-BP management in the hospital (AB/CD - AB= sick vasculopaths, CD= clinic, Alpha/ACE/Afterload, Beta-Blockers, Calcium Channel, Diuretics, If you have to start something in the hospital, start Nifedipine but DONT use the short or instant release, use extended release, convert to Amlodipine on DC, ACE/ARB/Thiazides make things more complication with the majority of hospital patients that have moving pieces, especially the old, sick. Don't use hydralazine PRN, starting a thiazide in the hospital is an admirable tribute to the JNC but stick with CCBs. You can try an ACE after checking the K-trend and check the UA to see if you can hit two birds with one stone. IF you're looking to reduce the BP acutely on the floor but no one wants to send the patient to the ICU to start a nitro gtt, your choices are oral labetalol or captopril. I prefer the latter but there are specific contraindications as most sick patients can't tolerate it long term).
-What to do for constipation, what bowel regimens exist (not as important, just use senna...docusate is terrible, finger impaction is underrated for obvious reasons, always give a bowel regimen with opiates)
-What hardware your patients have in (lines, catheters, devices, etc)
-Methods for supplemental oxygen delivery
-Understanding anti-coagulation and DVT prophylaxis (Heparin subQ BID is standard, you can do Lovenox subQ daily for stroke and cancer or also Heparin subQ TID).
-Understanding types of IV fluids and rates for different patients (no big difference, normal saline can lead to acidosis if used in excess, LR has been shown to have be better in acute pancreatitis, google the study if interested but don't linger on this point)
-Dosing/managing Insulin and learning what supplies might be needed outpatient (basal/bolus always, cut the dose in half when they're admitted or do the hospital, hypo is more dangerous than hyper. For tube feeds give them REGULAR insulin q6. A good goal is 160 for diabetics in the hospital. If the fasting sugars are high adjust the long acting regardless of what time you give it. If a daytime sugar is high, adjust the mealtime scheduled before the meal)
-Intake/Output, fluid status (volume=sodium content, pitting edema/lung sounds for overload)
-Anti nausea/vomiting medications (zofran is best but watch QTC, I like compazine for less effect, tigan is also an option but watch anti-dopa, steroids are an atypical second or third line)
-Dealing with agitation/anxiety in hospital patients (talk with them first, AVOID benzos in any severe COPD'er or old person, use oral if you can. Always start with Atarax first.)
-Work-up for new onset fever >101.6 (honestly, cost conscientiousness is great but if someone spikes a new fever or comes in for one and you're the one to investigate it, get the CXR, UA w/ reflex (to culture), blood cultures, and start empiric antibiotics afterwards overnight for the majority of sick/comorbid patients. Other things you can chase are skin/deeth and DVTs. Sometimes the CT isn't a bad idea if there's pelvic or abdominal pain.)
