AF and stroke

Atrial fibrillation is a type of irregular heartbeat, often caused when the two upper chambers of the heart beat unpredictably and sometimes rapidly. These irregular heartbeats can cause blood to collect in the heart and potentially form a clot, which can travel to a person’s brain and cause a stroke.

(source: stroke.org)

中大醫學院為1700多名長者進行心房顫動篩查，發現有近7%有心房顫動……醫學院指出，及早發現病人有心房顫動的問題，可以減低中風的風險，計劃加強篩查和教育，及早提供治療。

(香港電台 – 6小時前)

坐骨神經痛

sciatica

tubigrip

(e.g.) pressure socks

assessment (orthopedic)

Pain (numerical rating scale)
pulse
color
sensation
swelling
movement
skin temperature
capillary refill
foot drop

NEATS (HA@HK)

non-emergency ambulance transfer service

DI and ADH

diabetes insipidus
antidiuretic hormone

清創術

debridement

acetabulum

The head of the femur meets with the pelvis at the acetabulum.

(source: en.wikipedia.org)

abbreviation

ToF: intertrochanteric fracture of femur
MBI: modified Barthel Index (ADL)
NRS: numerical rating scale
DHS: dynamic hip screw
TKR: total knee replacement
SCD: sequential compression device
DVT: deep vein thrombosis
PVD: peripheral vascular disease
N/V: neurovascular
AVN: avascular necrosis
C/ST: culture and sensitivity test
ERS: erythrocyte sedimentation rate
CRP: C-reactive protein
PICC: peripherally inserted central catheter
MES: Mistura Expectorants Stimulans
SFI: self-financed items
PCA: patient controlled analgesia
NF: necrotizing fasciitis

VFSS

videofluoroscopic swallowing study

NGT marking

nose to earlobe to xiphoid process

diet of patient

full diet
congee
soft rice
puree
minced

SBAR for 交更

communication tool

situation
background
assessment
recommendation

documentation

DAR format
data
action
response

clear, concise, complete, correct, current

standardized, spacing, sequence

creatinine

The creatinine blood test measures the level of creatinine in the blood. This test is done to see how well your kidneys work.

(source: nlm.nih.gov/medlineplus)

TIA

Transient ischemic attack is a "mini-stroke" and should be taken very seriously.

(source: strokeassociation.org)

stat

immediately

abscess and ascites

Abscess: a painful swollen part of your skin or inside your body that has become infected and is full of a yellowish liquid.

(source: hk.dictionary.search.yahoo.com)

Ascites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.

(source: nlm.nih.gov)

AT

alcohol hand rub before opening dressing set

heart disease

Ischemic heart disease is a disease characterized by reduced blood supply to the heart.

(source: sciencedaily.com)

Myocardial infarction (MI) (i.e., heart attack) is the irreversible necrosis of heart muscle secondary to prolonged ischemia.

(source: emedicine.medscape.com)

CPJ

cyanosis
pallor
jaundice

calcium channel blockers

The heart is mainly made of special muscle cells which contract to pump blood into the blood vessels (arteries). The walls of the arteries also contain 'smooth' muscle cells. When these contract, the artery narrows. The heart muscle cells and smooth muscle cells need calcium to contract. Calcium passes into these cells via tiny 'channels'.

Calcium-channel blockers reduce the amount of calcium that goes into these muscle cells. This causes these muscle cells to relax.

(source: patient.co.uk)

AR

The apical pulse is located midclavicular line, at the 5th intercostal space.

insulin

protaphane HM: long-lasting
actrapid HM: short-term

道德經譯文39

(經) 兵革是不祥的東西，人們都厭惡，所以有道的人不使用它。君子平時居處以左方為貴，用兵的時候則以右方為貴。兵革是不祥的東西，不是君子所用的東西，迫不得已而使用它，也要淡然處之。戰勝了也不要認為是好事，而認為是好事，就是喜歡殺人。喜歡殺人的人，就不可能在天下得到成功。

