For LTC site evaluations we met over zoom to discuss H&Ps, journal articles, and pharm cards. At the first site visit I presented an H&P from a patient I saw while working with the stroke team. The patient was seen about 30 minutes after onset of symptoms and was a candidate for tPA and thrombectomy. I thought it was a very interesting case as it demonstrated workup of a stroke patient and the importance of the timing and history to determine whether the patient is a candidate for tPA. Also presented 5 pharm cards about various medications I saw used during my first week.

            At the second site visit I presented another H&P, a journal article, and more pharm cards. I presented a patient with HTN and ESRD on hemodialysis who was having pulmonary edema, fluid overload, and elevated BP. We discussed other potential causes of the patient’s symptoms and elements of how to move forward with the workup. We also discussed important lifestyle changes such as smoking cessation, diet, exercise, support.  I presented an article about evaluating and managing HTN in patients with ESRD on HD. The article discussed when to best measure the BP, which medications work best in this population, and the aim for systolic and diastolic BPs. I also presented 5 pharm cards, 3 of which were antibiotics.

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