9월 23일 강의 FREE

1. OO OP위해 Spous와 함께 입원 했는데 HIV 진단 받았다. 가장 먼저 우선해야할 것은?

① Spous가 같이 검사 받고 치료하기를 거부한다.

② 다른 환자와 격리한 뒤 독방준다.

③ 배우자를 먼저 나가게 한 뒤 최근에 복용한 약물이 뭔지 사정한다.

④ standard precaution 적용하며 op준비한다.

A husband is not required to sign for a wife's HIV test consent form; consent must be provided by the individual being tested, as HIV testing is a voluntary and personal medical decision requiring informed consent from the patient. The signing of the form by a husband would generally only occur if he is a legal guardian providing proxy consent on behalf of a minor or incapacitated individual, which is not the case for a consenting adult.

Perioperative Management

Continue ART:

Maintain ART regimens during the surgical period to keep viral load low.

Prophylaxis for Opportunistic Infections (OIs):

For patients with low CD4 counts (e.g., &200 cells/mm³), continue or substitute appropriate medications to prevent opportunistic infections like Pneumocystis jirovecii pneumonia (PJP).

Standard Precautions:

Employ universal precautions to prevent exposure to blood and body fluids during surgery.

Use personal protective equipment (PPE):

Wear disposable gowns, masks, protective eyewear, gloves, and boots to minimize the risk of occupational exposure.

Postoperative Care

Monitor for Complications:

Watch for increased risk of postoperative complications, such as surgical site infections, sepsis, or opportunistic infections, especially in patients with AIDS or low CD4 counts.

Continue Postoperative ART:

Ensure the patient continues their ART regimen to maintain viral suppression.

Manage fever, anemia, and tachycardia:

These are common postoperative symptoms in HIV-infected patients and require careful monitoring and management.

2.AAA 증상중 immidiatly 봐야하는 것 ?

severe back pain

bruit sound

갑자기 구토

abd girth

3.디곡신 부작용

서맥,

시야흐림,

오심

anorexia

hypo k

4.Nitrofurantoin 우선순위

호흡곤란 호소

darked urine

nausea and vomitting

Dyspnea (shortness of breath) is a serious potential side effect of nitrofurantoin, indicating lung toxicity, which can range from mild to severe. This reaction can manifest as an acute hypersensitivity pneumonitis with sudden onset of symptoms like fever, chills, and dyspnea, or as a chronic lung disease with progressive difficulty breathing and coughing. If you experience dyspnea or other breathing problems while taking nitrofurantoin, you must seek immediate medical attention

5. DI 인 환자에게 DI 에 대해 teaching 한다. sata

나는 dry mouth 를 느낄것이다.

소변이 예전보다 많이 나올것이다.

Concentrate urine 이 있을것이다.

이건 excessive ADH 이다.

오줌이 나온만큼 fluid 를 먹어야 한다.

hct. hb이 감소될것이다.

which would be production of more concentrated urine.

6. DI 환자에게 주면 안되는 수액 고르기

5% destrose sodium

5% dextrose water

NS 0.9% IV

Ringer’s solution

7.자간전증 lab 옳은 거 고르기

bp 140/90

sgot sgpt

Low platelet

DTR

8.PICC 관리 옳은거

약간 저항감이 있다면 힘을 살짝 줘서 플러싱한다

15초동안 소독한다

Chlorhexidine-impregnated sponge or dressing 사용한다

멸균장갑 착용한다

9.의식없는 사람 중재 Pinpoint eye 양팔에 홍반 .

ngn.마라톤아저씨 icu.er실려온 정체불명 흰색파우더 먹은 아저씨

NGN .멘탈없이 응급실에 입원(호흡수 한자리, pinpoint pupil) 지금 봐야해줘야할 파트 -> 아편 중독 증상같은 모습 -> ✅호흡계중재 -> 환자 신원 조회하니, 아동이랑 다른 폭력 범죄

- 진단

opioid toxicity

nalcotic cephalopathy

delirium trimens

opioid intoxification

10.multiple sexual partner 있고 팔에 주사자국 많고 출산한지 얼마 안된 22살여자가

멘찰 좀 처지고 의욕없이 왔다 NGN으로 엄청 물어 봤어염 ;의심되는 진단명.SATA

gonorrhea

chlamedia

HPV

HCV.HBV

11. Heroin 환자 증상 sata

PUD

chronic sinusitis

insomnia

lacrimation

nausea and vomitting

What are the withdrawal symptoms associated with opioids?

The opioid withdrawal syndrome is often characterised as a flu-like illness, subjectively severe but objectively mild. Signs and symptoms include dysphoria, insomnia, pupillary dilation, piloerection, yawning, muscle aches, lacrimation, rhinorrhea, nausea, fever, sweating, vomiting and diarrhoea

12.heroin opioid  withdrawal 증상sata

rhinorrhea,

lacrimation

dilated pupil #

drowsy

irritable

13.Opioid withdrawal  sata

n/v,

diarrhea

lacrimation

발한

고혈압

Opioid withdrawal symptoms typically include dilated pupils (mydriasis) rather than constricted pupils (miosis). Miosis, or pupil constriction, is more commonly associated with opioid intoxication or overdose, not withdrawal.

14.Opioid intoxication SATA

euphoria,

miosis

confusion

insomnia

Altered mental status, such as confusion, delirium, or decreased awareness or responsiveness

Breathing problems (breathing may slow and eventually stop)

Extreme sleepiness or loss of alertness

Nausea and vomiting

Small pupils

15. 부모님이 하얀가루를 먹었어요~

검사결과: 마리화나, 코카인, 벤조디아제핀인가?

(물질남용)

16.total hip replacement sugery 한 환자, rehab에서 전에 썼던 통증약이 좋았다고 계속 말함, 염증 수치 정상, 시술 부위 주변에 붉고 부풀었음

환자가 겪고 있는 2가지

(narcotic drug 의존증) (narcotic intoxification)

total hip replacement sugery 한 환자, rehab에서 전에 썼던 통증약이 좋았다고 계속 말함, 염증 수치 정상, 시술 부위 주변에 붉고 부풀었음

환자가 겪고 있는 2가지 (narcotic drug 의존증)  (narcotic intoxification)