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% Document Info
\author{Thomas Von Chao (chautommy93)}
\pdfinfo{
  /Title (self-care-exam-1.pdf)
  /Creator (Cheatography)
  /Author (Thomas Von Chao (chautommy93))
  /Subject (Self-Care Exam 1 Cheat Sheet)
}

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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Self-Care Exam 1 Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Thomas Von Chao (chautommy93)} via \textcolor{DarkBackground}{\uline{cheatography.com/178810/cs/44369/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Thomas Von Chao (chautommy93) \\
  \uline{cheatography.com/chautommy93} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 14th September, 2024.\\
   Updated 15th September, 2024.\\
   Page {\thepage} of \pageref{LastPage}.
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  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\begin{document}
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\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Exclusion Criteria for Constipation Self-Care}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{● {\bf{Age \textless{} 2 years old}} \{\{nl\}\} ● Dark, tarry or bloody stool \{\{nl\}\} ● Daily laxative use \{\{nl\}\} ● Fever/Nausea/vomiting \{\{nl\}\} ● Anorexia \{\{nl\}\}} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{● Chronic medical condition that precludes self-care laxative treatment \{\{nl\}\} ● Severe abdominal distention, cramping, or pain \{\{nl\}\} ● Severe or unexplained flatulence \{\{nl\}\} ● Severe change in stool character \{\{nl\}\} ● Unexplained bowel habit changes, especially with weight loss \{\{nl\}\} ● Bowel symptoms that continue for \textgreater{}2 weeks OR recur over 3 months or longer \{\{nl\}\} ● Bowel symptoms that persist after dietary or lifestyle changes or laxative use \{\{nl\}\}} \tn 
% Row Count 14 (+ 10)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.8718 cm} x{11.3982 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Non-Pharmacological Treatment (FIRST-LINE)}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Lifestyle changes}} & ‣  Balanced Diet \{\{nl\}\} ‣  {\bf{Fiber}}: 14g per 1,000kcal -OR- \{\{nl\}\} Women: 25 g/day \{\{nl\}\} Men: 38 g/day \{\{nl\}\} \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 5 (+ 0)
% Row 2
\SetRowColor{LightBackground}
{\bf{Fluid Intake}} & ‣  2 L water/day \{\{nl\}\} ‣  Pregnancy: extra 300 mL/day \{\{nl\}\} ‣  Lactating: extra 750 - 1,000 mL/day \{\{nl\}\} \tn 
% Row Count 10 (+ 5)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 10 (+ 0)
% Row 4
\SetRowColor{LightBackground}
{\bf{Exercise}} & ‣  150 minutes/week \tn 
% Row Count 11 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 11 (+ 0)
% Row 6
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{\bf{Bowel Training}} & ‣  Regularly-scheduled attempts (Usually first thing in the morning) \tn 
% Row Count 14 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{SHELBS for Constipation}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{ Saline }} & Liquid and solid (PO), Liquid (rectal)\{\{nl\}\} ‣  Mag Citrate/Hydroxide/Sulfate\{\{nl\}\} ‣  \seqsplit{Dibasic/Monobasic} Sodium phosphate\{\{nl\}\} & Draw water into the \seqsplit{intestine/colon} (PO) via Osmosis  \{\{nl\}\} → increase intraluminal pressure \{\{nl\}\} → promote GI motility\{\{nl\}\} \tn 
% Row Count 11 (+ 11)
% Row 1
\SetRowColor{white}
\mymulticolumn{3}{x{17.67cm}}{} \tn 
% Row Count 11 (+ 0)
% Row 2
\SetRowColor{LightBackground}
{\bf{ Hyperosmotic }} & ‣  Glycerin (Rectal Suppository/Enema)\{\{nl\}\} ‣  PEG 3350 (PO powder) & Large, \seqsplit{poorly-absorbed} \seqsplit{ions/molecules} draw water into the colon and rectum via osmosis \tn 
% Row Count 18 (+ 7)
% Row 3
\SetRowColor{white}
\mymulticolumn{3}{x{17.67cm}}{} \tn 
% Row Count 18 (+ 0)
% Row 4
\SetRowColor{LightBackground}
