Routine Lab Studes for the Stabilized TPN Patient
– Daily: I & O; Wt; Urine Glucose; – 2-3 qw: TPN lab panel; – 2 x qw: Nitrogen Balance; – qw: Platlets/CBC, PT, ZINC; – q monthly: Vit B12 and Folate; Original Text by Clifford R. Wheeless, III, MD.
Data Trace Editor
Serum Glucose Sliding Scale
Glucose Reg Insulin (SC) 0 – 200 0 201 – 250 5 units 251 – 300 8 units 301 – 350 10 units 351 – 400 12 units > 400 call HO.
References for Diabetes and Infection
Medical Intelligence: Drug Therapy — The Physiologic Replacement of Insulin: An Elusive Goal. Original Articles: Role of Insulin in Management of Surgical Patients with Diabetes Mellitus. Original Articles: Perioperative Management of Diabetic Subjects: Subcutaneous Versus Intravenous Insulin Administration During Glucose-Potassium Infusion. The influence of diabetes mellitus on the healing of closed fractures. Diabetic foot infections. … Read more
RIGHT VENTRICULAR HYPERTROPHY
Note: mean QRS Vector & Vent Hypertrophy Can’t be accurately calculated in the presence of B.B.B. Consider Causes: – HTN – Pulmonary Stenosis – Primary Pulmonary HTN – Long standing CAD – Congenital heart dz: Endocard. Cush Def/Ost. Primum Def Atrial Septal Defect Tetralogy of Fallot / Note: large R wave in V1; / small … Read more
Rotational Alignment of Femoral Shaft Frx
– Discussion – see adult femoral anteversion – w/ flouroscopy obtain a true lateral view of proximal femur in which femoral neck & shaft are parallel but offset about 1 cm; – measure the angle referenced from the horizontal; – from the true lateral view, one can adjust rotation of the … Read more
Review of Systems
General. Fever, chills, desired weight, fatigue. Diet. Appetite, restrictions, supplements, vitamins. Skin, hair, and nails. Rashes, pigment changes, pruritus, easy bruising; change in hair texture, quantity, distribution; nail changes. Head and neck. Injuries, headaches, dizziness, loss of consciousness. Eyes. Visual changes, trauma, eye diseases. Ears. Tinnitus, hearing loss, pain, vertigo. Nose. Congestion, nose bleeds, post-nasal … Read more
Anatomy of the Hand
– See: Dorsal Interossei from An Atlas of Human Anatomy by Carl Toldt, M.D., 1919. Original Text by Clifford R. Wheeless, III, MD.
References for Ankle Fractures
Fractures of the distal part of the fibula with associated disruption of the deltoid ligament. Treatment without repair of the deltoid ligament. Instability of the distal tibiofibular syndesmosis after bimalleolar and trimalleolar ankle fractures. Examination of the pathologic anatomy of ankle fractures. Ankle fractures. A clinical and roentgenographic stereophotogrammetric study. Operative treatment of ankle fracture-dislocations. … Read more