{"id":142,"date":"2024-03-06T01:12:11","date_gmt":"2024-03-06T06:12:11","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/?post_type=chapter&#038;p=142"},"modified":"2024-04-10T09:37:51","modified_gmt":"2024-04-10T13:37:51","slug":"2-4","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/chapter\/2-4\/","title":{"raw":"2.4 Acute Episodic Illness","rendered":"2.4 Acute Episodic Illness"},"content":{"raw":"<h2>Common Episodic Conditions<\/h2>\r\nLTC Pearls for differential diagnosis during an acute change:\r\n<ul>\r\n \t<li>Differential diagnosis will be often based on your physical exam and subjective information<\/li>\r\n \t<li>Medications, delirium, review of intake and output, falls, vitals, LOC, etc.<\/li>\r\n \t<li>Atypical presentation is common, behavioural changes are common<\/li>\r\n \t<li>Availability of labs in your LTC<\/li>\r\n \t<li>Responsibility of potential recognition of an outbreak<\/li>\r\n<\/ul>\r\nLTC Treatment Plan Pearls:\r\n<ul>\r\n \t<li>Availability of medications<\/li>\r\n \t<li>Goals of care conversations<\/li>\r\n \t<li>Prognostication<\/li>\r\n \t<li>Medications<\/li>\r\n \t<li>Level of Consciousness (LOC)<\/li>\r\n \t<li>Hypodermoclysis<\/li>\r\n \t<li>Oral intake<\/li>\r\n \t<li>Hypodermoclysis<\/li>\r\n \t<li>Consider pain control, symptoms of delirium, fall risk, impact of isolation<\/li>\r\n \t<li>Monitor for exacerbation of underlying chronic condition<\/li>\r\n \t<li>Skin\/wound<\/li>\r\n<\/ul>\r\n<strong>Respiratory<\/strong>\r\n<ul>\r\n \t<li>Influenza Like Illness (ILI)<\/li>\r\n \t<li>COVID-19<\/li>\r\n \t<li>Influenza<\/li>\r\n \t<li>Pneumonia\/Aspiration Pneumonia<\/li>\r\n \t<li>COPD Exacerbation[footnote]National Institute for Health and Care Excellence, 2022[\/footnote][footnote]Aoki et al., 2022[\/footnote][footnote]Ontario Ministry of Health, 2023c[\/footnote][footnote]Choosing Wisely Canada, 2023[\/footnote][footnote]Mums Health, 2019[\/footnote]<\/li>\r\n<\/ul>\r\n<strong>Musculoskeletal<\/strong>\r\n<ul>\r\n \t<li>Falls +\/- fractures<\/li>\r\n<\/ul>\r\n<strong>Neurological<\/strong>\r\n<ul>\r\n \t<li>Seizure: new onset seizures vs know seizure disorder<\/li>\r\n \t<li>Cerebrovascular Accident (CVA)[footnote]Brignole et al., 2018[\/footnote]<\/li>\r\n<\/ul>\r\n<strong>Cardiovascular<\/strong>\r\n<ul>\r\n \t<li>CHF exacerbation<\/li>\r\n \t<li>DVT<\/li>\r\n \t<li>Acute Coronary Syndrome[footnote]Canadian Cardiovascular Society, 2021[\/footnote]<\/li>\r\n<\/ul>\r\n<strong>Skin &amp; Wound<\/strong>\r\n<ul>\r\n \t<li>Cellulitis<\/li>\r\n \t<li>Wound infection<\/li>\r\n \t<li>Herpes Zoster[footnote]Thrombosis Canada, 2022[\/footnote]<\/li>\r\n<\/ul>\r\n<strong>ENT<\/strong>\r\n<ul>\r\n \t<li>Conjunctivitis<\/li>\r\n \t<li>Acute glaucoma<\/li>\r\n<\/ul>\r\n<strong>Genitourinary\/Gastroinestinal<\/strong>\r\n<ul>\r\n \t<li>UTI:\u00a0Cloudy urine or smelly urine does not = UTI. Only collect and treat for UTI if symptomatic<\/li>\r\n \t<li>Urinary retention:\u00a0Bladder scanners or catheterization to evaluate.