{\bf{ Emollients \{\{nl\}\} (aka Stool Softeners) }} & ‣  Docusate \seqsplit{Sodium/Calcium} (PO Capsule and Syrup) & Anionic Surfactants \tn 
% Row Count 22 (+ 4)
% Row 5
\SetRowColor{white}
\mymulticolumn{3}{x{17.67cm}}{} \tn 
% Row Count 22 (+ 0)
% Row 6
\SetRowColor{LightBackground}
{\bf{ Lubricants }} & ‣  Mineral oil (PO/PR Liquid) & Coats stool and prevent colonic absorption of fecal water \{\{nl\}\} → softens fecal contents \tn 
% Row Count 29 (+ 7)
% Row 7
\SetRowColor{white}
\mymulticolumn{3}{x{17.67cm}}{} \tn 
% Row Count 29 (+ 0)
% Row 8
\SetRowColor{LightBackground}
{\bf{ Bulk-Forming (DOC) }} & ‣  \seqsplit{Methylcellulose}, \seqsplit{polycarbophil}, \seqsplit{psyllium-containing} products (PO) & (Mimic what the body does naturally)  Absorb water in intestine \{\{nl\}\} → provides bulk \{\{nl\}\} → promotes peristalsis \tn 
% Row Count 39 (+ 10)
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\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{SHELBS for Constipation (cont)}}  \tn
% Row 9
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\mymulticolumn{3}{x{17.67cm}}{} \tn 
% Row Count 0 (+ 0)
% Row 10
\SetRowColor{white}
{\bf{ Stimulants }} & ‣  Senna, Bisacodyl (PO Caps/Tabs; PR Supp.) & (Increase gastric motility in colon)\{\{nl\}\} Local irritation of mucosa or more selective action on intramural nerve plexus of intestinal smooth muscle + increased water and electrolyte secretion by the intestine \tn 
% Row Count 17 (+ 17)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
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\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Fast vs. Slow Relief OTC}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Faster Relief}} \{\{nl\}\}  (within 15 min - 6 hours) & {\bf{Lubricants}}\{\{nl\}\}  ‣  Mineral oil (PR): 5-15 minutes \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
 & {\bf{Saline Laxatives}}\{\{nl\}\}  ‣  Magnesium citrate (PR): 2-15 min\{\{nl\}\}  ‣  Magnesium citrate (PO): 30 min - 3 hours \{\{nl\}\}  ‣  Magnesium hydroxide: 30 min-6 hours \tn 
% Row Count 12 (+ 9)
% Row 2
\SetRowColor{LightBackground}
 & {\bf{Hyperosmotic}}\{\{nl\}\}  ‣  Glycerin (PR): 15-30 minutes \tn 
% Row Count 15 (+ 3)
% Row 3
\SetRowColor{white}
 & {\bf{Stimulants}}\{\{nl\}\}  ‣  Bisacodyl (PR): 15-60 minutes\{\{nl\}\}  ‣  Senna (PO): 6-10 hours\{\{nl\}\}  ‣  Bisacodyl (PO): 6-10 hours \tn 
% Row Count 22 (+ 7)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 22 (+ 0)
% Row 5
\SetRowColor{white}
{\bf{Slower Relief}} \{\{nl\}\} (6+ hours, up to 72 hours) & {\bf{Bulk-Forming Agents}}\{\{nl\}\}  ‣  Methylcellulose, Polycarbophil, Psyllium-containing products (PO): 12-24 hours, up to 72 hours \tn 
% Row Count 29 (+ 7)
% Row 6
\SetRowColor{LightBackground}
 & {\bf{Emollients (Stool Softeners)}}\{\{nl\}\} ‣  Docusate Na/Ca: 12-72 hours, up to 3-5 days \tn 
% Row Count 34 (+ 5)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Fast vs. Slow Relief OTC (cont)}}  \tn
% Row 7
\SetRowColor{LightBackground}
 & {\bf{Lubricants}}\{\{nl\}\} ‣  Mineral oil (PO): 6-8 hours \tn 
% Row Count 3 (+ 3)
% Row 8
\SetRowColor{white}
 & {\bf{Hyperosmotic}}\{\{nl\}\} ‣  PEG 3350 (PO): 12-72 hours (up to 96 hours) \tn 
% Row Count 7 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Contraindication, Caution, and DDI with OTC}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{ Saline }} & {\bf{AVOID IN:}} \{\{nl\}\} ‣  Intolerant of fluid loss, Electrolyte imbalances, Renal impairment, Newborns, Older adults, or CHF (sodium phosphate) \{\{nl\}\} ‣  PR Sodium phosphate: megacolon, GI obstruction, anus perforation, colostomy \{\{nl\}\} \tn 
% Row Count 12 (+ 12)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 12 (+ 0)
% Row 2
\SetRowColor{LightBackground}
{\bf{ Hyperosmotic }} & {\bf{PEG 3350}}: Caution in renal disease, IBS \tn 
% Row Count 15 (+ 3)
% Row 3
\SetRowColor{white}