(傳) 魏惠王瑩與田侯牟締結盟約，田侯牟違背盟約，魏惠王瑩憤怒，準備派人去刺殺他。
        將軍公孫衍聽了而感到恥辱，就說︰"君為大國的國君，卻用匹夫的手段來報仇! 我請您給我甲兵二十萬，為您攻打他。俘虜他的人民，掠取他的牛馬，使他的君主內心焦急而病發於背，然後拔取他的國家。田忌戰敗逃亡，然後鞭打他的脊背，折斷他的脊梁。"
        季子聽了而感到恥辱，就說︰"壘築十仞高的城牆，城牆已經十仞高了，而又毀壞它，這是徒役者所苦的事。現今已有七年不打仗了，這是王業的基礎。公孫衍是個好亂的人，不能聽他的。"
        華子聽了而感到羞愧，就說︰"花言巧語說要討伐齊國的人，是好亂的人；花言巧語說不要討伐齊國的人，也是好亂的人；講主張討伐齊國和不主張討伐齊國的人是好亂的人的，也是好亂的人。"
        君王說︰"那麼該怎麼辦?"
        華子說︰"君王求虛靜之道就是了!"
        惠子聽了之後就引見戴晉人。戴晉人說︰"有名叫蝸牛的東西，君王知道嗎?"
        君王說︰"知道。"
        戴晉人說︰"蝸牛的左角有個國家叫觸氏，右角有個國家叫蠻氏，常常為了爭奪土地而打仗，死亡數萬，追逐敗軍十五天才回來。"
        君王說︰"噫! 這是虛話嗎?"
        戴晉人說︰"臣請為君證實它。君主認為上下四方有窮盡嗎?"
        君王說︰"沒有窮盡。"
        戴晉人說︰"知道遊心於無窮的境域，而返回於通達之國，好像若有若無嗎?"
        君王說︰"是的。"
        戴晉人說︰"通達國中有魏國，魏國中有梁，在梁中有君王。君王和蠻氏，有分別嗎?"
        君王說︰"沒有分別。"
        戴晉人告辭出來而君王悵然若有所失。
        客人出來，惠子進見。君王說︰"客人，是大人啊，聖人也不足以和他相提並論。"
        惠子說︰"吹管的，還有聲音；吹劍首的，只有一絲響聲而已。堯舜，是人們所讚譽的。在戴晉人面前講堯舜，就好比一絲響聲罷了。"

EPR and CDDH

electronic patient record
corporate drug dispensing history

ILI and CAP

influenza like illness
community acquired pneumonia

reflex

The plantar reflex is a reflex elicited when the sole of the foot is stimulated with a blunt instrument.

(source: en.wikipedia.org)

Babinski reflex is one of the reflexes that occurs in infants. Reflexes are responses that occur when the body receives a certain stimulus.

The Babinski reflex occurs after the sole of the foot has been firmly stroked. The big toe then moves upward or toward the top surface of the foot. The other toes fan out.

(source: nlm.nih.gov/medlineplus)

TOCC

travel occupation contact cluster

TGR

tenderness
guarding
rigidity

tumor marker

Blood tests can be done to check for a substance called AFP (alpha-fetoprotein). People with liver cancer often have high AFP levels. Doctors also can compare the AFP levels before and after treatment to see how well the treatment is working.

(source: cancer.org)

The carcinoembryonic antigen (CEA) test measures the amount of this protein that may appear in the blood of some people who have certain kinds of cancers, especially cancer of the large intestine (colon and rectal cancer). It may also be present in people with cancer of the pancreas, breast, ovary, or lung.

(source: webmd.com)

PSA: prostate specific antigen

alpha-blocker (-zosin)

Treating high blood pressure or benign prostatic hyperplasia (BPH).

Minipress is an alpha-blocker. It works by causing the blood vessels and the muscles around the urethra to relax. This helps to lower blood pressure and to improve urinary symptoms associated with enlargement of the prostate.

