source: FOIAVistA/trunk/g/AUTTEDT.zwr@ 1540

Globals from FOIA VistA with corrected Node problem for the cross references in the mental health files for C and AU
Cache 13-Sep-2008 18:35:03 ZWR
^AUTTEDT(0)="EDUCATION TOPICS^9999999.09^612086^48"
^AUTTEDT(1,0)="VA-SUBSTANCE ABUSE^^^Substance Abuse"
^AUTTEDT(1,10,0)="^9999999.091001P^7^7"
^AUTTEDT(1,10,1,0)="2^^1"
^AUTTEDT(1,10,2,0)="3^^2"
^AUTTEDT(1,10,3,0)="4^^3"
^AUTTEDT(1,10,4,0)="5^^4"
^AUTTEDT(1,10,5,0)="6^^5"
^AUTTEDT(1,10,6,0)="7^^6"
^AUTTEDT(1,10,7,0)="8^^7"
^AUTTEDT(1,10,"B",2,1)=""
^AUTTEDT(1,10,"B",3,2)=""
^AUTTEDT(1,10,"B",4,3)=""
^AUTTEDT(1,10,"B",5,4)=""
^AUTTEDT(1,10,"B",6,5)=""
^AUTTEDT(1,10,"B",7,6)=""
^AUTTEDT(1,10,"B",8,7)=""
^AUTTEDT(2,0)="VA-SUBSTANCE ABUSE LIFESTYLE ADAPTATIONS^^^Subs. Abuse Lifestyle Adapt."
^AUTTEDT(2,11,0)="^^2^2^2960520^"
^AUTTEDT(2,11,1,0)="The patient and family will recognize chemical dependency as a primary,"
^AUTTEDT(2,11,2,0)="chronic, and arrestable disease."
^AUTTEDT(2,12,0)="^^16^16^2960520^^"
^AUTTEDT(2,12,1,0)="1.  Discuss the patient's use/abuse of chemicals. Identify the drug of"
^AUTTEDT(2,12,2,0)="choice."
^AUTTEDT(2,12,3,0)=" "
^AUTTEDT(2,12,4,0)="2.  Discuss the attitudes towards their dependency, specifically"
^AUTTEDT(2,12,5,0)="addressing denial issues."
^AUTTEDT(2,12,6,0)=" "
^AUTTEDT(2,12,7,0)="3.  Assess the patient's motivation for change vs. the level of denial."
^AUTTEDT(2,12,8,0)=" "
^AUTTEDT(2,12,9,0)="4.  Explain that both patient and family need to acknowledge, admit and"
^AUTTEDT(2,12,10,0)="request help.  This requirement must be met before deciding on a "
^AUTTEDT(2,12,11,0)="treatment plan."
^AUTTEDT(2,12,12,0)=" "
^AUTTEDT(2,12,13,0)="5.  Review treatment options available at the VA and in the community."
^AUTTEDT(2,12,14,0)=" "
^AUTTEDT(2,12,15,0)="6.  Discuss the power of addiction and the need to utilize family and"
^AUTTEDT(2,12,16,0)="community resources to help control this addiction."
^AUTTEDT(3,0)="VA-SUBSTANCE ABUSE DISEASE PROCESS^^^Subs. Abuse Disease Process"
^AUTTEDT(3,11,0)="^^2^2^2960520^"
^AUTTEDT(3,11,1,0)="The patient and family will recognize the disease process of chemical"
^AUTTEDT(3,11,2,0)="dependency and define motivation for change."
^AUTTEDT(3,12,0)="^^13^13^2960520^^"
^AUTTEDT(3,12,1,0)="1.  Review the current factual information i.e., the patient's specific"
^AUTTEDT(3,12,2,0)="chemical dependency."
^AUTTEDT(3,12,3,0)=" "
^AUTTEDT(3,12,4,0)="2.  Provide the patient with an opportunity for discussion and referral for the"
^AUTTEDT(3,12,5,0)="purpose of acknowledging and understanding the diagnosis of chemical"
^AUTTEDT(3,12,6,0)="dependency."
^AUTTEDT(3,12,7,0)=" "
^AUTTEDT(3,12,8,0)="3.  Explain co-dependency to patient and spouse or significant other."
^AUTTEDT(3,12,9,0)=" "
^AUTTEDT(3,12,10,0)="4.  Discuss a plan of care that will achieve the goal of sobriety and freedom"
^AUTTEDT(3,12,11,0)="from use of mood altering chemicals.  Patient can be offered rehabilitation"
^AUTTEDT(3,12,12,0)="assistance but must prove an interest by attendance and follow-up with groups"
^AUTTEDT(3,12,13,0)="as an outpatient."
^AUTTEDT(4,0)="VA-SUBSTANCE ABUSE COMPLICATIONS^^^Substance Abuse Complications"
^AUTTEDT(4,11,0)="^^3^3^2960520^"
^AUTTEDT(4,11,1,0)="The patient and family will explain how to avoid the complications of"
^AUTTEDT(4,11,2,0)="chemical dependency and slow the progression of the disease by compliance"
^AUTTEDT(4,11,3,0)="with a prescribed daily program."
^AUTTEDT(4,12,0)="^^7^7^2951213^"
^AUTTEDT(4,12,1,0)="1.  Review the effects that the different chemicals have on the body. "
^AUTTEDT(4,12,2,0)="Emphasize the long term effects of the patients continued use of the"
^AUTTEDT(4,12,3,0)="patients specific dependency."
^AUTTEDT(4,12,4,0)=" "
^AUTTEDT(4,12,5,0)="2.  Discuss the symptoms indicative of progression of disease."
^AUTTEDT(4,12,6,0)=" "
^AUTTEDT(4,12,7,0)="3.  Review the effects of chemical dependency on all family members."
^AUTTEDT(5,0)="VA-SUBSTANCE ABUSE DIET^^^Substance Abuse Diet"
^AUTTEDT(5,11,0)="^^3^3^2960520^"
^AUTTEDT(5,11,1,0)="The patient and family will identify the importance of a nutritionally"
^AUTTEDT(5,11,2,0)="balanced diet in relationship to recovery from chemical dependency."
^AUTTEDT(5,11,3,0)="Patients will strive to acquire and maintain a safe weight level."
^AUTTEDT(5,12,0)="^^14^14^2951213^"
^AUTTEDT(5,12,1,0)="1.  Assess the patient's current nutritional habits.  Review how these habits"
^AUTTEDT(5,12,2,0)="might be improved."
^AUTTEDT(5,12,3,0)=" "
^AUTTEDT(5,12,4,0)="2.  Discuss the importance of the four food groups, regular eating habits,"
^AUTTEDT(5,12,5,0)="and the possible need to increase carbohydrates."
^AUTTEDT(5,12,6,0)=" "
^AUTTEDT(5,12,7,0)="3.  Emphasize the importance of limiting snack foods, fatty foods, red meats,"
^AUTTEDT(5,12,8,0)="reducing sodium consumption and adding more fresh fruits, fresh vegetables and"
^AUTTEDT(5,12,9,0)="fiber to the diet."
^AUTTEDT(5,12,10,0)=" "
^AUTTEDT(5,12,11,0)="4.  Emphasize the necessary component -WATER- in a healty diet.  Reduce the"
^AUTTEDT(5,12,12,0)="use of colas and coffee."
^AUTTEDT(5,12,13,0)=" "
^AUTTEDT(5,12,14,0)="5.  Review the symptoms of hypoglycemia and dietary prevention."
^AUTTEDT(6,0)="VA-SUBSTANCE ABUSE EXERCISE^^^Substance Abuse Exercise"
^AUTTEDT(6,11,0)="^^2^2^2960520^"
^AUTTEDT(6,11,1,0)="The patient and family will identify the role of an exercise program as"
^AUTTEDT(6,11,2,0)="part of rehabilitation and maintenance of sobriety."
^AUTTEDT(6,12,0)="^^4^4^2951213^^"
^AUTTEDT(6,12,1,0)="1.  Review the benefits of regular exercise i.e. reduced stress, weight"
^AUTTEDT(6,12,2,0)="control, increased self-esteem, and overall sense of wellness."
^AUTTEDT(6,12,3,0)=" "
^AUTTEDT(6,12,4,0)="2.  Refer to EXERCISE education protocol."
^AUTTEDT(7,0)="VA-SUBSTANCE ABUSE MEDICATIONS^^^Substance Abuse Medications"
^AUTTEDT(7,11,0)="^^2^2^2960520^"
^AUTTEDT(7,11,1,0)="If applicable, the patient and family will recognize the importance of"
^AUTTEDT(7,11,2,0)="complying with a prescribed medication regimen."
^AUTTEDT(7,12,0)="^^8^8^2951213^^^^"
^AUTTEDT(7,12,1,0)="1.  Review the mechanism of action of the prescribed medication."
^AUTTEDT(7,12,2,0)=" "
^AUTTEDT(7,12,3,0)="2.  Discuss the side effects of prescribed medications."
^AUTTEDT(7,12,4,0)=" "
^AUTTEDT(7,12,5,0)="3.  Emphasize the importance of not self-medicating for any purpose."
^AUTTEDT(7,12,6,0)=" "
^AUTTEDT(7,12,7,0)="4.  Review OTC medications (e.g., cough syrup) that contain ETOH/drug additives"
^AUTTEDT(7,12,8,0)="and the signs/symptoms of innocent ingestion."
^AUTTEDT(8,0)="VA-SUBSTANCE ABUSE FOLLOW-UP^^^Substance Abuse Follow-up"
^AUTTEDT(8,11,0)="^^2^2^2960520^"
^AUTTEDT(8,11,1,0)="The patient and family will explain how participation in a support program"
^AUTTEDT(8,11,2,0)="may prevent relapse."
