作為一位NP除了病患評估及處置外,最重要的就是病歷書寫,因為病歷記載了病患住院治療的一切,因此病歷應該書寫清楚,尤其當有法醫糾紛時,它就是法律上的證據喔!!!
簡報檔1(大家參考看看) 簡報檔2 簡報檔3
簡報檔1(大家參考看看) 簡報檔2 簡報檔3
- 11月 17 週一 200822:12
病歷書寫規範
- 11月 17 週一 200821:49
腹部檢查--身評影片
臨床上除了history taking外,最重要的就是physical exam, 好的PE對於臨床診斷是非常重要的~~
- 11月 17 週一 200817:35
Nimbex(Cisatracurium besylate)--肝腎衰竭可使用的肌肉鬆弛劑
Nimbex 是一種肌肉鬆弛劑,可作為外科手術前全身麻醉或加護病房鎮靜時的輔助劑，用以鬆弛骨骼肌，幫助氣管內插管，及機械性人工呼吸器的協調使用,優點:血壓不會影響,約80％的cisatracurium 在體內經由Hofmannelimination 機制代謝(非腎代謝)，缺點是起效時間約在90~120秒
詳細內容請按此
藥物彷單請按此
詳細內容請按此
藥物彷單請按此
- 11月 16 週日 200801:19
臨床診斷記憶術-CHF: causes of exacerbation
FAILURE:
Forgot medication
Arrhythmia/ Anaemia
Ischemia/ Infarction/ Infection
Lifestyle: taken too much salt
Upregulation of CO: pregnancy, hyperthyroidism
Renal failure
Embolism: pulmonary
Forgot medication
Arrhythmia/ Anaemia
Ischemia/ Infarction/ Infection
Lifestyle: taken too much salt
Upregulation of CO: pregnancy, hyperthyroidism
Renal failure
Embolism: pulmonary
- 11月 16 週日 200800:25
橫紋肌溶解症 --lifethreatening and requires quick recognition and treatment
在加護單位裡容易忽略的診斷，因位早期並無徵狀，唯有盡早找出病因並積極治療才不至惡化病況！！
The cascade of events that results in rhabdomyolysis begins with muscle injury secondary to a variety of causes. The quickest way to prevent the potentially life-threatening complications from this muscle disintegration is early and generous hydration. The precipitating event is usually evident from the patient's history. The differential diagnosis is best approached by categorizing the etiologic variables. The clinical features, however, are nonspecific. The large spectrum of presentation spans a continuum from asymptomatic myoglobinemia to renal failure. Rapid recognition and treatment of rhabdomyolysis are essential for a positive outcome
全文按此 取自台灣醫事檢驗學會
The cascade of events that results in rhabdomyolysis begins with muscle injury secondary to a variety of causes. The quickest way to prevent the potentially life-threatening complications from this muscle disintegration is early and generous hydration. The precipitating event is usually evident from the patient's history. The differential diagnosis is best approached by categorizing the etiologic variables. The clinical features, however, are nonspecific. The large spectrum of presentation spans a continuum from asymptomatic myoglobinemia to renal failure. Rapid recognition and treatment of rhabdomyolysis are essential for a positive outcome
全文按此 取自台灣醫事檢驗學會
- 11月 15 週六 200822:37
細菌性腦膜炎-2006
細菌性腦膜炎在臨床加護單位也是偶而會碰到的案例--此是一篇2006回顧性文章
abstract:
Bacterial meningitis is a medical, neurologic, and sometimes neurosurgical emergency that requires a multidisciplinary approach. Bacterial meningitis has an annual incidence of 4 to 6 cases per 100,000 adults (defined as patients older than 16 years of age), and Streptococcus pneumoniae and Neisseria meningitidis are responsible for 80 percent of all cases.A diagnosis of bacterial meningitis is often considered, but the disease can be difficult to recognize. Recommendations for antimicrobial therapy are changing as a result of the emergence of antimicrobial resistance. In this review we summarize the current concepts of the initial approach to the treatment of adults with bacterial meningitis, highlighting adjunctive dexamethasone therapy and focusing on the management of neurologic complications
abstract:
Bacterial meningitis is a medical, neurologic, and sometimes neurosurgical emergency that requires a multidisciplinary approach. Bacterial meningitis has an annual incidence of 4 to 6 cases per 100,000 adults (defined as patients older than 16 years of age), and Streptococcus pneumoniae and Neisseria meningitidis are responsible for 80 percent of all cases.A diagnosis of bacterial meningitis is often considered, but the disease can be difficult to recognize. Recommendations for antimicrobial therapy are changing as a result of the emergence of antimicrobial resistance. In this review we summarize the current concepts of the initial approach to the treatment of adults with bacterial meningitis, highlighting adjunctive dexamethasone therapy and focusing on the management of neurologic complications
- 11月 15 週六 200821:10
NP考試簡章出爐啦!!
97年度專師考試簡章終於出來啦,不知到今年的考題難度會如何??無論如何今年的考題不能像去年那樣偏頗!!
不然一定會廣大準專師罵死喔!而看看今年考試參考書目將近有30幾種喔~~真是大海撈針~~
希望各位準專師們加油喔~~而第一屆專師考試是從5000題庫中隨機抽取100題,但今年題目不知囉?
95年專師考題--內科進階照護 外科進階照護 專科護理通論
不然一定會廣大準專師罵死喔!而看看今年考試參考書目將近有30幾種喔~~真是大海撈針~~
希望各位準專師們加油喔~~而第一屆專師考試是從5000題庫中隨機抽取100題,但今年題目不知囉?
95年專師考題--內科進階照護 外科進階照護 專科護理通論
- 11月 15 週六 200820:45
全身性類固醇治療COPD的最佳治療劑量--文獻回顧/實証醫學證據
這是一篇取自台灣內科醫學會的內科學誌的一篇文章,主要對於COPD急性發作時全身性類固醇介入治療時所應選擇的最佳治療劑量,這是一篇回顧數十種文獻的文章並加註了實証等級!!
全文按此取自台灣內科醫學會
2007 COPD指引-取自The Global Initiative for Chronic Obstructive Lung Disease (GOLD)
全文按此取自台灣內科醫學會
2007 COPD指引-取自The Global Initiative for Chronic Obstructive Lung Disease (GOLD)