(source: drugs.com)

T2N0M0

The TNM staging system is based on the size and/or extent (reach) of the primary tumor (T), whether cancer cells have spread to nearby (regional) lymph nodes (N), and whether metastasis (M), or the spread of the cancer to other parts of the body, has occurred.

(source: cancer.gov)

abbreviations

CBC: complete blood count
FFP: fresh frozen plasma
OGD: oesophago-gastro-duodenoscopy

NSTEMI: non-ST segment elevation myocardial infarction

PTCA: percutaneous transluminal coronary angioplasty

PCI: percutaneous coronary intervention

CABG: coronary artery bypass graft

inguinal hernia

These include incisional, epigastric, and umbilical hernias in children and adults.

An inguinal hernia occurs when tissue pushes through a weak spot in your groin muscle. This causes a bulge in the groin or scrotum. The bulge may hurt or burn.

You are more likely to get a hernia if you are overweight or you do a lot of lifting, coughing, or straining. Hernias are more common in men. A woman may get a hernia while she is pregnant because of the pressure on her belly wall.

(source: webmd.com)

TACE

Transcatheter arterial chemoembolization (TACE) is a minimally invasive procedure performed in interventional radiology to restrict a tumor's blood supply. Small embolic particles coated with chemotherapeutic agents are injected selectively into an artery directly supplying a tumor.

(en.wikipedia.org)

HCC and ICG

Indocyanine green (ICG), an organic anion used in liver function tests, is known to accumulate in hepatocellular carcinoma (HCC) tissues after an intravenous injection.

(source: journalofsurgicalresearch.com)

warfarin diet

One nutrient that can lessen warfarin's effectiveness is vitamin K. It's important to be consistent in how much vitamin K you get daily. While eating small amounts of foods that are rich in vitamin K shouldn't cause a problem, avoid eating or drinking large amounts of:

• Kale
• Spinach
• Brussels sprouts
• Parsley
• Collard greens
• Mustard greens
• Chard
• Green tea

Certain drinks can increase the effect of warfarin, leading to bleeding problems. Avoid or drink only small amounts of these drinks when taking warfarin:

• Cranberry juice
• Alcohol

(source: mayoclinic.org)

purine diet

Purines (specific chemical compounds found in some foods) are broken down into uric acid. A diet rich in purines from certain sources can raise uric acid levels in the body, which sometimes leads to gout. Meat and seafood may increase your risk of gout. Dairy products may lower your risk.

(source: webmd.com)

response levels

alert response level
serious response level
emergency response level

PEARL

pupils equal and reactive to light

ACEI side effect

As many as one-third of the people who take widely prescribed cardiovascular drugs called angiotensin-converting enzyme inhibitor develop a dry, hacking cough.

Duoderm

A hydrocolloid dressing (Duoderm) is an opaque dressing for wounds. A hydrocolloid dressing is biodegradeable, non-breathable, and adheres to the skin, so no separate taping is needed.

In contact with wound exudate, the polysaccharides and other polymers absorb water and swell, forming a gel which is held within the structure of the adhesive matrix.

The moist conditions produced under the dressing are intended to promote fibrinolysis, angiogenesis and wound healing, without causing softening and breaking down of tissue.

Hydrocolloid dressings are used for pressure ulcers.

(source: en.wikipedia.org)

suction force

80-120 mmHg
below 200 mmHg

abbreviations

CVVH: continuous veno-venous hemofiltration
HP: helicobacter pylori
Hba1c: glycated hemoglobin
mane: tomorrow
NPA: nasal pharygeal aspiration (influenza)

ATT: Antitetanus Toxoid (vaccination)

complications of diabetes

neuropathy
nephropathy
retinopathy

OGTT

Though not routinely used anymore, the oral glucose tolerance test (OGTT) is the gold standard for making the diagnosis of type 2 diabetes. However, it is still commonly used for diagnosing gestational diabetes.

(source: webmd.com)

Troponin I

A troponin test measures the levels troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack.

(source: nlm.nih.gov/medlineplus)

PND

Paroxysmal nocturnal dyspnea (PND) is a sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position.