^AUTTEDT(8,12,0)="^^7^7^2951213^"
^AUTTEDT(8,12,1,0)="1.  Discuss the philosophy of AA, ALANON, and related groups."
^AUTTEDT(8,12,2,0)=" "
^AUTTEDT(8,12,3,0)="2.  Review the nature of chemical dependency as a primary, chronic, and"
^AUTTEDT(8,12,4,0)="arrestable disease."
^AUTTEDT(8,12,5,0)=" "
^AUTTEDT(8,12,6,0)="3.  Review the treatment and support options available to the patient and"
^AUTTEDT(8,12,7,0)="family."
^AUTTEDT(9,0)="VA-ADVANCE DIRECTIVES SCREENING^^^Advance Directives Screening"
^AUTTEDT(9,11,0)="^^5^5^2960520^^^^"
^AUTTEDT(9,11,1,0)="This topic represents the inquiry process done by a clinician to"
^AUTTEDT(9,11,2,0)="determine if the patient should receive Advance Directives education."
^AUTTEDT(9,11,3,0)=" "
^AUTTEDT(9,11,4,0)="This topic was created as an example of a screening topic that could be"
^AUTTEDT(9,11,5,0)="used on an Encounter Form, for check-off by the clinician."
^AUTTEDT(9,12,0)="^^9^9^2960307^^^"
^AUTTEDT(9,12,1,0)="This standard is actually a guideline.  Clinicians could use this"
^AUTTEDT(9,12,2,0)="guideline as an example of the type of questions to ask the patient when"
^AUTTEDT(9,12,3,0)="the clinician needs to determine whether the patient should receive"
^AUTTEDT(9,12,4,0)="Advance Directives education."
^AUTTEDT(9,12,5,0)=" "
^AUTTEDT(9,12,6,0)="Ask the patient if he or she has ever discussed his or her wishes"
^AUTTEDT(9,12,7,0)="concerning aggressive medical care during the end of life or a persistent"
^AUTTEDT(9,12,8,0)="vegetative state, and if these discussions have even been made formal in"
^AUTTEDT(9,12,9,0)="any signed document."
^AUTTEDT(10,0)="VA-ALCOHOL ABUSE SCREENING^^^Alcohol Abuse Screening"
^AUTTEDT(10,11,0)="^^18^18^2960520^^^^"
^AUTTEDT(10,11,1,0)="This topic represents the inquiry process done by a clinician to determine"
^AUTTEDT(10,11,2,0)="if the patient should receive Alcohol Abuse education. This topic was"
^AUTTEDT(10,11,3,0)="created as an example of a screening topic that could be used on an"
^AUTTEDT(10,11,4,0)="Encounter Form, for check-off by the clinician."
^AUTTEDT(10,11,5,0)=" "
^AUTTEDT(10,11,6,0)="Clinicians at sites will be required to document activity related to the"
^AUTTEDT(10,11,7,0)="""Problem Drinking Screening"" PCE reminder, or your local sites"
^AUTTEDT(10,11,8,0)="equivalent. The ""Problem Drinking Screening"" reminder was defined by"
^AUTTEDT(10,11,9,0)="the National Center for Health Promotion and Disease Prevention (NCHP)."
^AUTTEDT(10,11,10,0)="The data collected in PCE reflecting activity related to the Problem"
^AUTTEDT(10,11,11,0)="Drinking Screening reminder, or your local sites equivalent, will be used"
^AUTTEDT(10,11,12,0)="by the National Center for Health Promotion and Disease Prevention in"
^AUTTEDT(10,11,13,0)="preparation of an annual report to Congress."
^AUTTEDT(10,11,14,0)=" "
^AUTTEDT(10,11,15,0)="This screening topic is considered the ""minimum"" requirement for"
^AUTTEDT(10,11,16,0)="clinicians to reflect the clinical activity.  If the clinician actually"
^AUTTEDT(10,11,17,0)="provides education, the appropriate Education topic should be recorded,"
^AUTTEDT(10,11,18,0)="reflecting the education given."
^AUTTEDT(10,12,0)="^^19^19^2960307^"
^AUTTEDT(10,12,1,0)="This standard is actually a guideline.  Clinicians could use this"
^AUTTEDT(10,12,2,0)="guideline as an example of the type of questions to ask the patient"
^AUTTEDT(10,12,3,0)="when the clinician needs to determine whether the patient should"
^AUTTEDT(10,12,4,0)="receive Alcohol Abuse education."
^AUTTEDT(10,12,5,0)=" "
^AUTTEDT(10,12,6,0)="Ask the patient how many days a week he or she usually has alcohol and how"
^AUTTEDT(10,12,7,0)="many drinks the patient usually has each day.  Three or more drinks a day"
^AUTTEDT(10,12,8,0)="are usually a trigger for counseling. "
^AUTTEDT(10,12,9,0)=" "
^AUTTEDT(10,12,10,0)="You may want to ask the CAGE questions as well.  Affirmitive answers on at"
^AUTTEDT(10,12,11,0)="least two of the four may be a trigger for counseling."
^AUTTEDT(10,12,12,0)=" "
^AUTTEDT(10,12,13,0)="  CAGE questions are:"
^AUTTEDT(10,12,14,0)=" "
^AUTTEDT(10,12,15,0)="  Have you ever felt you ought to Cut down on drinking?"
^AUTTEDT(10,12,16,0)="  Have people ever Annoyed you by criticizing your drinking?"
^AUTTEDT(10,12,17,0)="  Have you ever felt bad or Guilty about your drinking?"
^AUTTEDT(10,12,18,0)="  Have you ever had a drink first thing in the morning to steady your"
^AUTTEDT(10,12,19,0)="      nerves or get rid of a hangover (Eye-opener)?"
^AUTTEDT(11,0)="VA-EXERCISE SCREENING^^^Exercise Screening"
^AUTTEDT(11,11,0)="^^18^18^2960520^^^^"
^AUTTEDT(11,11,1,0)="This topic represents the inquiry process done by a clinician to determine"
^AUTTEDT(11,11,2,0)="if the patient should receive Exercise education. This topic was created"
^AUTTEDT(11,11,3,0)="as an example of a screening topic that could be used on an Encounter"
^AUTTEDT(11,11,4,0)="Form, for check-off by the clinician."
^AUTTEDT(11,11,5,0)=" "
^AUTTEDT(11,11,6,0)="Clinicians at sites will be required to document activity related to"
^AUTTEDT(11,11,7,0)="the ""Fitness and Exercise Screening"" PCE reminder, or your local sites"
^AUTTEDT(11,11,8,0)="equivalent. The ""Fitness and Exercise Screening"" reminder was defined"
^AUTTEDT(11,11,9,0)="by the National Center for Health Promotion and Disease Prevention"
^AUTTEDT(11,11,10,0)="(NCHP). The data collected in PCE reflecting activity related to the"
^AUTTEDT(11,11,11,0)="Fitness and Exercise Screening reminder, or your local sites equivalent,"
^AUTTEDT(11,11,12,0)="will be used by the National Center for Health Promotion and Disease"
^AUTTEDT(11,11,13,0)="Prevention in preparation of an annual report to Congress."
^AUTTEDT(11,11,14,0)=" "
^AUTTEDT(11,11,15,0)="This screening topic is considered the ""minimum"" requirement for"
^AUTTEDT(11,11,16,0)="clinicians to reflect the clinical activity.  If the clinician actually"
^AUTTEDT(11,11,17,0)="provides education, the appropriate Education topic should be recorded,"
^AUTTEDT(11,11,18,0)="reflecting the education given."
^AUTTEDT(11,12,0)="^^10^10^2960307^"
^AUTTEDT(11,12,1,0)="This standard is actually a guideline.  Clinicians could use this"
^AUTTEDT(11,12,2,0)="guideline as an example of the type of questions to ask the patient when"
^AUTTEDT(11,12,3,0)="the clinician needs to determine whether the patient should receive"
^AUTTEDT(11,12,4,0)="Exercise education."
^AUTTEDT(11,12,5,0)=" "
^AUTTEDT(11,12,6,0)="Ask the patient to describe his or her usual exercise patterns in general,"
^AUTTEDT(11,12,7,0)="and also in particular ask how many days per week the person engages in at"
^AUTTEDT(11,12,8,0)="least moderate physical exercise like brisk walking for 30 minutes or"
^AUTTEDT(11,12,9,0)="more.  Moderate physical exercise of 30 minutes or more three times a week"
^AUTTEDT(11,12,10,0)="is optimal; less often may be a trigger for counseling."
^AUTTEDT(12,0)="VA-NUTRITION/WEIGHT SCREENING^^^Nutrition/Weight Screening"
^AUTTEDT(12,11,0)="^^18^18^2960524^^^^"
^AUTTEDT(12,11,1,0)="This topic represents the inquiry process done by a clinician to"
^AUTTEDT(12,11,2,0)="determine if the patient should receive Nutrition/Weight education. This"
^AUTTEDT(12,11,3,0)="topic was created as an example of a screening topic that could be used on"
^AUTTEDT(12,11,4,0)="an EncounterForm, for check-off by the clinician."
^AUTTEDT(12,11,5,0)=" "
^AUTTEDT(12,11,6,0)="Clinicians at sites will be required to document activity related to the"
^AUTTEDT(12,11,7,0)="""Weight and Nutrition Screening"" PCE reminder, or your local sites"
^AUTTEDT(12,11,8,0)="equivalent. The ""Weight and Nutrition Screening"" reminder was defined by"
^AUTTEDT(12,11,9,0)="the National Center for Health Promotion and Disease Prevention (NCHP)."
