82 yr old male in SNF established pt.
Seen @ req of DON to eval for use of anticholinestrase inhibitors.
HX unobtainable from pt (demtentia)
Meds reviewed: sulfa, codeine
exam: all areas examined; exceptions:
Neuro: Conf/disoriented. speech clear-inappropriate
Psych: flat affect
assessment/plan: dementia-advanced stages. riske of side effects + polypharmacy> benefit to tx. no indication of benefit to tx with anticholinesterase inhibitors @ this time. will check labs to r/o other reversable cx for decrease cognition. DC aricept. DNR. Cont care.
Seen @ req of DON to eval for use of anticholinestrase inhibitors.
HX unobtainable from pt (demtentia)
Meds reviewed: sulfa, codeine
exam: all areas examined; exceptions:
Neuro: Conf/disoriented. speech clear-inappropriate
Psych: flat affect
assessment/plan: dementia-advanced stages. riske of side effects + polypharmacy> benefit to tx. no indication of benefit to tx with anticholinesterase inhibitors @ this time. will check labs to r/o other reversable cx for decrease cognition. DC aricept. DNR. Cont care.