(source: ncbi.nlm.nih.gov)

NIDDM and IDDM

Diabetes mellitus type 2 (NIDDM) is a metabolic disorder that is characterized by hyperglycemia in the context of insulin resistance and relative lack of insulin. This is in contrast to diabetes mellitus type 1, in which there is an absolute lack of insulin due to breakdown of islet cells in the pancreas.

(source: en.wikipedia.org)

ST elevation

The ST segment is the flat, isoelectric section of the ECG between the end of the S wave (the J point) and the beginning of the T wave.

It represents the interval between ventricular depolarization and repolarization.

The most important cause of ST segment abnormality (elevation or depression) is myocardial ischemia or infarction.

(source: lifeinthefastlane.com)

Tenckhoff cath

Peritoneal dialysis was first used for the management of end-stage renal disease in 1959. In 1968, Henry Tenckhoff developed the indwelling peritoneal catheter, which was placed via an open surgical technique.

(source: http://emedicine.medscape.com)

wound dressing documentation

exudate: (amount) scanty, moderate, excessive
               (type) serous, blood stained, purulent, hemopurulent
tissue: hyper-granulation (?), granulation, slough, eschar

Granulation tissue is new connective tissue and tiny blood vessels that form on the surfaces of a wound during the healing process. (source: en.wikipedia.org)

reverse isolation

positive pressure
transplantation
immunosuppresant

OA and RA

osteoarthritis and rheumatoid arthritis

CABG

Coronary artery bypass graft surgery (CABG) is a procedure used to treat coronary artery disease in certain circumstances. (source: google)

atrial fibrillation

AF occurs if rapid, disorganized electrical signals cause the heart's two upper chambers—called the atria —to fibrillate. The term "fibrillate" means to contract very fast and irregularly.

(source: nhlbi.nih.gov)

DKI drip

dextrose
insulin
potassium

Resonium A and C

Resonium A is an ion-exchange resin that is recommended for the treatment of hyperkalaemia associated with anuria or severe oliguria. It is also used to treat hyperkalaemia in patients requiring dialysis and in patients on regular haemodialysis or on prolonged peritoneal dialysis.

(source: medicines.org.uk)

Calcium resonium powder contains the active ingredient calcium polystyrene sulphonate, which is a type of medicine called an ion exchange resin.

Calcium polystyrene sulphonate binds with potassium in the gut, forming a complex that cannot be absorbed into the blood. This effectively reduces the levels of potassium in the bloodstream.

(source: netdoctor.co.uk)

urine output

less than 30mL per hour
bladder scan and report

gout medications

Allopurinol: long-term
Colchicine: acute

Braden scale

pressure sore risk

TLSO

thoracolumbar sacral orthosis brace

blood transfusion

hemoglobin level less than 8 g/dL

靜脈曲張

varicose veins
pressure stocking

CTLSC

cervical
thoracic
lumbar
sacral
coccyx

MSU

http://www.nhs.uk/chq/Pages/how-should-i-collect-and-store-a-urine-sample.aspx?CategoryID=69&SubCategoryID=692

ESBL

Bacteria that produce enzymes called extended-spectrum beta-lactamases (ESBLs) are resistant to many penicillin and cephalosporin antibiotics and often to other types of antibiotic.

(source: gov.uk)

name of fingers

thumb
I/F index finger
M/F middle finger
R/F ring finger
L/F little finger

bones of hand

distal phalanges
intermediate phalanges
proximal phalanges
metacarpals
carpals

Hibitane

Chlorhexidine gluconate is an antiseptic effective against a wide range of bacteria, yeasts, some fungi and viruses. It is most active at a neutral or alkaline conditions. Its activity is reduced by the presence of blood or body fluids. It binds strongly to skin, mucosa and other tissues and is therefore poorly absorbed.

