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PERITONEAL DIALYSIS: FROM BASIC CONCEPTS TO CLINICAL EXCELLENCE (CONTRIBUTIONS TO NEPHROLOGY) 1ST EDITION BY C. RONCO (AUTHOR, EDITOR), C. CREPALDI (EDITOR), D.N. CRUZ (EDITOR)€12,17
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PERITONEAL DIALYSIS: FROM BASIC CONCEPTS TO CLINIC
PERITONEAL DIALYSIS: FROM BASIC CONCEPTS TO CLINIC
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PERITONEAL DIALYSIS: FROM BASIC CONCEPTS TO CLINICAL EXCELLENCE (CONTRIBUTIONS TO NEPHROLOGY) 1ST EDITION BY C. RONCO (AUTHOR, EDITOR), C. CREPALDI (EDITOR), D.N. CRUZ (EDITOR)
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PERITONEAL DIALYSIS: FROM BASIC CONCEPTS TO CLINIC
PERITONEAL DIALYSIS: FROM BASIC CONCEPTS TO CLINICAL EXCELLENCE (CONTRIBUTIONS TO NEPHROLOGY) 1ST EDITION
BY C. RONCO (AUTHOR, EDITOR), C. CREPALDI (EDITOR), D.N. CRUZ (EDITOR)
PERITONEAL DIALYSIS: FROM BASIC CONCEPTS TO CLINIC
PERITONEAL DIALYSIS: FROM BASIC CONCEPTS TO CLINIC
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PERITONEAL DIALYSIS FROM BASIC CONCEPTS
TO CLINICAL EXCELLENCE (CONTRIBUTIONS TO
NEPHROLOGY) 1ST EDITION
BY C. RONCO (AUTHOR, EDITOR), C. CREPALDI
(EDITOR), D.N. CRUZ (EDITOR)
what might excessively energetic movements or constantly watchful eyes suggest? ANSWER : tension, mania, anxiety, or metabolic disorder
what might a slumped posture or lack of facial expression indicate? ANSWER : depression or neurologic condition such as Parkinson disease
what might cause person disorientation? ANSWER : cerebral trauma, seizures, amnesia
what might cause place disorientation? ANSWER : psychiatric disorders, delirium, cognitive impairment
what might cause time disorientation? ANSWER : anxiety, delirium, depression, cognitive impairment
what is the most studied screening test for assessing cognition? ANSWER : Mini-Mental State Examination (MMSE)
What is included in the Mini-Cog screening tool? for what specifically is it testing? how is one determined negative? what is the sensitivity and specificity? ANSWER : - remember and repeat three unrelated words with no help - draw the face of a clock, put numbers on clock, draw hands to repeat a specific time
- repeat the three words again
- negative for dementia when all three words are recalled or when one or two words recalled and the clock face is normal
- sensitivity of 76-99%
- specificity of 89-96%
- successful in non-English and culturally diverse populations as well as varying levels of education
if you have concerns about the patient, what should you ask family members? ANSWER : has patient had problems with:
forgetting important appointments or events, paying bills, shopping independently for food or clothing, taking medication, getting lost while walking or driving, making decisions about daily life, asking the same thing again and again
list some signs of possible cognitive impairment: ANSWER : - significant memory loss
- confusion - impaired communication
- inappropriate affect
- personal care difficulties
- hazardous behavior
- agitation
- suspiciousness
what are the unexpected levels of consiousness? ANSWER : - lethargy (drowsy, when aroused responds appropriately)
- obtundation (sleepy, still drowsy when awakened, decreased alertness and limited interest in environment)
- stupor (responsive only to vigorous and repeated visual, verbal, and painful stimuli) - coma (unresponsive even with painful stimuli)
how many items are on the MMSE? what do they measure? how long does it take? ANSWER : - 11 items measuring: orientation, registration, attention, calculation, recall, language
- 10 minutes
what score on the MMSE is a positive screen for normal? what are the sensitivity and specificity values of this exam? ANSWER : - 25-30 normal
- 19-24 mild Alzheimer
- 10-19 moderate dementia
- <10 severe impairment
what does the inability to describe similarities or differences indicate? ANSWER : a lesion of the left or dominant cerebral hemisphere
what does inability to explain a fable, proverb or metaphor indicate? ANSWER : poor cognition, dementia, brain damage or schizophrenia
what might impairment of arithmetic skills indicate? ANSWER : may be associated with depression and diffuse brain disease
when writing, what might omission or addition of letters, syllables, words or mirror writing indicate? ANSWER : aphasia (impairment in language function), dementia, parietal lobe damage, cerebellar lesion, peripheral neuropathy
why are you testing for when asking a patient to comb their hair?
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