^AUTTEDT(12,11,10,0)="The data collected in PCE reflecting activity related to the Weight and"
^AUTTEDT(12,11,11,0)="Nutrition Screening reminder, or your local sites equivalent, will be used"
^AUTTEDT(12,11,12,0)="by the National Center for Health Promotion and Disease Prevention in"
^AUTTEDT(12,11,13,0)="preparation of an annual report to Congress."
^AUTTEDT(12,11,14,0)=" "
^AUTTEDT(12,11,15,0)="This screening topic is considered the ""minimum"" requirement"
^AUTTEDT(12,11,16,0)="for clinicians to reflect the clinical activity.  If the clinician"
^AUTTEDT(12,11,17,0)="actually provides education, the appropriate Education topic should be"
^AUTTEDT(12,11,18,0)="recorded, reflecting the education given."
^AUTTEDT(12,12,0)="^^10^10^2960524^^"
^AUTTEDT(12,12,1,0)="This standard is actually a guideline.  Clinicians could use this"
^AUTTEDT(12,12,2,0)="guideline as an example of the type of questions to ask the patient when"
^AUTTEDT(12,12,3,0)="the clinician needs to determine whether the patient should receive"
^AUTTEDT(12,12,4,0)="Nutrition/Weight education."
^AUTTEDT(12,12,5,0)=" "
^AUTTEDT(12,12,6,0)="Ask the patient to describe his or her usual dietary intake, eating"
^AUTTEDT(12,12,7,0)="habits, and snacking patterns.  Discuss the importance of restricting fat"
^AUTTEDT(12,12,8,0)="(particularly saturated fat) intake and the benefits of high fiber diets."
^AUTTEDT(12,12,9,0)="For those overweight, discuss the value of reduced caloric intake."
^AUTTEDT(12,12,10,0)="Excessive weight may be a trigger for nutrition counseling."
^AUTTEDT(13,0)="VA-SEAT BELT USE SCREENING^^^Seat Belt Use Screening"
^AUTTEDT(13,11,0)="^^21^21^2960520^^^^"
^AUTTEDT(13,11,1,0)="This topic represents the inquiry process done by a clinician to determine"
^AUTTEDT(13,11,2,0)="if the patient should receive Seat Belt Use education. This topic was"
^AUTTEDT(13,11,3,0)="created as an example of a screening topic that could be used on an"
^AUTTEDT(13,11,4,0)="Encounter Form, for check-off by the clinician."
^AUTTEDT(13,11,5,0)=" "
^AUTTEDT(13,11,6,0)="Clinicians at sites will be required to document activity related the"
^AUTTEDT(13,11,7,0)="""Seatbelt and Accident Screening"" PCE reminder, or your local sites"
^AUTTEDT(13,11,8,0)="equivalent. The ""Seatbelt and Accident Screening"" reminder was defined"
^AUTTEDT(13,11,9,0)="by the National Center for Health Promotion and Disease Prevention (NCHP)."
^AUTTEDT(13,11,10,0)="The data collected in PCE reflecting activity related to the Sealtbelt and"
^AUTTEDT(13,11,11,0)="Accident Screening reminder, or your local sites equivalent, will be"
^AUTTEDT(13,11,12,0)="used by the National Center for Health Promotion and Disease Prevention"
^AUTTEDT(13,11,13,0)="in preparation of an annual report to Congress."
^AUTTEDT(13,11,14,0)=" "
^AUTTEDT(13,11,15,0)="This screening topic is considered the ""minimum"" requirement for"
^AUTTEDT(13,11,16,0)="clinicians to reflect the clinical activity.  If the clinician actually"
^AUTTEDT(13,11,17,0)="provides education, the appropriate Education topic should be recorded,"
^AUTTEDT(13,11,18,0)="reflecting the education given."
^AUTTEDT(13,11,19,0)=" "
^AUTTEDT(13,11,20,0)="The goal of this screening is to identify whether the patient needs"
^AUTTEDT(13,11,21,0)="education for seatbelt use and accident avoidance."
^AUTTEDT(13,12,0)="^^8^8^2960520^^"
^AUTTEDT(13,12,1,0)="This standard is actually a guideline.  Clinicians could use this"
^AUTTEDT(13,12,2,0)="guideline as an example of the type of questions to ask the patient when"
^AUTTEDT(13,12,3,0)="the clinician needs to determine whether the patient should receive"
^AUTTEDT(13,12,4,0)="Seatbelt Use education."
^AUTTEDT(13,12,5,0)=" "
^AUTTEDT(13,12,6,0)="Ask the patient if he or she usually use a seatbelt when driving or riding"
^AUTTEDT(13,12,7,0)="in an automobile, and if he or she usually wears a helmet when bicycling"
^AUTTEDT(13,12,8,0)="or riding a motorcycle.  Provide education as appropriate."
^AUTTEDT(14,0)="VA-TOBACCO USE SCREENING^^^Tobacco Use Screening"
^AUTTEDT(14,11,0)="^^18^18^2960520^^^^"
^AUTTEDT(14,11,1,0)="This topic represents the inquiry process done by a clinician to determine"
^AUTTEDT(14,11,2,0)="if the patient should receive Tobacco Use education. This topic was"
^AUTTEDT(14,11,3,0)="created as an example of a screening topic that could be used on an"
^AUTTEDT(14,11,4,0)="Encounter Form, for check-off by the clinician. "
^AUTTEDT(14,11,5,0)=" "
^AUTTEDT(14,11,6,0)="Clinicians at sites will be required to document activity related to the"
^AUTTEDT(14,11,7,0)="""Tobacco Use Screening"" PCE reminder, or your local sites equivalent. The"
^AUTTEDT(14,11,8,0)="""Tobacco Use Screening"" reminder was defined by the National Center for"
^AUTTEDT(14,11,9,0)="Health Promotion and Disease Prevention (NCHP). The data collected in PCE"
^AUTTEDT(14,11,10,0)="reflecting activity related to the Tobacco Use Screening reminder, or your"
^AUTTEDT(14,11,11,0)="local sites equivalent, will be used by the National Center for Health"
^AUTTEDT(14,11,12,0)="Promotion and Disease Prevention in preparation of an annual report to"
^AUTTEDT(14,11,13,0)="Congress."
^AUTTEDT(14,11,14,0)=" "
^AUTTEDT(14,11,15,0)="This screening topic is considered the ""minimum"" requirement for"
^AUTTEDT(14,11,16,0)="clinicians to reflect the clinical activity.  If the clinician actually"
^AUTTEDT(14,11,17,0)="provides education, the appropriate Education topic should be recorded,"
^AUTTEDT(14,11,18,0)="reflecting the education given."
^AUTTEDT(14,12,0)="^^9^9^2960307^"
^AUTTEDT(14,12,1,0)="This standard is actually a guideline.  Clinicians could use this"
^AUTTEDT(14,12,2,0)="guideline as an example of the type of questions to ask the patient when"
^AUTTEDT(14,12,3,0)="the clinician needs to determine whether the patient should receive"
^AUTTEDT(14,12,4,0)="Tobacco Use (Smoking) education."
^AUTTEDT(14,12,5,0)=" "
^AUTTEDT(14,12,6,0)="Ask the patient if he or she currently smokes cigarettes or chews tobacco"
^AUTTEDT(14,12,7,0)="on a regular basis.  If not, ask if he or she ever did and how many years"
^AUTTEDT(14,12,8,0)="since the person has used tobacco regularly.  Current use of tobacco may"
^AUTTEDT(14,12,9,0)="be a trigger for tobacco use education."
^AUTTEDT(15,0)="VA-HTN EXERCISE^^^Exercise Education for HTN"
^AUTTEDT(15,11,0)="^^2^2^3061122"
^AUTTEDT(15,11,1,0)="The patient will understand the importance and the role of exercise in"
^AUTTEDT(15,11,2,0)="the control of hypertension."
^AUTTEDT(15,12,0)="^^3^3^3061122"
^AUTTEDT(15,12,1,0)="Exercise is an useful intervention for the improvement in BP control.  The"
^AUTTEDT(15,12,2,0)="target for aerobic exercise should be 30 to 45 minutes per session, three"
^AUTTEDT(15,12,3,0)="to five times per week if possible."
^AUTTEDT(16,0)="VA-HTN NUTRITION EDUCATION^^^Nutrition Education for HTN"
^AUTTEDT(16,11,0)="^^3^3^3061122"
^AUTTEDT(16,11,1,0)="The patient will understand the lifestyle modifications that may help"
^AUTTEDT(16,11,2,0)="improve blood pressure control including weight loss, decreased sodium"
^AUTTEDT(16,11,3,0)="intake, and a heart healthy diet."
^AUTTEDT(16,12,0)="^^26^26^3061122"
^AUTTEDT(16,12,1,0)="Patients with HTN should receive counseling on the following nutritional"
^AUTTEDT(16,12,2,0)="modifications:"
^AUTTEDT(16,12,3,0)=" "
^AUTTEDT(16,12,4,0)="1.      WEIGHT REDUCTION:  Overweight patients should reduce their weight"
^AUTTEDT(16,12,5,0)="to within 10 percent of their ideal body weight. However, reduction even"
^AUTTEDT(16,12,6,0)="of 5 to 10 pounds can be helpful in controlling HTN."