(source: netdoctor.co.uk)

Timentin

Ticarcillin and clavulanate

debridement

the removal of damaged tissue or foreign objects from a wound
(google translate)

MEWS

Modified early warning score

systolic blood pressure
heart rate
respiratory rate
temperature
level of consciousness

Scoliosis

Scoliosis causes a sideways curve of your backbone, or spine. These curves are often S- or C-shaped. Scoliosis is most common in late childhood and the early teens, when children grow fast. Girls are more likely to have it than boys. It can run in families. Symptoms include leaning to one side and having uneven shoulders and hips.

(source: nlm.nih.gov)

Cellulitis

Cellulitis is a common skin infection that happens when bacteria spread through the skin to deeper tissues. Most cases are mild and last several days to a couple of weeks. But cellulitis can sometimes progress to a more serious infection, causing severe illness that affects the whole body (sepsis) or other dangerous problems.

(source: webmd.com)

IV A+C

ampicillin cloxacillin

rheumatoid factor

Rheumatoid factor (RF) is the autoantibody (antibody directed against an organism's own tissues) that was first found in rheumatoid arthritis.

(source: google)

ORIF

An open reduction and internal fixation (ORIF) is a type of surgery used to fix broken bones. This is a two-part surgery. First, the broken bone is reduced or put back into place. Next, an internal fixation device is placed on the bone. This can be done with screws, plates, rods, or pins that are used to hold the broken bone together.

(source: bidmc.org)

I&D

incision and drainage

potassium serum level

3.5 - 5.0 mmol/L
one mole = 6.0221415×10²³

mouth washing

thymol gargle
1︰3

繃帶卷闊度

上肢: 2 吋
下肢: 3 吋
軀幹: 6 吋

Routine (A/P)

0630 交更
0640 Treat bed
         Vital signs
         H'stix
         打針
0700-0715 食早餐 (1st)
                   HCA 開水: 洗面 (Treat mouth)
                   Charting/BW
0800 AOM
         R/T feeding / PEG feeding
         食早餐 (2nd)
0805 Pt 食早餐 (assist/chart I&O)
0845 Dressing (sores/routine wound)
         跟巡房 / treatment (Rx)
0930-0945 2nd routine
                   (fever R/C temp.)
1030 Tea 1st
1100 打12N針
         round 片/ turning
12N 上 Ryle's / PEG 奶 / AOM
1215 H'stix

1245-1300 派Pt餐, Chart I&O
1330 交更
         Bed bath / round 片/ turning
         Routine (R/C fever temp, 問有無BO)
         Charting
1430 跟 treatment
1530 Tea 1st
1600 上 Ryle's / PEG 奶 / AOM / 打針
1630 2nd routine (R/C fever temp.)
1715 H'stix
1800 派餐 / Chart I&O
1830 食1st
1930 round 片/ turning / 食2nd
         上PEG奶/Ryle's (H'stix / 打針)

on-going 要做: PRN Dressing / Q1H / 上 IVF / resuscitation

five rights

drug
time
dosage
patient
route

FMN

fast midnight
fast after midnight (FAMN?)

aneurysm

It is a localized, blood-filled balloon-like bulge in the wall of a blood vessel
(source: wikipedia.org)

hematuria

presence of red blood cells in the urine

Fistula-in-ano

An anal fistula is a small channel that develops between the end of the bowel, known as the anal canal or back passage, and the skin near the anus. (source:uhs.uk)

RU

post-void residue urine test by ultrasound

CISC

clean intermittent self-catheterization

urination (case study)

dysuria: 排尿困難

Cystoscopy is a test that allows your doctor to look at the inside of the bladder and the urethra using a thin, lighted instrument called a cystoscope . The cystoscope is inserted into your urethra and slowly advanced into the bladder. (source: google)

drink more water to prevent clotting

elimination

BO bowel open
PU passed urine (by patient himself?)
WN wet napkin
WB wet bed

rubbish bag

紅: 醫療廢物
黑: 一般廢物

droplet precaution

close contact
3 feet

short form

a.c. before meal
p.c. after meal

b.i.d. twice a day
q1h every one hour
q.i.d. 4 times a day

NPO nil by mouth
p.o. by mouth

color of thermometer

red: rectal
blue: oral

heart rate

tachycardia (more than 100 bpm)
bradycardia (less than 60 bpm)

