Pneu Pnurse

In order to remember what warrants droplet precautions (which means a private room or cohort, plus mask), think SPIDERMAN!

S - Sepsis
S - Scarlet Fever
S - Streptococcal pharyngitis
P - Parvovirus B19
P - Pneumonia
P - Pertussis
I - Influenza
D - Diptheria
E - Epiglottitis
R - Rubella
M - Mumps
M - Meningitis
M - Mycoplasma or meningeal pneumonia
An - Adenovirus

A. Assessment
- Flashes of light
- Blurred or “sooty” vision, “floaters”
- Sensation of particles moving in line of vision
- Delineated areas of vision blank
- A feeling of a curtain coming up or down
- Loss of vision
- Confusion, apprehension

B. Diagnose
- Separation of the retina from the choroid
- Cause
   a. Trauma
   b. Aging process
   c. Diabetes
   d. Tumors

C. Plan/Implementation
- Bedrest - do not bed forward, avoid excessive movements
- Affected eye or both eyes may be patched to decrease movement of eye
- Specific positioning - area of detachment should be in the dependent position
- Take precautions to avoid bumping head, moving eyes rapidly, or rapidly jerking the head
- Surgery to reattach retina to choroid; gas or air bubble used to apply pressure to retina
- No hair-washing for 1 week
- Administer sedatives and tranquilizers
- Avoid strenuous activity for 3 months

I always see detached retina questions on my Kaplan!

In the land of NCLEX, know that Lung Cancer is associated with the following things:

SIADH - Lung Cancer is the number one risk factor for SIADH

Superior Vena Cavae Syndrome - Due to the tumor compressing the vessel

Spinal Cord Compression - Due to the tumor compressing the spine

HYPERcalcemia - tumors are loaded with either hormones or Calcium

Example: Which of the following elderly patients would you assess as the HIGHEST risk for SIADH:
A. A diabetic patient taking 10 units of Insulin
B. A women being admitted with a fractured femur from a fall from home
C. A lung cancer patient being treated with Platinol
D. A man being treated for a sickle cell crisis

The answer would be: C

I currently have a patient who’s father is doing everything possible to avoid his children from being vaccinated? The father has never allowed the children to have ANY vaccinations of any kind, and claims to have legal documents stating his children are exempt due to religious reasons, as well as so he can avoid them from “being shot up with mercury and synthetic garbage only to be brain damaged” — I kind of felt insulted when the patients father said this, as he did not believe in me, or the healthcare industry.

A few months ago, I read an article in the Wall Street Journal, that stated 20 to 30% of physicians have reported kicking out patients from their practices because of vaccine refusal — I don’t think that this is the correct way to deal with things. I mean sure, I understand bringing an unvaccinated child to a pediatricians office can spread diseases to other children, and even be fatal to some — but we can’t just fire our patients. We have to show the strong evidence for vaccine safety, and educate them about the frightening consequences of infection with meningitis, hepatitis, measles, polio, and other vaccine preventable diseases.

As a physician-in-training — the only thing I can do is try to explain why I believe the children should be vaccinated, and educate the patients families on why vaccines are important, not just to them — but to the rest of population as well. 

First off — vaccines have been so successful at eliminating childhood infections that parents no longer see these infections as a threat. Ironically, the very success of vaccines has allowed the anti-vaccine movement to sway so many people.

Now, let’s get down to the facts — vaccines do not cause autism, nor do the ingredients in vaccines — scientific studies involving hundreds of thousands of patients support these conclusions. 

Anti-vaccinations claims on the internet started when Andrew Wakefield published one small study of 12 patients, now retracted, which claimed a link between the MMR vaccine and autism. Investigations later revealed that he was paid a large sum of money to recruit patients for a lawsuit against vaccine makers, and that he did not reveal these payments to his co-authors or patients, and that he manipulated the data itself.

Ever since then the anti-vaccine movement has exploded and we have experienced multiple outbreaks of measles, mumps, and other illnesses linked directly to unvaccinated children.

If we’re going to avoid a return to the era when children routinely died from infections, we have to keep trying..