^AUTTEDT(16,12,7,0)=" "
^AUTTEDT(16,12,8,0)="2.      ALCOHOL INTAKE:  Alcohol intake should be limited to no more than"
^AUTTEDT(16,12,9,0)="one ounce (24 ounces of beer; or 10 ounces of wine; or 2 ounces of"
^AUTTEDT(16,12,10,0)="100-proof whiskey) per day for men or 0.5 ounces of alcohol per day for"
^AUTTEDT(16,12,11,0)="women and for lighter weight men."
^AUTTEDT(16,12,12,0)=" "
^AUTTEDT(16,12,13,0)="3.      SODIUM INTAKE:  Sodium intake in the patient with HTN should be"
^AUTTEDT(16,12,14,0)="limited to no more than 100 mmol/day (2.4 g of sodium or 6 g of sodium"
^AUTTEDT(16,12,15,0)="chloride)."
^AUTTEDT(16,12,16,0)=" "
^AUTTEDT(16,12,17,0)="4.      DIET:  An adequate dietary intake of potassium, calcium, and"
^AUTTEDT(16,12,18,0)="magnesium can be obtained from fresh fruits and vegetables. Other dietary"
^AUTTEDT(16,12,19,0)="advice should include a heart-healthy diet such as the DASH Diet. This is"
^AUTTEDT(16,12,20,0)="one means of satisfying the dietary steps above. See the DASH Diet table"
^AUTTEDT(16,12,21,0)="below."
^AUTTEDT(16,12,22,0)=" "
^AUTTEDT(16,12,23,0)="5.      HYPERLIPIDEMIA:  Counsel to reduce intake of dietary saturated"
^AUTTEDT(16,12,24,0)="fats and cholesterol. A diet rich in fresh fruits and vegetables as well"
^AUTTEDT(16,12,25,0)="as low in dietary saturated fats and cholesterol is also beneficial in"
^AUTTEDT(16,12,26,0)="lowering blood pressure."
^AUTTEDT(17,0)="VA-HTN MEDICATION ADHERENCE^^^HTN Medication Adherence"
^AUTTEDT(17,11,0)="^^3^3^3061122"
^AUTTEDT(17,11,1,0)="The patient will understand the role and importance of medications in the"
^AUTTEDT(17,11,2,0)="control of BP and will understand the importance of taking these"
^AUTTEDT(17,11,3,0)="medications on a regular basis."
^AUTTEDT(338,0)="VA-ADVANCE DIRECTIVES^^^Advance Directives"
^AUTTEDT(338,10,0)="^9999999.091001P^1^1"
^AUTTEDT(338,10,1,0)="9^^1"
^AUTTEDT(338,10,"B",9,1)=""
^AUTTEDT(338,11,0)="^^2^2^2960520^^^"
^AUTTEDT(338,11,1,0)="The patient and family will identify the implications of advance"
^AUTTEDT(338,11,2,0)="directives."
^AUTTEDT(338,12,0)="^^10^10^2951120^^^^"
^AUTTEDT(338,12,1,0)="1.  Explain what an advance directives is."
^AUTTEDT(338,12,2,0)="  "
^AUTTEDT(338,12,3,0)="2.  Explain the difference between advance directives and a living will."
^AUTTEDT(338,12,4,0)=" "
^AUTTEDT(338,12,5,0)="3.  Discuss how a living will is made."
^AUTTEDT(338,12,6,0)=" "
^AUTTEDT(338,12,7,0)="4.  Explain what a durable power of attorney for health care is and how to"
^AUTTEDT(338,12,8,0)="assign someone to have this power."
^AUTTEDT(338,12,9,0)=" "
^AUTTEDT(338,12,10,0)="5.  Identify a social worker to contact for further information as appropriate."
^AUTTEDT(339,0)="VA-ALCOHOL ABUSE^^^Alcohol Abuse"
^AUTTEDT(339,10,0)="^9999999.091001P^8^8"
^AUTTEDT(339,10,1,0)="340^^1"
^AUTTEDT(339,10,2,0)="347^^2"
^AUTTEDT(339,10,3,0)="348^^3"
^AUTTEDT(339,10,4,0)="349^^4"
^AUTTEDT(339,10,5,0)="350^^5"
^AUTTEDT(339,10,6,0)="351^^6"
^AUTTEDT(339,10,7,0)="352^^7"
^AUTTEDT(339,10,8,0)="10^^1"
^AUTTEDT(339,10,"B",10,8)=""
^AUTTEDT(339,10,"B",340,1)=""
^AUTTEDT(339,10,"B",347,2)=""
^AUTTEDT(339,10,"B",348,3)=""
^AUTTEDT(339,10,"B",349,4)=""
^AUTTEDT(339,10,"B",350,5)=""
^AUTTEDT(339,10,"B",351,6)=""
^AUTTEDT(339,10,"B",352,7)=""
^AUTTEDT(340,0)="VA-ALCOHOL ABUSE LIFESTYLE ADAPTATIONS^^^Alcohol Abuse Lifestle Adapt."
^AUTTEDT(340,11,0)="^^2^2^2960520^"
^AUTTEDT(340,11,1,0)="The patient and family will recognize and accept alcohol dependency as a"
^AUTTEDT(340,11,2,0)="primary, chronic, and arrestable disease."
^AUTTEDT(340,12,0)="^^16^16^2960520^^"
^AUTTEDT(340,12,1,0)="1.  Discuss the patient's use/abuse of alcohol.  Identify the alcohol of "
^AUTTEDT(340,12,2,0)="choice."
^AUTTEDT(340,12,3,0)=" "
^AUTTEDT(340,12,4,0)="2.  Discuss the attitudes towards their dependency, specifically"
^AUTTEDT(340,12,5,0)="addressing denial issues."
^AUTTEDT(340,12,6,0)=" "
^AUTTEDT(340,12,7,0)="3.  Assess the patient's motivation for change vs. the level of denial."
^AUTTEDT(340,12,8,0)=" "
^AUTTEDT(340,12,9,0)="4.  Explain that both patient and family need to acknowledge, admit and"
^AUTTEDT(340,12,10,0)="request help.  This requirement must be met before deciding on a "
^AUTTEDT(340,12,11,0)="treatment plan."
^AUTTEDT(340,12,12,0)=" "
^AUTTEDT(340,12,13,0)="5.  Review treatment options available at the VA and in the community."
^AUTTEDT(340,12,14,0)=" "
^AUTTEDT(340,12,15,0)="6.  Discuss the power of addiction and the need to utilize family and"
^AUTTEDT(340,12,16,0)="community resources to help control this addiction."
^AUTTEDT(345,0)="VA-SEAT BELT USE^^^Seat Belt Use"
^AUTTEDT(345,11,0)="^^3^3^2960520^^^^"
^AUTTEDT(345,11,1,0)="The patient will be able to identify the benefits of using and the risks of not"
^AUTTEDT(345,11,2,0)="using seat belts."
^AUTTEDT(345,11,3,0)=""
^AUTTEDT(345,12,0)="^^7^7^2960520^^^^"
^AUTTEDT(345,12,1,0)="1.  Discuss the regular use of seat belts and children's car seats, obeying the"
^AUTTEDT(345,12,2,0)="speed limit, and avoiding the use of alcohol while in a vehicle."
^AUTTEDT(345,12,3,0)=" "
^AUTTEDT(345,12,4,0)="2.  Discuss the proper application of seat belts on adults and children."
^AUTTEDT(345,12,5,0)=" "
^AUTTEDT(345,12,6,0)="3.  Discuss the current legal implications of not using seat belts."
^AUTTEDT(345,12,7,0)=""
^AUTTEDT(347,0)="VA-ALCOHOL ABUSE DISEASE PROCESS^^^Alcohol Abuse Disease Process"
^AUTTEDT(347,11,0)="^^2^2^2960520^"
^AUTTEDT(347,11,1,0)="The patient and family will recognize the disease process of alcohol"
^AUTTEDT(347,11,2,0)="dependency and define motivation for change."
^AUTTEDT(347,12,0)="^^13^13^2960520^^"
^AUTTEDT(347,12,1,0)="1.  Review the current factual information i.e., the patient's specific"
^AUTTEDT(347,12,2,0)="alcohol dependency."
^AUTTEDT(347,12,3,0)=" "
^AUTTEDT(347,12,4,0)="2.  Provide the patient with an opportunity for discussion and referral for the"
^AUTTEDT(347,12,5,0)="purpose of acknowledging and understanding the diagnosis of alcohol"
^AUTTEDT(347,12,6,0)="dependency."
^AUTTEDT(347,12,7,0)=" "
^AUTTEDT(347,12,8,0)="3.  Explain co-dependency to patient and spouse or significant other."
^AUTTEDT(347,12,9,0)=" "
^AUTTEDT(347,12,10,0)="4.  Discuss a plan of care that will achieve the goal of sobriety and freedom"
^AUTTEDT(347,12,11,0)="from use of mood altering chemicals.  Patient can be offered rehabilitation"
^AUTTEDT(347,12,12,0)="assistance but must prove an interest by attendance and follow-up with groups"
^AUTTEDT(347,12,13,0)="as an outpatient."
^AUTTEDT(348,0)="VA-ALCOHOL ABUSE COMPLICATIONS^^^Alcohol Abuse Complications"
^AUTTEDT(348,11,0)="^^3^3^2960520^^"
^AUTTEDT(348,11,1,0)="The patient and family will explain how to avoid the complications of"
^AUTTEDT(348,11,2,0)="alcohol dependency and slow the progression of the diesease by compliance"
^AUTTEDT(348,11,3,0)="with a prescribed daily program."
^AUTTEDT(348,12,0)="^^6^6^2951213^"
^AUTTEDT(348,12,1,0)="1.  Review the effects that the alcohol has on the body. "
^AUTTEDT(348,12,2,0)="Emphasize the long term effects of the patients continued use of alcohol."