 & {\bf{Glycerin}}: Pre-existing rectal irritation \tn 
% Row Count 18 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 18 (+ 0)
% Row 5
\SetRowColor{white}
{\bf{ Emollients \{\{nl\}\} (aka Stool Softeners) }} & {\bf{Caution}}: Electrolyte imbalances \tn 
% Row Count 21 (+ 3)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 21 (+ 0)
% Row 7
\SetRowColor{white}
{\bf{ Lubricants }} & {\bf{Avoid in}}: \textless{} 6 years, Pregnancy, Bedridden, Older adults, Difficulty swallowing, Risk for aspiration because Risk of Lipid Pneumonia when taken PO \tn 
% Row Count 29 (+ 8)
% Row 8
\SetRowColor{LightBackground}
 & {\bf{DDIs}}: Fat-soluble vitamins (ADEK) and Docusate (emollient) \tn 
% Row Count 33 (+ 4)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Contraindication, Caution, and DDI with OTC (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 0 (+ 0)
% Row 10
\SetRowColor{white}
{\bf{ Bulk-Forming (DOC) }} & {\bf{Avoid in}}: Difficulty swallowing, esophageal strictures, intestinal \seqsplit{ulcerations/stenosis/disabling} adhesions, and psyllium allergy \tn 
% Row Count 7 (+ 7)
% Row 11
\SetRowColor{LightBackground}
 & {\bf{Caution}}: Renal disease (calcium content), diabetes, restricted caloric intake, fluid intake \tn 
% Row Count 12 (+ 5)
% Row 12
\SetRowColor{white}
 & {\bf{DDIs}}: Digoxin, Anti-coagulants, Salicylates (separate by 2 hours) \tn 
% Row Count 16 (+ 4)
% Row 13
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 16 (+ 0)
% Row 14
\SetRowColor{white}
{\bf{ Stimulants }} & {\bf{Senna}}: Melanotic pigmentation of colonic mucosa, may discolor urine \seqsplit{(pink/red/violet/brown)} \tn 
% Row Count 21 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{6.5626 cm} x{10.7074 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Special Populations}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{ Children }} & {\bf{Mild constipation}}\{\{nl\}\} ‣  Dietary Modifications: \textgreater{} 2 yo extra fiber intake = {\emph{(age + 5 g/day)}} \{\{nl\}\} ‣  Behavioral Modifications: establish regular stooling time (if toilet trained) \tn 
% Row Count 8 (+ 8)
% Row 1
\SetRowColor{white}
 & {\bf{IF Modifications insufficient in 2 – 6 years old}} \{\{nl\}\} ‣   {\bf{PO}}: Senna, Docusate sodium, Magnesium hydroxide\{\{nl\}\} ‣   {\bf{Rectal}}: {\emph{Glycerin}}, mineral oil, sodium phosphate \tn 
% Row Count 16 (+ 8)
% Row 2
\SetRowColor{LightBackground}
 & {\bf{IF Modifications insufficient in 6 – 12 years old}} \{\{nl\}\} ‣   {\bf{PO}}: Senna, Docusate sodium, Magnesium hydroxide, bulk-forming, mineral oil, Magnesium (any formulation), Bisacodyl \{\{nl\}\} ‣   {\bf{Rectal}}: {\emph{Glycerin}}, mineral oil, sodium phosphate, Bisacodyl \tn 
% Row Count 28 (+ 12)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 28 (+ 0)
% Row 4
\SetRowColor{LightBackground}
{\bf{ \seqsplit{Pregnancy/Lactation} }} & {\bf{Goal}}: Achieve soft stools WITHOUT laxative use\{\{nl\}\} ‣   {\bf{First-line}}: Dietary (increase fibers)\{\{nl\}\} ‣   {\bf{Second-line}}: Bulk-forming with plenty of fluid, Docusate, PEG 3350, (maybe short-term) Senna/Bisacodyl\{\{nl\}\} ‣   {\bf{Breastfeeding}}: Senna, Bisacodyl, PEG 3350, Docusate \tn 
% Row Count 41 (+ 13)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{6.5626 cm} x{10.7074 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Special Populations (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 0 (+ 0)
% Row 6
\SetRowColor{white}
{\bf{ Older Adults  }} & {\bf{ALWAYS FLUID and FIBER}} \tn 
% Row Count 2 (+ 2)
% Row 7
\SetRowColor{LightBackground}
 & Bulk-forming Laxative (Avoid in dehydration, frailty, bedridden, unable to maintain hydration)\{\{nl\}\} ‣   If bulk-forming is contraindicated: PEG 3350 or Docusate\{\{nl\}\} ‣   AVOID: Mineral oil and Saline because of fluid and electrolyte imbalance \tn 
% Row Count 13 (+ 11)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}