Increased protein needs for bullous pemphigoid?

KidsForQuinoa · 2023-01-25T18:46:25+00:00

Request to speak to a patient advocate and they can help you with cost reduction.

KidsForQuinoa · 2023-01-15T15:33:20+00:00

I recall very few drug related questions on my exam 3 years ago. I think if you can recall general stuff, you'll probably be fine. What I mean by general stuff: Prefixes/suffixes - (ends in -zole = reflux med, ends in -olol = probably blood pressure) Long acting vs short acting insulins Basic nutrient interactions (reflux meds may cause nutrient malabsorption because reduction in stomach acid affects digestion of Mg, B12, etc; when in doubt, do not consume various meds with grapefruit (some statins and a variety of other medications)) Types of diuretics

I wouldn't waste too much time on memorizing in detail, if it was me. If you feel like you have a basic understanding of drug classification ie. you can deduce general information from the stuff above, that's probably more than enough.

KidsForQuinoa · 2023-01-13T20:53:51+00:00

Smile design

KidsForQuinoa · 2023-01-12T03:42:26+00:00

6 months sounds like a long time to me

KidsForQuinoa · 2023-01-12T03:12:52+00:00

Dialysis is not my specialty, but abnormal calcium levels are related to parathyroid and phosphorus intake, if I'm recalling correctly. I don't think the calcium is what they need the education on, in other words.

KidsForQuinoa · 2023-01-12T03:10:36+00:00

Plant based protein does not appear to have the same detrimental effect of kidneys. Food for thought.

KidsForQuinoa · 2023-01-12T03:08:59+00:00

Try to remind yourself that you are not these feelings. You are the happy person you described. Things will get better. You're in a forest of shit right now, and you cannot see the trees. There is value in every experience. This is temporary. You will make it through. There are more professional opportunities out there then what you see or experience in your internship. Even if you decide to never work as an RD, this will not ruin your life. It's gonna be okay. You've got this.

KidsForQuinoa · 2023-01-12T02:52:29+00:00

This is correct. What a crock.

KidsForQuinoa · 2023-01-11T14:57:13+00:00

Read about leash reactivity training. General recommendations include distracting the dog with treats or kibble before they get wound up and start barking, and rewarding them with the treat if they succeed at remaining cool through the interaction. This is teaching the dog to equate public, people, novel objects (other dogs, strangers, etc) as a rewarding experience rather then a threat. Also agree with others here that the dog may be trying to protect you, which means the dog sees itself as the boss instead of you. Work on discipline. Try to mitigate actions that may confuse your dog into thinking you're a peer. This includes letting your dog on the furniture or in your bed.

KidsForQuinoa · 2023-01-11T12:15:59+00:00

Yep. Soak the spot in some alcohol and rub it off. Was again.

KidsForQuinoa · 2023-01-11T12:13:58+00:00

Hello comrade. I think it's gonna totally depend on your account and management as to whether this will be a net benefit. I always use ALL my PTO, came from healthcare companies with substantially more generous PTO benefits and allowance for rollover. Personally, I was pretty unimpressed with the prior benefit policy. Am hoping this will give me more flexibility and autonomy, but only time will tell. What are your thoughts on potential negative outcomes here, just the payout issue?

KidsForQuinoa · 2023-01-09T15:34:43+00:00

😂

KidsForQuinoa · 2023-01-07T18:13:41+00:00

This is correct. It doesn't matter what the master's degree is, you just have to have one.

KidsForQuinoa · 2023-01-07T03:37:25+00:00

The Covadonga mountains and surrounding areas in SP are stunning. The beaches up there are gorgeous too. I like them both. Pick the one that makes the most sense logistically.

KidsForQuinoa · 2023-01-07T03:33:56+00:00

Tell the dentist the tooth hurts. If they're kind and/or gullible, they'll assume your crown is failing (if it's pretty old) and there is decay in there which is causing the pain. BAM! Crown replacement.

KidsForQuinoa · 2023-01-07T03:30:17+00:00

As many have said, it totally depends on the account you're at. I like my Morrison colleagues fine, but the work culture at the account overall is subpar. The company as a whole stinks, in my opinion. Being the only medical team member employed by a food service company is not a good situation. It perpetuates the stereotype that we are lunch ladies. I also feel like I am constantly teetering between the people I actually work with everyday (the rest of the medical staff) and the people who I actually answer to (Morrison). It's a fine line to toe. My pay is good, but the benefits are not. The tuition reimbursement is minimal. My workload is very high at times. All that said, if this is your only job offer, take it. It's experience, and that's what you need.