^AUTTEDT(348,12,3,0)=" "
^AUTTEDT(348,12,4,0)="2.  Discuss the symptoms indicative of progression of disease."
^AUTTEDT(348,12,5,0)=" "
^AUTTEDT(348,12,6,0)="3.  Review the effects of alcohol dependency on all family members."
^AUTTEDT(349,0)="VA-ALCOHOL ABUSE DIET^^^Alcohol Abuse Diet"
^AUTTEDT(349,11,0)="^^3^3^2960520^^"
^AUTTEDT(349,11,1,0)="The patient and family will identify the importance of a nutritionally"
^AUTTEDT(349,11,2,0)="balanced diet in relationship to recovery from alcohol dependency."
^AUTTEDT(349,11,3,0)="Patients will strive to acquire and maintain a safe weight level."
^AUTTEDT(349,12,0)="^^14^14^2951213^"
^AUTTEDT(349,12,1,0)="1.  Assess the patient's current nutritional habits.  Review how these habits"
^AUTTEDT(349,12,2,0)="might be improved."
^AUTTEDT(349,12,3,0)=" "
^AUTTEDT(349,12,4,0)="2.  Discuss the importance of the four food groups, regular eating habits,"
^AUTTEDT(349,12,5,0)="and the possible need to increase carbohydrates."
^AUTTEDT(349,12,6,0)=" "
^AUTTEDT(349,12,7,0)="3.  Emphasize the importance of limiting snack foods, fatty foods, red meats,"
^AUTTEDT(349,12,8,0)="reducing sodium consumption and adding more fresh fruits, fresh vegetables and"
^AUTTEDT(349,12,9,0)="fiber to the diet."
^AUTTEDT(349,12,10,0)=" "
^AUTTEDT(349,12,11,0)="4.  Emphasize the necessary component -WATER- in a healty diet.  Reduce the"
^AUTTEDT(349,12,12,0)="use of colas and coffee."
^AUTTEDT(349,12,13,0)=" "
^AUTTEDT(349,12,14,0)="5.  Review the symptoms of hypoglycemia and dietary prevention."
^AUTTEDT(350,0)="VA-ALCOHOL ABUSE EXERCISE^^^Alcohol Abuse Exercise"
^AUTTEDT(350,11,0)="^^2^2^2960520^^"
^AUTTEDT(350,11,1,0)="The patient and family will identify the role of an exercise program as"
^AUTTEDT(350,11,2,0)="part of rehabilitation and maintenance of sobriety."
^AUTTEDT(350,12,0)="^^4^4^2951213^"
^AUTTEDT(350,12,1,0)="1.  Review the benefits of regular exercise i.e. reduced stress, weight"
^AUTTEDT(350,12,2,0)="control, increased self-esteem, and overall sense of wellness."
^AUTTEDT(350,12,3,0)=" "
^AUTTEDT(350,12,4,0)="2.  Refer to EXERCISE education protocol."
^AUTTEDT(351,0)="VA-ALCOHOL ABUSE MEDICATIONS^^^Alcohol Abuse Medications"
^AUTTEDT(351,11,0)="^^2^2^2960520^"
^AUTTEDT(351,11,1,0)="If applicable, the patient and family will recognize the importance of"
^AUTTEDT(351,11,2,0)="complying with a prescribed medication regimen."
^AUTTEDT(351,12,0)="^^8^8^2951213^^^^"
^AUTTEDT(351,12,1,0)="1.  Review the mechanism of action of the prescribed medication."
^AUTTEDT(351,12,2,0)=" "
^AUTTEDT(351,12,3,0)="2.  Discuss the side effects of prescribed medications."
^AUTTEDT(351,12,4,0)=" "
^AUTTEDT(351,12,5,0)="3.  Emphasize the importance of not self-medicating for any purpose."
^AUTTEDT(351,12,6,0)=" "
^AUTTEDT(351,12,7,0)="4.  Review OTC medications (e.g., cough syrup) that contain ETOH/drug additives"
^AUTTEDT(351,12,8,0)="and the signs/symptoms of innocent ingestion."
^AUTTEDT(352,0)="VA-ALCOHOL ABUSE FOLLOW-UP^^^Alcohol Abuse Follow-up"
^AUTTEDT(352,11,0)="^^2^2^2960520^"
^AUTTEDT(352,11,1,0)="The patient and family will explain how participation in a support program"
^AUTTEDT(352,11,2,0)="may prevent relapse."
^AUTTEDT(352,12,0)="^^7^7^2951213^"
^AUTTEDT(352,12,1,0)="1.  Discuss the philosophy of AA, ALANON, and related groups."
^AUTTEDT(352,12,2,0)=" "
^AUTTEDT(352,12,3,0)="2.  Review the nature of alcohol dependency as a primary, chronic, and"
^AUTTEDT(352,12,4,0)="arrestable disease."
^AUTTEDT(352,12,5,0)=" "
^AUTTEDT(352,12,6,0)="3.  Review the treatment and support options available to the patient and"
^AUTTEDT(352,12,7,0)="family."
^AUTTEDT(353,0)="VA-CATHETER CARE^^^Catheter Care"
^AUTTEDT(354,0)="VA-DIABETES DISEASE PROCESS^^^Diabetes Disease Process"
^AUTTEDT(354,11,0)="^^1^1^2960520^"
^AUTTEDT(354,11,1,0)="The patient will describe the diabetic disease process."
^AUTTEDT(354,12,0)="^^12^12^2951120^^^^"
^AUTTEDT(354,12,1,0)="1.  Explain how the body uses glucose as a fuel and the function of insulin in"
^AUTTEDT(354,12,2,0)="converting glucose into units of energy.  Explain how hyperglycemia results"
^AUTTEDT(354,12,3,0)="from increased demand on the pancreas to produce insulin."
^AUTTEDT(354,12,4,0)=" "
^AUTTEDT(354,12,5,0)="2.  Explain the role of obesity in Diabetes Mellitus and insulin resistance."
^AUTTEDT(354,12,6,0)=" "
^AUTTEDT(354,12,7,0)="3.  Explain how high levels of freely circulating glucose damage blood vessels"
^AUTTEDT(354,12,8,0)="and highly vascular organs."
^AUTTEDT(354,12,9,0)=" "
^AUTTEDT(354,12,10,0)="4.  Assist the patient in understanding that diabetes is a lifelong condition"
^AUTTEDT(354,12,11,0)="that can be controlled, not cured, although they may be in total remission with"
^AUTTEDT(354,12,12,0)="weight loss.  Stress the importance of lifetime follow-up."
^AUTTEDT(355,0)="VA-DIABETES COMPLICATIONS^^^Diabetes Complications"
^AUTTEDT(355,11,0)="^^2^2^2960520^"
^AUTTEDT(355,11,1,0)="The patient will identify the complications resulting from untreated or"
^AUTTEDT(355,11,2,0)="inadequately treated diabetes."
^AUTTEDT(355,12,0)="^^25^25^2951120^^^"
^AUTTEDT(355,12,1,0)="1.  CIRCULATORY:  Explain that uncontrolled hyperglycemia increases"
^AUTTEDT(355,12,2,0)="atherosclerosis and arteriosclerosis which results in decreased circulation and"
^AUTTEDT(355,12,3,0)="organ perfusion.  Long term impairment of the circulatory system can lead to"
^AUTTEDT(355,12,4,0)="amputation, blindness, kidney failure, stroke, and myocardial infarcation."
^AUTTEDT(355,12,5,0)=" "
^AUTTEDT(355,12,6,0)="2.  RENAL:  Explain how poor perfusion of the kidneys and the increased"
^AUTTEDT(355,12,7,0)="workload required to diurese large amounts of glucose and protein results in"
^AUTTEDT(355,12,8,0)="eventual kidney failure."
^AUTTEDT(355,12,9,0)=" "
^AUTTEDT(355,12,10,0)="3.  NEUROLOGICAL: Explain how uncontrolled hyperglycemia causes a"
^AUTTEDT(355,12,11,0)="thickening of the capillary membranes resulting in reduced sensation. Loss"
^AUTTEDT(355,12,12,0)="of sensation complicates lower limb injuries by removing normal pain"
^AUTTEDT(355,12,13,0)="responses and protective reactions.  Amputation may result from limb"
^AUTTEDT(355,12,14,0)="injuries."
^AUTTEDT(355,12,15,0)=" "
^AUTTEDT(355,12,16,0)="4.  IMMUNOLOGICAL:  Explain how poor circulatory perfusion, reduced sensation"
^AUTTEDT(355,12,17,0)="and hyperglycemia decrease the body's ability to fight off infection that may"
^AUTTEDT(355,12,18,0)="result in amputation."
^AUTTEDT(355,12,19,0)=" "
^AUTTEDT(355,12,20,0)="5.  ENDOCRINE:  Explain how poorly controlled glucose levels may lead to"
^AUTTEDT(355,12,21,0)="Diabetic Ketoacidosis or hyperglycemia, the symptoms of each complication, and"
^AUTTEDT(355,12,22,0)="how to prevent and treat."
^AUTTEDT(355,12,23,0)=" "
^AUTTEDT(355,12,24,0)="6.  Emphasize the need for continuous diabetic surveillance to lessen and"
^AUTTEDT(355,12,25,0)="possibly avoid complications."
^AUTTEDT(356,0)="VA-DIABETES EXERCISE^^^Diabetes Exercise"
^AUTTEDT(356,11,0)="^^3^3^2960520^"
^AUTTEDT(356,11,1,0)="The patient will describe the relationship of exercise in maintaining an"
^AUTTEDT(356,11,2,0)="ideal body weight and will strive to increase weekly exercise by an agreed"
^AUTTEDT(356,11,3,0)="upon amount."
