Susan Oakley @susanoakley20
0 0 0
Current inpatient Med/Surg nurse at UW Health TAC. I have been a nurse since 2017 and had the opportunity to be in UW Health's Nurse Residency program out of nursing school. I started as an inpatient nurse on a Med/Surg floor for the first two years. I transitioned to their Burn and Wound speciality clinic Sept 2019 and just recently transitioned back inpatient for more flexibility with my upcoming clinicals this fall for my MSN with a focus in FNP at Concordia.
Contributor Ranks
Latest Searches
143 results
diagnosis clinical physicalexam differential management video algorithm cardiology neurology comparison workup ophthalmology table causes peds syndrome assessment pediatrics sign endocrinology
An Algorithm for the Evaluation of Chest Pain #Diagnosis #Management #EM #IM #Chest #Pain #ChestPain #Evaluation
An Algorithm for the Evaluation of Chest Pain #Diagnosis #Management #EM #IM #Chest #Pain #ChestPain #Evaluation #Differential #Algorithm #Ddxof
Algorithm for Treating Constipation in Hospitalized Patients 1. Start with miralax daily, uptitrate to desired BM, consider
Algorithm for Treating Constipation in Hospitalized Patients 1. Start with miralax daily, uptitrate to desired BM, consider addition of senna as needed/if on opioids 2. Give magnesium citrate/suppository If ESRD/cirrhosis: choose lactulose instead of milk of magnesia If neutropenic, no enemas disimpaction 3. Give an enema including tap water, smog, or soap suds w/ oral laxative (avoid fleet enema with advanced renal disease) 4. Manual disimpaction Dr. Ann Marie Kumfer @AnnKumfer #Constipation #Algorithm #management #treatment #inpatient
Pharmacologic Management of Constipation Fiber Laxatives - Bran powder - Psyllium - Methylcellulose - Calcium polycarbophil
Pharmacologic Management of Constipation Fiber Laxatives - Bran powder - Psyllium - Methylcellulose - Calcium polycarbophil - Guargum Stool Surfactants - Docusate sodium - Mineral oil Osmotic Laxatives - Magnesium hydroxide - Lactulose or 70% sorbitol - Polyethylene glycol (PEG 3350) Stimulant Laxatives - Bisacodyl - Bisacodyl suppository - Cascara - Senna - Lubiprostone - Linaclotide Enemas - Tap water - Sodium phosphate enema - Mineral oil enema Agents Used for Acute Purgative or to Clean Prior to Medical Procedures - Polyethylene glycol (PEG 3350) - Magnesium citrate #Constipation #Pharmacologic #Management #Pharmacology #Medications
Irritable Bowel Syndrome (IBS) Treatment Options Amitiza (Lubiprostone) Antidepressants: Celexa, Wellbutrin, Prozac, Paxil, Nortriptyline, and Zoloft Bentyl (Dicyclomine) Creon Ducolax Imodium, Maalox,
Irritable Bowel Syndrome (IBS) Treatment Options Amitiza (Lubiprostone) Antidepressants: Celexa, Wellbutrin, Prozac, Paxil, Nortriptyline, and Zoloft Bentyl (Dicyclomine) Creon Ducolax Imodium, Maalox, Kaopectate (Loperamide) Levsin (Hyoscyamine) Librax (Chlordiazepoxide and Clidinium) Linzess (Linaclotide) Lotronex (Alosetron) Marijuana Miralax (Polyethylene glycol) Nexium (Esomeprazole), Protonix (Pantoprazole), Prevacid (Lansoprazole), Prilosec (Omeprazole) Reglan (Metoclopramide) Rifaxamin (Xifaxan) Viberzi (Eluxadoline) Zantac (Ranitidine) #irritable #bowel #syndrome #ibs #diarrhea #constipation #management #pharmacology #table
Irritable Bowel Syndrome (IBS) - Diagnosis and Management Summary Diagnosis: • Use a positive diagnostic strategy with
Irritable Bowel Syndrome (IBS) - Diagnosis and Management Summary Diagnosis: • Use a positive diagnostic strategy with minimal testing. IBS is NOT a diagnosis of exclusion. • Rome IV Criteria - Recurrent abdominal pain ~ ≥ 1x/ week in last 3 months + symptom onset ≥ 6 months associated with ≥ 2 of the following: 1. Related to defecation 2. Change in frequency of stool 3. Change in form of stool * Bloating not required for diagnosis Treatment: • Global IBS Symptoms: - Limited trial low FODMAP diet - Soluble, viscous, poorly fermentable fiber - Peppermint oil (Menthe piperita) - Tricyclic Antidepressants - Gut-directed psychotherapies • IBS-D: - Rifaximin- up to 3 courses - Alosetron 0.5-1 mg BID in ♀ with severe symptoms who failed conventional tx - Mixed opioid agonists/antagonists (eluxadoline 75-100mg QD) • IBS-C: - Secretagogues → activate receptors on apical membranes of intestinal epithelial cells intestinal secretion & peristalsis - 5-HT4 (Serotonin) agonist tegaserod 6mg BID in ♀ <65yo with 1 cardiovascular risk factors who failed secretagogues by Tina Hang, MD @TinaPhamHang via Emory Gastroenterology and Hepatology @EmoryGastroHep #IBS #Irritable #Bowel #Syndrome #Diagnosis #Management #gastroenterology #treatment
Skin Ulcers of the Lower Legs / Feet - Differential Diagnosis Algorithm Physical: • Pressure • Trauma • Radiation Vascular: • Arterial
Skin Ulcers of the Lower Legs / Feet - Differential Diagnosis Algorithm Physical: • Pressure • Trauma • Radiation Vascular: • Arterial insufficiency • Vascular insufficiency • Vasculitis Neurological: • Diabetic neuropathy • Tabes dorsalis (syphilis) Metabolic: • Pyoderma gangrenosum • Diabetic dermopathy • Necrobiosis lipoidica Neoplastic: • Squamous cell carcinoma • Basal cell carcinoma • Melanoma #Lower #Legs #Feet #Ulcers #ulcerative #skinrash #dermatology #Differential #Diagnosis #Algorithm #causes
Decubitus Ulcer - Diagram of stages. A, Stage I pressure ulcer. B, Stage II pressure ulcer.