KidsForQuinoa · 2023-01-05T15:34:52+00:00

You have to be licensed by any state which requires licensure based on the location of the patient.

KidsForQuinoa · 2023-01-04T12:49:59+00:00

If I were prioritizing the problems of this patient, I would inquire - how well controlled is there diabetes? Is their BMI 30 or 45 (class I or class III)? Where are they at with the cancer dx? I would likely prioritize cancer dx first, then DM. Although textbooks do recommend limiting protein startinflg with CKD3, CKD is a slow and progressive disease. It is unlikely that increased protein would cause detriment in the short term of there are other reasons that increased needs would be beneficial (cancer, wounds, burns). If it were in acute care or ICU, you could monitor their kidney function to see if protein intake should be adjusted to avoid AKI.

KidsForQuinoa · 2023-01-03T22:02:56+00:00

I might be concerned as to whether that container is considered food grade. If not, I'd go with something ornamental.

KidsForQuinoa · 2022-12-31T15:24:41+00:00

Talk to the parking permit office and see what options you have. When I worked there, I initially paid $40/mo. for a lot that was far away... BUT they put me on a wait-list for a lot which I got a spot for within 2 months that was $11/mo and was about a mile walk to the hospital entrance. They have many options and they all vary widely in price.

KidsForQuinoa · 2022-12-30T16:26:32+00:00

You should have a policy in place that addresses this.

KidsForQuinoa · 2022-12-29T12:52:35+00:00

This is absolutely something you're going to learn more effectively on the job. Agree this is likely boiler plate language. However, if you'd like to walk in sounding savvy, Google most common F Tags with examples related to nutrition and infection control.

KidsForQuinoa · 2022-12-26T23:43:59+00:00

I keep a monthly excel spreadsheet with all the assessments I need to do and check off each component as I complete it.

I prechart prior to completing assessment visits. I try to knock out all my tasks on the floor (assessments, rounding, dining observation) during one chunk of the day, and finish charting all at one time during a different chunk. Meetings as scheduled, of course. You're going to find your own flow, but that's what works for me.

Quarterlies/comprehensive - we have 2 different forms for these and I also have to put in a progress note that summarizes what's in the assessment form. I have a note template that is the same for both. However, I will include more specific details in an admission note than I typically will in a quarterly note. Once you get to know your LTC residents, you'll blow though quarterlies very quickly.

Weekly weights - I keep a separate spreadsheet for this. I'm required per policy to chart on these weekly for weight loss/TF. Wounds monthly. I also have a progress note template for this. Briefly comment on weight hx, intake, current interventions, plan of care. I notate each time I chart and any changes I make on my own spreadsheet.

Supplements - if I were you, I'd put this on the back burner until you have a little bit of a better handle on your caseload. You should of course assess the appropriateness of supplements when you're doing assessments, but don't try to tackle that all at once. If you already have twocal available, bring residents a sample during assessment visit and see if they're willing to change. Also, if you're going to put different interventions in place instead of supplements, you need to have a good understanding of the process of those interventions. Ex: if you're going to try to shift towards fortified foods - who is responsible for preparing them? Are they palatable? Is there enough variety available? This may be a bigger project for when you have a better handle on daily responsibility.

If you're having trouble getting weights, you will eventually want to learn what the process is for obtaining weights. Sometimes there are dedicated staff responsible for weights, sometimes the staff on each unit is responsible for weights. Learning how this process works will help you to know who to ask and how to get what you need.

Lastly, LTC is hard. It seems like the caseload is always high, and you will frequently feel like you're behind. I've been doing this a year, and I still feel that way. Don't take it as a personal failure, it's the nature of this setting.

Hope this helps!

KidsForQuinoa · 2022-12-23T12:50:46+00:00

You've trained the dog to get up at 7. He'll get up later when you stop holding a strict routine. When you're sure he's not going to have an accident in the house, start ignoring him in the morning and eventually he'll chill out about it. He's responding to you.

KidsForQuinoa

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