Ambu bag

bag valve mask

CSSD

central sterile services department

Autoclaving

1. An autoclave is a pressure chamber used to sterilize equipment and supplies by subjecting them to high pressure saturated steam at 121 °C for around 15–20 minutes depending on the size of the load and the contents. (source: google)

Kaltostat

In the presence of exudate or other body fluids containing sodium ions, the fibres absorb liquid and swell and calcium ions present in the fibre are partially replaced by sodium, causing the dressing to take on a gel-like appearance.
(More: http://www.dressings.org/Dressings/kaltosta.html)

providing incontinence care

Assessment
Assess the patient's ability to perform perineal care
Assess for the presence of irritation, excoriation, inflammation and swelling

Planning
Perform hand hygiene
Prepare necessary equipments:

• commercially prepared package washcloth/moistened cotton wool pads
• incontinent sheets
• napkin
• clean linens: gown/pyjamas, bath blanket, top and bottom sheets, draw sheet
• clean gloves
• linen hamper
• ZnO cream
• disposable plastic bag or receptacle

Implementation

Gather equipment and bring to client's bedside

Identify the patient

Explain the procedure and gain cooperation

Provide privacy

Perform hand hygiene and adopt other appropriate infection control precautions

One nurse works on one side of the bed and the second nurse on the other side

Prepare the bed, and position the client appropriately

• raise bed to comfortable working height. Lower side rails
• remove top linens. If the linens are reused, place them on the bedside table/chair
• assist client in a dorsal recumbent position (lying down/legs flex)

The other nurse works on the opposite side.

Don gloves

Loosen pants or gown

• keep client covered by bath blanket if desired
• expose perineum

Observe skin condition for any presence of irritation, excoriation, inflammation and swelling. 

Place incontinent sheet under the buttock

Clean the soiled area by cleansing from tip of penis down to shaft. Pay attention to the gluteal folds, scrotal folds.

Cleansed tip of penis at urethral meatus using circular motion. Then cleanse shaft of the penis and scrotum. Cleansed the scrotum and the underlying skinfolds carefully

Use a clean washcloth for each area of the perineum in order to prevent cross contamination

Roll up the front side of the napkin

Pull or roll the client to the lateral position

Thoroughly clean up the fecal elimination with cotton swaps and thoroughly dry the area

Apply protective skin barrier cream if indicated.

Remove and discard the gloves and wash the hands

Change the draw sheet or the linen if soiled

Put the new napkin in correct position

Lie flat the client and adjust the position of the napkin

(Avoid any shearing force, roll the client back and forth if need to adjust the position of the napkin)

Palpitations

Heart palpitations are a feeling that your heart is beating too hard or too fast, skipping a beat, or fluttering. (source: webmd.com)

TNG

Glyceryl Trinitrate 0.5mg
sublingual medication
吃一粒，五分鐘後仍有心絞痛，再服一粒，最多服三粒。

MRSA

Methicillin-resistant Staphylococcus aureus

puree diet

A pureed diet is in between a full liquid diet and a mechanical soft diet in consistency.
(source: nutrition.about.com)

EVD

external ventricular drainage

VP shunt

ventriculoperitoneal shunting

hydrocephalus

Abnormal accumulation of cerebrospinal fluid in ventricles of the brain

CT

computed tomography

BPH and TURP

Benign prostatic hyperplasia
Transurethral resection of the prostate

Combivent

Ventolin (Salbutamol) + Atrovent (Ipratropium bromide)
Ventolin (short-acting β2-adrenergic receptor agonist)
Atrovent (anticholinergic bronchodilator)

SaO2 and SpO2

arterial oxygen saturation
peripheral capillary saturation?

DNR

Do not resuscitate

PEG

percutaneous endoscopic gastrotomy

AROU

acute retention of urine
foley insertion
cath once?

H'stix

Normal blood glucose level is 4-8 mmol/L
(fasting: 3.9-6.1 mmol/L)