^AUTTEDT(356,12,0)="^^16^16^2951120^"
^AUTTEDT(356,12,1,0)="1.  Stress the fact that exercise is a must in any weight/loss maintenance"
^AUTTEDT(356,12,2,0)="program."
^AUTTEDT(356,12,3,0)=" "
^AUTTEDT(356,12,4,0)="2.  Review the basic recommendations of any exercise program:"
^AUTTEDT(356,12,5,0)="    a.  If any diabetic complications exist, consult with provider."
^AUTTEDT(356,12,6,0)="    b.  Start out slow."
^AUTTEDT(356,12,7,0)="    c.  Exercise for 20 minutes a minimum of three times a week, which"
^AUTTEDT(356,12,8,0)="would include brisk walking, aerobic exercises."
^AUTTEDT(356,12,9,0)=" "
^AUTTEDT(356,12,10,0)="3.  Discuss the positive effect of exercise on metabolism and the utilization"
^AUTTEDT(356,12,11,0)="of carbohydrates."
^AUTTEDT(356,12,12,0)=" "
^AUTTEDT(356,12,13,0)="4.  If using insulin, review the symptoms of hypoglycemia and how to treat a"
^AUTTEDT(356,12,14,0)="hypolglycemic reaction."
^AUTTEDT(356,12,15,0)=" "
^AUTTEDT(356,12,16,0)="5.  Review the exercise programs available in the community."
^AUTTEDT(357,0)="VA-DIABETES MEDICATIONS^^^Diabetes Medications"
^AUTTEDT(357,11,0)="^^2^2^2960520^"
^AUTTEDT(357,11,1,0)="The patient will recognize the importance medication compliance plays in"
^AUTTEDT(357,11,2,0)="controlling diabetes and its complications."
^AUTTEDT(357,12,0)="^^9^9^2951120^^^^"
^AUTTEDT(357,12,1,0)="1.  Review the two types of diabetes medications.  Explain their indication,"
^AUTTEDT(357,12,2,0)="mechanism of action, and possible side effects."
^AUTTEDT(357,12,3,0)=" "
^AUTTEDT(357,12,4,0)="2.  Review the symptoms of hypoglycemia and how to treat a hypoglycemic"
^AUTTEDT(357,12,5,0)="reaction."
^AUTTEDT(357,12,6,0)=" "
^AUTTEDT(357,12,7,0)="3.  If using insulin, demonstrate the proper way to prepare and administer an"
^AUTTEDT(357,12,8,0)="insulin injection and how to perform a finger stick to check glucose level"
^AUTTEDT(357,12,9,0)="using a glucometer.  Have patient return demonstration."
^AUTTEDT(358,0)="VA-DIABETES FOLLOW-UP^^^Diabetes Follow-up"
^AUTTEDT(358,11,0)="^^1^1^2960520^"
^AUTTEDT(358,11,1,0)="The patient will describe the importance of keeping appointments."
^AUTTEDT(358,12,0)="^^6^6^2951120^^^"
^AUTTEDT(358,12,1,0)="1.  Stress the individual's responsibility in controlling diabetes."
^AUTTEDT(358,12,2,0)=" "
^AUTTEDT(358,12,3,0)="2.  Review the treatment plan with the patient."
^AUTTEDT(358,12,4,0)=" "
^AUTTEDT(358,12,5,0)="3.  Encourage patient to seek medical care for any unusual or abnormal"
^AUTTEDT(358,12,6,0)="condition e.g., foot ulcers, slow healing wounds, prolonged illness."
^AUTTEDT(359,0)="VA-DIABETES FOOT CARE^^^Diabetes Foot Care"
^AUTTEDT(359,11,0)="^^2^2^2960520^"
^AUTTEDT(359,11,1,0)="The patient will recognize the importance of daily foot care in preventing"
^AUTTEDT(359,11,2,0)="complications."
^AUTTEDT(359,12,0)="^^15^15^2951120^"
^AUTTEDT(359,12,1,0)="1.  Explain the importance of daily foot checks.  Explain that loss of"
^AUTTEDT(359,12,2,0)="sensation leads to callouses.  Callouses break down, ulcers result which,"
^AUTTEDT(359,12,3,0)="unchecked, may lead to gangrene and amputation."
^AUTTEDT(359,12,4,0)=" "
^AUTTEDT(359,12,5,0)="2.  Stress the importance of daily foot hygiene.  Warm (NOT HOT) bathing of the"
^AUTTEDT(359,12,6,0)="feet, complete drying, and thorough inspection for changes in the condition of"
^AUTTEDT(359,12,7,0)="the skin constitute daily foot care.  Demonstrate how to do a thorough foot"
^AUTTEDT(359,12,8,0)="check."
^AUTTEDT(359,12,9,0)=" "
^AUTTEDT(359,12,10,0)="3.  Emphasize the use of clean, non-restrictive socks/stockings and"
^AUTTEDT(359,12,11,0)="well-fitting shoes."
^AUTTEDT(359,12,12,0)=" "
^AUTTEDT(359,12,13,0)="4.  Stress the importance of immediate follow-up of any foot injuries or"
^AUTTEDT(359,12,14,0)="ulcers.  The patient should be non-weight bearing, whenever there are lesions on"
^AUTTEDT(359,12,15,0)="the foot, to prevent further cellular damage."
^AUTTEDT(360,0)="VA-DIABETES^^^Diabetes"
^AUTTEDT(360,10,0)="^9999999.091001P^8^8"
^AUTTEDT(360,10,1,0)="354^^1"
^AUTTEDT(360,10,2,0)="355^^2"
^AUTTEDT(360,10,3,0)="361^^3"
^AUTTEDT(360,10,4,0)="362^^4"
^AUTTEDT(360,10,5,0)="356^^5"
^AUTTEDT(360,10,6,0)="357^^6"
^AUTTEDT(360,10,7,0)="359^^7"
^AUTTEDT(360,10,8,0)="358^^8"
^AUTTEDT(360,10,"B",354,1)=""
^AUTTEDT(360,10,"B",355,2)=""
^AUTTEDT(360,10,"B",356,5)=""
^AUTTEDT(360,10,"B",357,6)=""
^AUTTEDT(360,10,"B",358,8)=""
^AUTTEDT(360,10,"B",359,7)=""
^AUTTEDT(360,10,"B",361,3)=""
^AUTTEDT(360,10,"B",362,4)=""
^AUTTEDT(361,0)="VA-DIABETES LIFESTYLE ADAPTATIONS^^^Diabetes Lifestyle Adaptations"
^AUTTEDT(361,11,0)="^^2^2^2960520^"
^AUTTEDT(361,11,1,0)="The patient will identify the lifestyle adaptations that are necessary to"
^AUTTEDT(361,11,2,0)="reduce the effects of diabetes."
^AUTTEDT(361,12,0)="^^10^10^2951120^^^^"
^AUTTEDT(361,12,1,0)="1.  Review necessary modifications in diet, exercise, weight control, daily"
^AUTTEDT(361,12,2,0)="medication regimen, health surveillance, and an awareness for prompt follow-up"
^AUTTEDT(361,12,3,0)="of illness and infection using the diabetic protocols for diet, exercise,"
^AUTTEDT(361,12,4,0)="follow-up, and medications."
^AUTTEDT(361,12,5,0)=" "
^AUTTEDT(361,12,6,0)="2.  Discuss the methods of blood glucose control-weight control, oral"
^AUTTEDT(361,12,7,0)="hypoglycemics, and insulin."
^AUTTEDT(361,12,8,0)=" "
^AUTTEDT(361,12,9,0)="3.  Assess the patients's lifestyle and review areas needing improvement. "
^AUTTEDT(361,12,10,0)="Stress the individual's responsibility in controlling diabetes."
^AUTTEDT(362,0)="VA-DIABETES DIET^^^Diabetes Diet"
^AUTTEDT(362,11,0)="^^2^2^2960520^^"
^AUTTEDT(362,11,1,0)="The patient will recognize that diet and weight control are the foundation"
^AUTTEDT(362,11,2,0)="of diabetic management."
^AUTTEDT(362,12,0)="^^23^23^2960520^"
^AUTTEDT(362,12,1,0)="1.  Explain the importance of weight loss in the control of diabetes and"
^AUTTEDT(362,12,2,0)="insulin requirements."
^AUTTEDT(362,12,3,0)=" "
^AUTTEDT(362,12,4,0)="2.  Explain the role of diet in the control of diabetes.  Review how food is"
^AUTTEDT(362,12,5,0)="converted to sugar and the role of insulin in utilizing these sugars."
^AUTTEDT(362,12,6,0)=" "
^AUTTEDT(362,12,7,0)="3.  Discuss the importance of eliminating ""simple sugars"" from the diabetic"
^AUTTEDT(362,12,8,0)="diet."
^AUTTEDT(362,12,9,0)=" "
^AUTTEDT(362,12,10,0)="4.  Discuss the importance of the nutritional pyramid."
^AUTTEDT(362,12,11,0)=" "
^AUTTEDT(362,12,12,0)="5.  Emphasize the importance of limiting snack foods, fatty foods, red meats,"
^AUTTEDT(362,12,13,0)="reducing sodium consumption, and adding more fresh fruits, fresh vegetables,"
^AUTTEDT(362,12,14,0)="and fiber to the diet."
^AUTTEDT(362,12,15,0)=" "
^AUTTEDT(362,12,16,0)="6.  Emphasize the necessary component -WATER- in a healty diet.  Reduce the use"
^AUTTEDT(362,12,17,0)="of colas, coffee, and alcohol."