<\/li>\r\n \t<li>Dehydration<\/li>\r\n \t<li>Vomiting &amp; Obstination\/Constipation[footnote]Public Health Ontario, 2019[\/footnote]<\/li>\r\n<\/ul>\r\n<strong>Endocrine<\/strong>\r\n<ul>\r\n \t<li>Diabetes:\u00a0With acute illness, hold SADMANS meds[footnote]Diabetes Canada, 2018[\/footnote]\r\n<ul>\r\n \t<li>S:sulfonylureas, other secretagogues\/<\/li>\r\n \t<li>A: ACE-inhibitors<\/li>\r\n \t<li>D: diuretics, direct renin inhibitors<\/li>\r\n \t<li>M: metformin<\/li>\r\n \t<li>A :angiotensin receptor blockers<\/li>\r\n \t<li>N :non-steroidal anti-inflammatory<\/li>\r\n \t<li>S: SGLT2 inhibitors<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>","rendered":"<h2>Common Episodic Conditions<\/h2>\n<p>LTC Pearls for differential diagnosis during an acute change:<\/p>\n<ul>\n<li>Differential diagnosis will be often based on your physical exam and subjective information<\/li>\n<li>Medications, delirium, review of intake and output, falls, vitals, LOC, etc.<\/li>\n<li>Atypical presentation is common, behavioural changes are common<\/li>\n<li>Availability of labs in your LTC<\/li>\n<li>Responsibility of potential recognition of an outbreak<\/li>\n<\/ul>\n<p>LTC Treatment Plan Pearls:<\/p>\n<ul>\n<li>Availability of medications<\/li>\n<li>Goals of care conversations<\/li>\n<li>Prognostication<\/li>\n<li>Medications<\/li>\n<li>Level of Consciousness (LOC)<\/li>\n<li>Hypodermoclysis<\/li>\n<li>Oral intake<\/li>\n<li>Hypodermoclysis<\/li>\n<li>Consider pain control, symptoms of delirium, fall risk, impact of isolation<\/li>\n<li>Monitor for exacerbation of underlying chronic condition<\/li>\n<li>Skin\/wound<\/li>\n<\/ul>\n<p><strong>Respiratory<\/strong><\/p>\n<ul>\n<li>Influenza Like Illness (ILI)<\/li>\n<li>COVID-19<\/li>\n<li>Influenza<\/li>\n<li>Pneumonia\/Aspiration Pneumonia<\/li>\n<li>COPD Exacerbation<a class=\"footnote\" title=\"National Institute for Health and Care Excellence, 2022\" id=\"return-footnote-142-1\" href=\"#footnote-142-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><a class=\"footnote\" title=\"Aoki et al., 2022\" id=\"return-footnote-142-2\" href=\"#footnote-142-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><a class=\"footnote\" title=\"Ontario Ministry of Health, 2023c\" id=\"return-footnote-142-3\" href=\"#footnote-142-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><a class=\"footnote\" title=\"Choosing Wisely Canada, 2023\" id=\"return-footnote-142-4\" href=\"#footnote-142-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><a class=\"footnote\" title=\"Mums Health, 2019\" id=\"return-footnote-142-5\" href=\"#footnote-142-5\" aria-label=\"Footnote 5\"><sup class=\"footnote\">[5]<\/sup><\/a><\/li>\n<\/ul>\n<p><strong>Musculoskeletal<\/strong><\/p>\n<ul>\n<li>Falls +\/- fractures<\/li>\n<\/ul>\n<p><strong>Neurological<\/strong><\/p>\n<ul>\n<li>Seizure: new onset seizures vs know seizure disorder<\/li>\n<li>Cerebrovascular Accident (CVA)<a class=\"footnote\" title=\"Brignole et al., 2018\" id=\"return-footnote-142-6\" href=\"#footnote-142-6\" aria-label=\"Footnote 6\"><sup class=\"footnote\">[6]<\/sup><\/a><\/li>\n<\/ul>\n<p><strong>Cardiovascular<\/strong><\/p>\n<ul>\n<li>CHF exacerbation<\/li>\n<li>DVT<\/li>\n<li>Acute Coronary Syndrome<a class=\"footnote\" title=\"Canadian Cardiovascular Society, 2021\" id=\"return-footnote-142-7\" href=\"#footnote-142-7\" aria-label=\"Footnote 7\"><sup class=\"footnote\">[7]<\/sup><\/a><\/li>\n<\/ul>\n<p><strong>Skin &amp; Wound<\/strong><\/p>\n<ul>\n<li>Cellulitis<\/li>\n<li>Wound infection<\/li>\n<li>Herpes Zoster<a class=\"footnote\" title=\"Thrombosis Canada, 2022\" id=\"return-footnote-142-8\" href=\"#footnote-142-8\" aria-label=\"Footnote 8\"><sup class=\"footnote\">[8]<\/sup><\/a><\/li>\n<\/ul>\n<p><strong>ENT<\/strong><\/p>\n<ul>\n<li>Conjunctivitis<\/li>\n<li>Acute glaucoma<\/li>\n<\/ul>\n<p><strong>Genitourinary\/Gastroinestinal<\/strong><\/p>\n<ul>\n<li>UTI:\u00a0Cloudy urine or smelly urine does not = UTI. Only collect and treat for UTI if symptomatic<\/li>\n<li>Urinary retention:\u00a0Bladder scanners or catheterization to evaluate.