Decubitus Ulcer - Diagram of stages. A, Stage I pressure ulcer. B, Stage II pressure ulcer. C, Stage III pressure ulcer. D, Stage IV pressure ulcer. E, Unstageable wound. F, Suspected deep tissue #Diagnosis #Staging #Sacral #Decubitus #Pressure #Ulcers #Stages #III #IV #Nursing
Hydroxyapatite Deposition Disease (HADD) - MSK Radiology Imaging Findings: • Ovoid hypointense structures along the bursal surface
Hydroxyapatite Deposition Disease (HADD) - MSK Radiology Imaging Findings: • Ovoid hypointense structures along the bursal surface of the superior cuff footprint attachment consistent with Calcium Hydroxyapatite deposits. • Fluid-like signal seen within the deltoid muscle fibers and soft-tissues adjacent to the Calcium Hydroxyapatite deposits consistent with myositis. • T2-hyperintense fluid-signal is seen within the subacromial/subdeltoid bursa consistent with bursitis. Case description: • Hydroxyapatite Deposition Disease is a broad spectrum of musculoskeletal pathology due to crystal deposition. • This is generally monoarticular with inhomogeneous calcifications which are generally round/ovoid and faint on radiograph. • MRI shows globular low-signal on all sequences with surrounding hyperintense signal of the soft-tissues. - Deposits may show blooming on gradient-echo imaging with abnormal signal in the adjacent cuff. - Limits evaluation of cuff pathology (i.e. lower specificity of tear diagnosis) • Milwaukee shoulder: - Generally elderly women with severe destructive arthropathy of the shoulder with hydroxyapatite deposition in the synovial fluid. • Treatment for HADD: generally conservative. They may be needled, lavaged, and aspirated with variable results. Differential diagnosis: • Dystrophic calcifications from other systemic disorders: Progressive systemic sclerosis, hyperparathyroidism, etc. • Tendinopathy or tenosynovitis: Differentiate low-signal normal tendon from globular low-signal Hydroxyapatite deposits. Dr. Donald von Borstel @DrvonBorstel #HADD #Hydroxyapatite #Deposition #Disease #clinical #mri #clinical #Radiology #diagnosis #msk
Illustrations showing elements of a shoulder assessment. Also included on a shoulder assessment would be determination
Illustrations showing elements of a shoulder assessment. Also included on a shoulder assessment would be determination of acromioclavicular joint tenderness, supraspinatus/greater tuberosity tenderness, biceps tendon tenderness (using Speed's test), atrophy and crepitus. (In Speed's test, the arm is fully extended anteriorly, palm facing up. The examiner pushes down on the hand as the patient resists. Pain in the anterior shoulder is a positive test for biceps tendinitis.) #Diagnosis #PhysicalExam #RotatorCuff #Shoulder #Examination #Tendinopathy #Impingement
Posterior Ankle Impingement (Os Trigonum) Syndrome - MSK Radiology Imaging Findings: • Os trigonum which has marrow
Posterior Ankle Impingement (Os Trigonum) Syndrome - MSK Radiology Imaging Findings: • Os trigonum which has marrow signal alteration with T2-hyperintense and T1-hypointense signal; consistent with marrow edema/contusion. • Arrows showing posterolateral capsular thickening and fluid-signal consistent with synovitis. • "Edema-like" marrow signal of the posterolateral talus and calcaneus adjacent to the os trigonum. Case description: • Usually presents with localized severe pain at the back of the ankle, worse upon plantar flexion. • Ballet dancer or other athletes with plantar flexion. • MRI: Posterolateral capsular thickening/synovitis; Predisposing factors such as Stieda process, os trigonum, abnormal morphology calcaneal tuberosity; Tenosynovitis flexor hallucis longus Differential diagnosis for similar location of pain: • Posterior syndesmotic ligament tear: no impingement findings and torn ligament on MRI. • Achilles tendinopathy: thickening and abnormal signal of the achilles tendon. • Posterior talar dome osteochondral lesion: pain limits plantar flexion but no symptoms of impingement. Dr. Donald von Borstel @DrvonBorstel #Posterior #Ankle #Impingement #Os #Trigonum #OsTrigonum #Syndrome #clinical #mri #clinical #Radiology #diagnosis #msk
empty