Maddie Milner

CVICU RN
PNP-AC Student

[Maddie Milner @MMilnerPNP]

It looks like that link is not useable - try this one!
https://t.co/MiNypBOEe9

[Maddie Milner @MMilnerPNP]

This article discusses IgA deficiency and what that can mean for many different body systems!
#EmoryACPNP2023 @brownam130

https://t.co/oKN7weN5Uq

1/5

[Maddie Milner @MMilnerPNP]

@KMallonPNP This is so interesting! I had no idea that acetaminophen was a common cause of SJS. It seems like such a benign, over the counter pain reliever but can clearly have very serious consequences if not dosed appropriately!

[Christine Simon @CSimonPNP]

❄️Brrrrr, it’s cold in here ❄️

As we approach winter season, we must remember to protect ourselves from the cold❕#coldinjuries #EmoryACPNP2023 @brownam130

Follow this thread on cold injuries to:
🧠Test your knowledge
⭐️Learn something new

[Kara Gromnicki @KGromnickiPNP]

Frequent, early onset infections in an infant⁉️👶

Is it just coincidence🦠🚩 or could it be Severe Combined Immunodeficiencies (SCID)🧬❓ #SCID #EmoryACPNP2023 @brownam130

[Maddie Milner @MMilnerPNP]

Which of the following diseases are associated with IgA deficiency?
5/5

[Maddie Milner @MMilnerPNP]

However, this deficiency can be very significant and is seen in conjunction with other deficiencies, sometimes causing life-threatening conditions. Since the antibody is found in our mucous membranes, some of the most commonly affected areas are the 🫁 and GI system.
4/5

[Maddie Milner @MMilnerPNP]

@DaniSebbens At Riley Children's Hospital, the critical care units have dedicated pharmacists who round daily and review the mediation lists of children. I have seen them make some amazing catches over the years!

#ACPNPChat @brownam130

[Maddie Milner @MMilnerPNP]

@awatkinsPNP @lizespinoza_dnp The most common causes of cirrhosis (leading to disease) in children are most commonly - biliary atresia, choledochal cysts , Hep B virus and autoimmune hepatitis

#ACPNPChat @brownam130

[Maddie Milner @MMilnerPNP]

@brownam130 @KMallonPNP Yes! And the progression to HRS is regardless of the original infection resolution because there has been severe circulatory dysfunction! #ACPNPChat

[Maddie Milner @MMilnerPNP]

@CSindall_ACPNP @KMallonPNP @brownam130 @dukeacpnp It is likely HRS-1 if the ascites accumulates quickly but more likely HRS-2 if the ascites is a chronic condition! But bacterial peritonitis is also more likely to cause type 1! #ACPNPChat @brownam130 #EmoryACPNP2023

[Maddie Milner @MMilnerPNP]

@Jac_SantosPNP @dukeacpnp @brownam130 Is Terlipressin still the first line treatment drug if it has similar clinical effects as norepinephrine while having more potential side effects?

[Maddie Milner @MMilnerPNP]

@TajEaton25 You are right, that if you are able to identify hepatorenal syndrome as the cause, the best treatment is albumin; however this is a fluid challenge to help identify that syndrome versus other acute AKI!

[Maddie Milner @MMilnerPNP]

Hepatorenal Syndrome: A Thread🚩
#EMORYACPNP2023 #ACPNPCHAT @brownam130

Review this article and thread and try your hand at the quiz question!

https://t.co/BGYrVFdwRp

[Maddie Milner @MMilnerPNP]

The article discusses that a fluid resuscitation challenge can help differentiate between these two etiologies. You should see clinical improvement in hemodynamic stability with pre-renal AKI but if the patient is suffering from Hepatorenal Syndrome, there will not be improvement

[Maddie Milner @MMilnerPNP]

Does pre-renal acute kidney injury (AKI) or Hepatorenal Syndrome (HRS) respond to fluid resuscitation therapy?

[Maddie Milner @MMilnerPNP]

@KGromnickiPNP @brownam130 This is such an amazing breakdown of HRS! 😍

AKI is now newly defined when the creatinine⬆️more than 0.3mg/dL in 48 hours or ⬆️50% from baseline within 7 days = AKI and can indicate risk for #HRS1 or #HRS2

May want to call up the transplant team with numbers like those!🌡️

[Kara Gromnicki @KGromnickiPNP]

GI🩸or Bacterial Peritonitis🦠 ➡️ #HRS1
Chronic Ascites💧 ➡️ #HRS2
#HRS1 ➕ #HRS2 in 👶👦 ➡️
🔸🚫 NSAIDs/Diuretics
🔸 Albumin ➕ Antibiotics💉
🔸 Hemodynamic Support💊
🔸 Renal Replacement Therapy🪫
🔸 Liver Transplant🧬

Have you seen #HRS1 or #HRS2⁉️
#ACPNPChat @brownam130

[Maddie Milner @MMilnerPNP]

@MARmPNP @lizespinoza_dnp Are these all examples of pale stools for different etiologies to help parents understand the scale of what that phrase could mean clinically?

[Ann-Marie Brown PhD-ACPNP 🟧 @brownam130]

Excited to announce our Fall 23 #ACPNPChat Journal Club! Students from #ACPNP programs across the 🇺🇸will spend the next 48hrs presenting & critiquing articles addressing the topic of liver dysfunction in pediatrics.

Follow along! #NPsforKids #EmoryACPNP2023 @EmoryNursing