<\/li>\n<li>Dehydration<\/li>\n<li>Vomiting &amp; Obstination\/Constipation<a class=\"footnote\" title=\"Public Health Ontario, 2019\" id=\"return-footnote-142-9\" href=\"#footnote-142-9\" aria-label=\"Footnote 9\"><sup class=\"footnote\">[9]<\/sup><\/a><\/li>\n<\/ul>\n<p><strong>Endocrine<\/strong><\/p>\n<ul>\n<li>Diabetes:\u00a0With acute illness, hold SADMANS meds<a class=\"footnote\" title=\"Diabetes Canada, 2018\" id=\"return-footnote-142-10\" href=\"#footnote-142-10\" aria-label=\"Footnote 10\"><sup class=\"footnote\">[10]<\/sup><\/a>\n<ul>\n<li>S:sulfonylureas, other secretagogues\/<\/li>\n<li>A: ACE-inhibitors<\/li>\n<li>D: diuretics, direct renin inhibitors<\/li>\n<li>M: metformin<\/li>\n<li>A :angiotensin receptor blockers<\/li>\n<li>N :non-steroidal anti-inflammatory<\/li>\n<li>S: SGLT2 inhibitors<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-142-1\">National Institute for Health and Care Excellence, 2022 <a href=\"#return-footnote-142-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-142-2\">Aoki et al., 2022 <a href=\"#return-footnote-142-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-142-3\">Ontario Ministry of Health, 2023c <a href=\"#return-footnote-142-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-142-4\">Choosing Wisely Canada, 2023 <a href=\"#return-footnote-142-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><li id=\"footnote-142-5\">Mums Health, 2019 <a href=\"#return-footnote-142-5\" class=\"return-footnote\" aria-label=\"Return to footnote 5\">&crarr;<\/a><\/li><li id=\"footnote-142-6\">Brignole et al., 2018 <a href=\"#return-footnote-142-6\" class=\"return-footnote\" aria-label=\"Return to footnote 6\">&crarr;<\/a><\/li><li id=\"footnote-142-7\">Canadian Cardiovascular Society, 2021 <a href=\"#return-footnote-142-7\" class=\"return-footnote\" aria-label=\"Return to footnote 7\">&crarr;<\/a><\/li><li id=\"footnote-142-8\">Thrombosis Canada, 2022 <a href=\"#return-footnote-142-8\" class=\"return-footnote\" aria-label=\"Return to footnote 8\">&crarr;<\/a><\/li><li id=\"footnote-142-9\">Public Health Ontario, 2019 <a href=\"#return-footnote-142-9\" class=\"return-footnote\" aria-label=\"Return to footnote 9\">&crarr;<\/a><\/li><li id=\"footnote-142-10\">Diabetes Canada, 2018 <a href=\"#return-footnote-142-10\" class=\"return-footnote\" aria-label=\"Return to footnote 10\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":517,"menu_order":29,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-142","chapter","type-chapter","status-publish","hentry"],"part":3,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/142","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/users\/517"}],"version-history":[{"count":5,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/142\/revisions"}],"predecessor-version":[{"id":970,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/142\/revisions\/970"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/parts\/3"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/142\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/media?parent=142"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapter-type?post=142"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/contributor?post=142"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/license?post=142"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}