Procedure to monitor single CC (complication or comorbidity) and MCC (major complication or comorbidity

Full Answer Section

         

• Comprehensive Physical Examination:
  • NP/Clinical Officer: Perform a head-to-toe physical examination, with particular attention to signs of target organ damage or established complications (e.g., fundoscopic exam for retinopathy, detailed cardiovascular exam for murmurs/signs of heart failure, abdominal exam for organomegaly, neurological exam for neuropathy, comprehensive foot exam for diabetic foot complications).
• Initial Diagnostic Work-up:
  • NP/Clinical Officer: Order relevant baseline investigations based on history and exam findings (e.g., Fasting Blood Glucose, HbA1c, Lipid Profile, Renal Function Tests (Creatinine, eGFR), Urinalysis (for proteinuria), HIV test, Chest X-ray if indicated). Consider ECG for cardiovascular risk assessment.
• Clinical Diagnosis and Classification:
  • NP/Clinical Officer: Based on history, exam, and initial lab results, establish and record all identified CCs and classify any as MCCs if they meet the criteria for significant impact.

Sample Answer

          Developing a robust procedure for monitoring Complications and Comorbidities (CCs) and Major Complications and Comorbidities (MCCs) is fundamental for providing holistic and effective care, particularly for Nurse Practitioners in a busy primary care clinic in a setting like Kisumu, Kenya, where patient complexity often coexists with resource constraints. This procedure aims to ensure early detection, proactive management, and improved patient outcomes.

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Procedure for Monitoring Single CC and MCC

  Purpose: To systematically identify, document, monitor, and manage all active single Complications/Comorbidities (CCs) and Major Complications/Comorbidities (MCCs) for each patient, ensuring comprehensive,