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Asthma Patient Education
Can a md. Deny medicare-paid hospice end-stage dementia patient physical therapy if patient's family requests it to maintain movement with new law?
Hmmm . . . : Could there maybe be a disagreement between this physician and your family about what's in the patient's best interests? This is a deep discussion that involves much thought and consideration, and which deserves scheduled time with your relative's doctor to go over treatment plans, prognosis, etc. Maybe such a discussion can resolve these issues? Doctors want to help, not hurt or harm. ...Read moreSee 1 more doctor answer
Don't understand: The question? There are really no teaching plans for altered mental status. You need to figure out the cause and treat it if possible. ...Read more
Mother aged 80 patient copd. Ventilator once. Inhaler asthalin, neubulising asthaline , budecort. Deriphyllyne, prbpm90-100, spo2 is 50 advise.?
All health care DO: All providers, including social workers are required to respect patient confidentiality, just like dentists, physicians, nurses, and pas. In the case of suspected child abuse for example, it is normall legally required for the provider to alert the authorities (child protection services). There are other situations that would require alerting authorities such as elder abuse and death threats. ...Read more
Mother aged 80 patient copd. Ventilator once. Inhaler asthalin, neubulising asthaline and budecort. Deriphyllyne, prbpm90-100, spo2p. Advice?
Difficult situation: COPD at advanced age is difficult. You are probably looking at longterm oxygen which has been showing to decrease mortality in the disease. Make sure your mother's medications are maximized. Also consider physical therapy or pulmonary rehab to help her physically deal with her illness. ...Read more
Palliative care question: good reference guideline for end-stage COPD clinical/functional markers for poor response to CPR, and should recommend DNR?
COPD and DNR: I recommend going to uptodate and review what their recommendations are. This is the best source of good medical information I have found. When you read the sections on these issues you can also click on the reference to see the cited reference. ...Read more
Difficult to answer: I do not think Alupent (metaproterenol) is really available any more. But the problem with Alupent (metaproterenol) and diabetes patients is that it could either exacerbate or mask problems of blood sugar reactions. There is not direct problem with the drug and diabetes to my knowledge. It is an old drug that has really been taken over by albuterol which is given to diabetics without that warning. ...Read more
See explanation: You served on or after september 16, 1940 and •your service-connected disabilities (scd) are rated at least 20% disabling by va and •you need vocational rehabilitation to overcome an employment handicap and • it has been less than 12 years since va notified you of your qualified scd. ...Read moreSee 1 more doctor answer
Yes: You do not need to be a vegetarian to follow a heart healthy diet. That being said, you definitely want to incorporate lots of fresh fruits and vegetables in your nutritional plan. While you may can have some lean meats, non-fat dairy, you will want to minimize saturated and trans fats and emphasize mono and polyunsaturated fats. You will also wants to eat lots of whole grains and some nuts. ...Read moreSee 2 more doctor answers
Geriatrics md: how can nursing home refuse to share care plan with woman's child citing hipaa even before she moves in? Older nonmedical sib has poa.
HIPAA strictly: Demands that medical personnel do not discuss medical care issues with anyone but the person designated by the patient. It appears it is not you. Don't get mad at the nursing home, your beloved government came up with the rule. If they are ever found in contempt, the home is fined and potentially taken out of business. So there's that! ...Read moreSee 3 more doctor answers
Sticky issue: This is a huge question. On one hand, online records can be transmitted quickly when medically needed. This could save a life. On the other hand, this quick transmission can also allow breaches of privacy that are potentially painful, embarrassing, and invasive. Balancing these things is precarious! electronic records seems to be where we're going, so we need safeguards to do it well. ...Read moreSee 1 more doctor answer
CPR: less than 10% of people with cardiac arrest and CPR survive overall. After 10 min of CPR survival is miniscule. Early CPR and defibrillation within less than 4-5min give the best outcomes. Las Vegas casinos with abundant automated defibrillators, trained staff and people watching on monitors have the fastest response and best results. ...Read more
What's the prognosis for frail geriatric esrd patient with 3-weekly hd, uncontrollable BP (> 180/100) and dm (fasting blood sugar >350)?
In ca, if a patient's advanced directive says dnr, but the patient verbally states desire for resuscitation at hospital admission. What will happen?
Most recent is right: An advanced directive is just a statement of someone's wishes in the event of a serious illness. Wishes can change. The most recent and clear statement of intent is the one that counts. But it can't be some relative interpreting the patient's intent for them. The reason you need advanced directives is if the situation arises where a dnr is needed, the patient is usually too out of it to change it. ...Read moreSee 1 more doctor answer
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