start on demopressein to treat DI. http://www.uptodate.com/contents/treatment-of-nephrogenic-diabetes-insipidus

- When adjusting dosage for lithium => see pt every 8 days ideally or 2 weeks (easier for pt to remember 2 weeks) initially. Not for the rest of the time.

- If pt is menopausal => ask about sexual difficulties due to dry vagina

- Over 65 y/o => pneumoccoccal vaccine. Usu. missed unless pt has been in the hospital.

- always promote diet & exercise in ALL patients

- try NOT to use the affected arm of the pt w/ total mastectomy for invasive procedures due to risks for lymphedema See: http://www.hopkinsmedicine.org/healthlibrary/conditions/breast_health/lymphedema_following_a_mastectomy_85,P00148/

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