Deteriorating

Question 1

What are the levels of ECOG?

Answer 1

0. fully active
1. can carry out light work but limited physically stenous activies
2. is capable for more then 50% of the day but cannot carry out any work acitivies
3. capable of limited self care for less then 50% of the day
4. completely disabeled
5. dead

Question 2

What are some common changes in patient presentation? (10)

Answer 2

1. changed mental status
2. drowsy
3. nausea and vomitting
4. agitated/agressive
5. depressed
6. increase pain
7. neurological deficit
8. flushed
9. hot/feverish
10. dry

Question 3

What are some possible conditions causing changes in patient presentation?

Answer 3

1. metabolic
2. septic
3. malignant
4. medications
5. psychiatric

Question 4

What are some metabolic changes that can affect patients?

Answer 4

• hypercalcemia
• diabetetic
• dehydrated
• acute organ failure

Question 5

What are some septic changes that can affect patients?

Answer 5

• sepsis
• low blood count so they behave differen
• UTI

Question 6

What are some malignant changes that can affect the patient?

Answer 6

• spincal cord compression

- cerebral secondaries

Question 7

What are some medication changes that can affect the patient?

Answer 7

• dexamethasone (pushes up blood sugar, motivated or depressed, can’t sleep)
• morphine (relaxed, nausea, confused)

Question 8

How do you deal with patients with delirium?

Answer 8

• bring them back to reality
• put on bright lights
• talk softly
• take away anything they may have that is dangerious
• be caucious

Question 9

What are some symptoms that suggest a patient has cerebral secondaries?

Answer 9

• early morning headaches
• nausea and vomitting
• forgetful
• difficulty expressing words
• uncoordinated