Family Medicine

Pupil Dilation in the Elderly

It can be difficult to see an elderly patient’s pupils react to light, even in a darkened room. Have the patient close his or her eyes for approximately one minute while you perform another part of the exam (e.g., auscultation). This makes for increased pupil dilation.—GERALDINE CALANDRA, APRN-BC, Rochester, N.Y. (119-28) n

How Many Insulin Vials?

To quickly calculate the number of vials necessary for a 90-day supply of insulin, take the total daily dose (TDD) and divide by 10. For example, if a patient is taking isophane insulin 30 units b.i.d., the TDD is 60 units per day; 60 divided by 10 is six. Therefore, six vials are needed to…

Dealing with a Sensitive Abdomen

Many patients cannot keep from laughing when their abdomen is touched. Place their hands on the abdomen and your fingers between theirs.—THOMAS MORAN, PA-C, Pontiac, Ill. (119-26)

HIPAA Rules For Patient Charts

I belong to a group of three internists who have separate outpatient clinics attached to the hospital in the same building. When I am on call for a colleague, can I take a patient’s chart from…

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