^AUTTEDT(362,12,18,0)=" "
^AUTTEDT(362,12,19,0)="7.  Assess the patient's current nutritional habits and review which"
^AUTTEDT(362,12,20,0)="improvements can be made."
^AUTTEDT(362,12,21,0)=" "
^AUTTEDT(362,12,22,0)="8.  Review which VA and community resources exist to assist with diet"
^AUTTEDT(362,12,23,0)="modification and weight control."
^AUTTEDT(363,0)="VA-EXERCISE^^^Exercise"
^AUTTEDT(363,11,0)="^^2^2^2960520^^^^"
^AUTTEDT(363,11,1,0)="The patient will relate exercise and or physical fitness to health promotion"
^AUTTEDT(363,11,2,0)="and disease prevention."
^AUTTEDT(363,12,0)="^^10^10^2960520^"
^AUTTEDT(363,12,1,0)="1.  Review the benefits of regular exercise."
^AUTTEDT(363,12,2,0)=" "
^AUTTEDT(363,12,3,0)="2.  Discuss the three types of exercise: aerobic, flexibility, and endurance."
^AUTTEDT(363,12,4,0)=" "
^AUTTEDT(363,12,5,0)="3.  Review the basic recommendations for any exercise program:"
^AUTTEDT(363,12,6,0)="    a.  If any chronic health problems exist, consult with provider."
^AUTTEDT(363,12,7,0)="    b.  Start out slow."
^AUTTEDT(363,12,8,0)="    c.  Exercise a minimum of three times a week."
^AUTTEDT(363,12,9,0)=" "
^AUTTEDT(363,12,10,0)="4.  Review the exercise programs available in the community/VA resources."
^AUTTEDT(364,0)="VA-HIV TRANSMISSION^^^HIV Transmission"
^AUTTEDT(364,11,0)="^^1^1^2960520^"
^AUTTEDT(364,11,1,0)="The patient will describe what the HIV virus is and how it is transmitted."
^AUTTEDT(364,12,0)="^^10^10^2951120^^^^"
^AUTTEDT(364,12,1,0)="1.  Explain what the human immunodeficiency virus (HIV) is and how it is"
^AUTTEDT(364,12,2,0)="related to AIDS."
^AUTTEDT(364,12,3,0)=" "
^AUTTEDT(364,12,4,0)="2.  Discuss the ways that HIV is transmitted via blood and sexual contact."
^AUTTEDT(364,12,5,0)=" "
^AUTTEDT(364,12,6,0)="3.  Explain how to clean shared needles."
^AUTTEDT(364,12,7,0)=" "
^AUTTEDT(364,12,8,0)="4.  Describe safe sex and safer sex."
^AUTTEDT(364,12,9,0)=" "
^AUTTEDT(364,12,10,0)="5.  Explain that HIV is not transmitted via casual contact."
^AUTTEDT(365,0)="VA-IMMUNIZATIONS^^^Immunizations"
^AUTTEDT(365,11,0)="^^1^1^2960520^"
^AUTTEDT(365,11,1,0)="The patient will recognize the importance of routine immunizations."
^AUTTEDT(365,12,0)="^^8^8^2951120^^^"
^AUTTEDT(365,12,1,0)="1.  Review the recommended schedule for tetanus, pneumovax, and influenza"
^AUTTEDT(365,12,2,0)="immunizations."
^AUTTEDT(365,12,3,0)=" "
^AUTTEDT(365,12,4,0)="2.  Discuss the implications of not receiving the immunizations according to"
^AUTTEDT(365,12,5,0)="schedule."
^AUTTEDT(365,12,6,0)=" "
^AUTTEDT(365,12,7,0)="3.  Review VA and community resources available outside of the current"
^AUTTEDT(365,12,8,0)="facility to obtain immunizations."
^AUTTEDT(366,0)="VA-MEDICATIONS^^^Medications"
^AUTTEDT(366,11,0)="^^2^2^2960520^^^"
^AUTTEDT(366,11,1,0)="The patient will recognize accurate information about prescribed"
^AUTTEDT(366,11,2,0)="medications."
^AUTTEDT(366,12,0)="^^11^11^2960520^"
^AUTTEDT(366,12,1,0)="1.  Discuss the following information for each prescribed medication:"
^AUTTEDT(366,12,2,0)="    a.  Name, generic or trade name"
^AUTTEDT(366,12,3,0)="    b.  Amount to take"
^AUTTEDT(366,12,4,0)="    c.  Route of administration"
^AUTTEDT(366,12,5,0)="    d.  Medication schedule"
^AUTTEDT(366,12,6,0)=" "
^AUTTEDT(366,12,7,0)="2.  Explain the purpose and effect of the prescribed medication."
^AUTTEDT(366,12,8,0)=" "
^AUTTEDT(366,12,9,0)="3.  Explain common side-effects of medication."
^AUTTEDT(366,12,10,0)=" "
^AUTTEDT(366,12,11,0)="4.  Explain special precautions such as drug/food interactions. "
^AUTTEDT(367,0)="VA-SAFETY/HOME/FALLS^^^Safety/Home/Falls"
^AUTTEDT(367,11,0)="^^1^1^2960520^^^^"
^AUTTEDT(367,11,1,0)="The patient will be able to identify ways to reduce accident risk."
^AUTTEDT(367,12,0)="^^24^24^2951120^"
^AUTTEDT(367,12,1,0)="1.  Discuss the safe use of medications.  All medications should be stored in"
^AUTTEDT(367,12,2,0)="a safe place, in their original containers."
^AUTTEDT(367,12,3,0)=" "
^AUTTEDT(367,12,4,0)="2.  Review the safe use of electricity and gas."
^AUTTEDT(367,12,5,0)=" "
^AUTTEDT(367,12,6,0)="3.  Identify which community resources promote safety and accident prevention. "
^AUTTEDT(367,12,7,0)="Provide information regarding key contacts for accidents/emergencies, e.g. 911,"
^AUTTEDT(367,12,8,0)="Poison Control, hospital ER."
^AUTTEDT(367,12,9,0)=" "
^AUTTEDT(367,12,10,0)="4.  Review the proper procedure for getting up out of chairs and beds using"
^AUTTEDT(367,12,11,0)="sturdy hand supports: railing, walkers."
^AUTTEDT(367,12,12,0)=" "
^AUTTEDT(367,12,13,0)="5.  Discuss the extra precaution necessary when rising after taking certain"
^AUTTEDT(367,12,14,0)="medications."
^AUTTEDT(367,12,15,0)=" "
^AUTTEDT(367,12,16,0)="6.  Discuss the steps to take when feeling lightheaded."
^AUTTEDT(367,12,17,0)=" "
^AUTTEDT(367,12,18,0)="7.  Discuss the importance of using non-slip rugs, illuminating steps, and"
^AUTTEDT(367,12,19,0)="proper lighting."
^AUTTEDT(367,12,20,0)=" "
^AUTTEDT(367,12,21,0)="8.  Review and evaluate household risk regarding showers, bathtubs, etc."
^AUTTEDT(367,12,22,0)=" "
^AUTTEDT(367,12,23,0)="9.  Evaluate support systems available for assistance and emergencies,"
^AUTTEDT(367,12,24,0)="including household members, etc."
^AUTTEDT(368,0)="VA-SELF BREAST EXAM^^^Self Breast Exam"
^AUTTEDT(368,11,0)="^^2^2^2960520^"
^AUTTEDT(368,11,1,0)="The patient will recognize the importance of monthly breast"
^AUTTEDT(368,11,2,0)="self-examination."
^AUTTEDT(368,12,0)="^^12^12^2951120^"
^AUTTEDT(368,12,1,0)="1.  Discuss breast anatomy and the normal changes that occurs with"
^AUTTEDT(368,12,2,0)="menstruation and aging."
^AUTTEDT(368,12,3,0)=" "
^AUTTEDT(368,12,4,0)="2.  Emphasize the importance of monthly examination in early detection of"
^AUTTEDT(368,12,5,0)="breast cancer.  Survival rates are markedly higher when cancer is detected and"
^AUTTEDT(368,12,6,0)="treated early."
^AUTTEDT(368,12,7,0)=" "
^AUTTEDT(368,12,8,0)="3.  Teach breast self-exam.  Have the patient give a return demonstration."
^AUTTEDT(368,12,9,0)=" "
^AUTTEDT(368,12,10,0)="4.  Discuss indications for mammography.  Patients who have first degree"
^AUTTEDT(368,12,11,0)="relatives (mother, sister, or daughter) with breast cancer are encouraged to"
^AUTTEDT(368,12,12,0)="have baseline and follow-up mammograms."
^AUTTEDT(369,0)="VA-SMOKING CESSATION^^^Smoking Cessation"
^AUTTEDT(369,11,0)="^^2^2^2960520^^^"
^AUTTEDT(369,11,1,0)="The patient and family will recognize the disease processes involved as a"
^AUTTEDT(369,11,2,0)="result of smoking and identify the need for change to quit smoking."
^AUTTEDT(369,12,0)="^^13^13^2960520^^^^"
^AUTTEDT(369,12,1,0)="1.  Review the effects that smoking has on the body, emphasizing the long term"
^AUTTEDT(369,12,2,0)="effects of continued use."
^AUTTEDT(369,12,3,0)=" "
^AUTTEDT(369,12,4,0)="2.  Discuss the benefits of smoking cessation."
^AUTTEDT(369,12,5,0)=" "
^AUTTEDT(369,12,6,0)="3.  Disucss alternative ways to smoking cessation."
^AUTTEDT(369,12,7,0)=" "
^AUTTEDT(369,12,8,0)="4.  Discuss the power of addiction and the need to utilize family and community"
^AUTTEDT(369,12,9,0)="resources to help control this addiction.  Offer smoking cessation clinic"
^AUTTEDT(369,12,10,0)="referral."
^AUTTEDT(369,12,11,0)=" "
^AUTTEDT(369,12,12,0)="5.  Provide information on VA and community resources available for support"
^AUTTEDT(369,12,13,0)="groups."
^AUTTEDT(370,0)="VA-SUNSCREEN^^^Sunscreen"
^AUTTEDT(370,11,0)="^^2^2^2960520^"
^AUTTEDT(370,11,1,0)="The patient will recognize the effects of prolonged sun exposure on the"
^AUTTEDT(370,11,2,0)="skin."
^AUTTEDT(370,12,0)="^^13^13^2951120^"
^AUTTEDT(370,12,1,0)="1.  Explain how prolonged sun exposure, especially between the hours of 10AM"
^AUTTEDT(370,12,2,0)="and 2PM, damages the skin."
^AUTTEDT(370,12,3,0)=" "
^AUTTEDT(370,12,4,0)="2.  Discuss the appearance of sun damaged skin."
^AUTTEDT(370,12,5,0)=" "
^AUTTEDT(370,12,6,0)="3.  Explain the importance of consulting a provider for skin lesions that are"
^AUTTEDT(370,12,7,0)="new, changing in appearance, painful, or not healing."
^AUTTEDT(370,12,8,0)=" "
^AUTTEDT(370,12,9,0)="4.  Discuss the use of sunscreen before going outside and repeated applications"
^AUTTEDT(370,12,10,0)="for prolonged exposure."
^AUTTEDT(370,12,11,0)=" "
^AUTTEDT(370,12,12,0)="5.  Discuss the use of long sleeved shirts and using wide brimmed hats for"
^AUTTEDT(370,12,13,0)="scalp and face protection."
^AUTTEDT(371,0)="VA-NUTRITION/OBESITY^^^Nutrition/Obesity Education"
^AUTTEDT(612027,0)="ALCOHOL USE AND MEDICAL PROBLEMS^^^Medical Problems of Alcohol"
^AUTTEDT(612027,11,0)="^^2^2^3080203"
^AUTTEDT(612027,11,1,0)="The patient will understand the medical consequences of alcohol"
^AUTTEDT(612027,11,2,0)="consumption."
^AUTTEDT(612027,12,0)="^^10^10^3080203"
^AUTTEDT(612027,12,1,0)="The medical risks of alcohol consumption will be reviewed with the"
^AUTTEDT(612027,12,2,0)="patient including:"
^AUTTEDT(612027,12,3,0)="1. liver disease and cirrhosis"
^AUTTEDT(612027,12,4,0)="2. congestive heart failure"
^AUTTEDT(612027,12,5,0)="3. seizures"
^AUTTEDT(612027,12,6,0)="4. interaction with medications"
^AUTTEDT(612027,12,7,0)="5. falls"
^AUTTEDT(612027,12,8,0)="6. hypertension"
^AUTTEDT(612027,12,9,0)="7. diabetes and poor glucose control"
^AUTTEDT(612027,12,10,0)="8. psychiatric disease/depression"
^AUTTEDT(612086,0)="MEDICAL PROBLEMS OF ALCOHOL (SCREENING)^^^Medical Problems of Alcohol "
^AUTTEDT(612086,11,0)="^^2^2^3080203"
^AUTTEDT(612086,11,1,0)="Education done during screening - educate the patient on the medical "
^AUTTEDT(612086,11,2,0)="problems of alcohol."
^AUTTEDT("B","ALCOHOL USE AND MEDICAL PROBLEMS",612027)=""
^AUTTEDT("B","MEDICAL PROBLEMS OF ALCOHOL (SCREENING)",612086)=""
^AUTTEDT("B","VA-ADVANCE DIRECTIVES",338)=""
^AUTTEDT("B","VA-ADVANCE DIRECTIVES SCREENING",9)=""
^AUTTEDT("B","VA-ALCOHOL ABUSE",339)=""
^AUTTEDT("B","VA-ALCOHOL ABUSE COMPLICATIONS",348)=""
^AUTTEDT("B","VA-ALCOHOL ABUSE DIET",349)=""
^AUTTEDT("B","VA-ALCOHOL ABUSE DISEASE PROCESS",347)=""
^AUTTEDT("B","VA-ALCOHOL ABUSE EXERCISE",350)=""
^AUTTEDT("B","VA-ALCOHOL ABUSE FOLLOW-UP",352)=""
^AUTTEDT("B","VA-ALCOHOL ABUSE LIFESTYLE ADAPTATIONS",340)=""
^AUTTEDT("B","VA-ALCOHOL ABUSE MEDICATIONS",351)=""
^AUTTEDT("B","VA-ALCOHOL ABUSE SCREENING",10)=""
^AUTTEDT("B","VA-CATHETER CARE",353)=""
^AUTTEDT("B","VA-DIABETES",360)=""
^AUTTEDT("B","VA-DIABETES COMPLICATIONS",355)=""
^AUTTEDT("B","VA-DIABETES DIET",362)=""
^AUTTEDT("B","VA-DIABETES DISEASE PROCESS",354)=""
^AUTTEDT("B","VA-DIABETES EXERCISE",356)=""
^AUTTEDT("B","VA-DIABETES FOLLOW-UP",358)=""
^AUTTEDT("B","VA-DIABETES FOOT CARE",359)=""
^AUTTEDT("B","VA-DIABETES LIFESTYLE ADAPTATIONS",361)=""
^AUTTEDT("B","VA-DIABETES MEDICATIONS",357)=""
^AUTTEDT("B","VA-EXERCISE",363)=""
^AUTTEDT("B","VA-EXERCISE SCREENING",11)=""
^AUTTEDT("B","VA-HIV TRANSMISSION",364)=""
^AUTTEDT("B","VA-HTN EXERCISE",15)=""
^AUTTEDT("B","VA-HTN MEDICATION ADHERENCE",17)=""
^AUTTEDT("B","VA-HTN NUTRITION EDUCATION",16)=""
^AUTTEDT("B","VA-IMMUNIZATIONS",365)=""
^AUTTEDT("B","VA-MEDICATIONS",366)=""
^AUTTEDT("B","VA-NUTRITION/OBESITY",371)=""
^AUTTEDT("B","VA-NUTRITION/WEIGHT SCREENING",12)=""
^AUTTEDT("B","VA-SAFETY/HOME/FALLS",367)=""
^AUTTEDT("B","VA-SEAT BELT USE",345)=""
^AUTTEDT("B","VA-SEAT BELT USE SCREENING",13)=""
^AUTTEDT("B","VA-SELF BREAST EXAM",368)=""
^AUTTEDT("B","VA-SMOKING CESSATION",369)=""
^AUTTEDT("B","VA-SUBSTANCE ABUSE",1)=""
^AUTTEDT("B","VA-SUBSTANCE ABUSE COMPLICATIONS",4)=""
^AUTTEDT("B","VA-SUBSTANCE ABUSE DIET",5)=""
^AUTTEDT("B","VA-SUBSTANCE ABUSE DISEASE PROCESS",3)=""
^AUTTEDT("B","VA-SUBSTANCE ABUSE EXERCISE",6)=""
^AUTTEDT("B","VA-SUBSTANCE ABUSE FOLLOW-UP",8)=""
^AUTTEDT("B","VA-SUBSTANCE ABUSE LIFESTYLE ADAPTATIONS",2)=""
^AUTTEDT("B","VA-SUBSTANCE ABUSE MEDICATIONS",7)=""
^AUTTEDT("B","VA-SUNSCREEN",370)=""
^AUTTEDT("B","VA-TOBACCO USE SCREENING",14)=""
^AUTTEDT("D","ABUSE",1)=""
^AUTTEDT("D","ABUSE",2)=""
^AUTTEDT("D","ABUSE",3)=""
^AUTTEDT("D","ABUSE",4)=""
^AUTTEDT("D","ABUSE",5)=""
^AUTTEDT("D","ABUSE",6)=""
^AUTTEDT("D","ABUSE",7)=""
^AUTTEDT("D","ABUSE",8)=""
^AUTTEDT("D","ABUSE",10)=""
^AUTTEDT("D","ABUSE",339)=""
^AUTTEDT("D","ABUSE",340)=""
^AUTTEDT("D","ABUSE",347)=""
^AUTTEDT("D","ABUSE",348)=""
^AUTTEDT("D","ABUSE",349)=""
^AUTTEDT("D","ABUSE",350)=""
^AUTTEDT("D","ABUSE",351)=""
^AUTTEDT("D","ABUSE",352)=""
^AUTTEDT("D","ADAPTATIONS",2)=""
^AUTTEDT("D","ADAPTATIONS",340)=""
^AUTTEDT("D","ADAPTATIONS",361)=""
^AUTTEDT("D","ADHERENCE",17)=""
^AUTTEDT("D","ADVANCE",9)=""
^AUTTEDT("D","ADVANCE",338)=""
^AUTTEDT("D","ALCOHOL",10)=""
^AUTTEDT("D","ALCOHOL",339)=""
^AUTTEDT("D","ALCOHOL",340)=""
^AUTTEDT("D","ALCOHOL",347)=""
^AUTTEDT("D","ALCOHOL",348)=""
^AUTTEDT("D","ALCOHOL",349)=""
^AUTTEDT("D","ALCOHOL",350)=""
^AUTTEDT("D","ALCOHOL",351)=""
^AUTTEDT("D","ALCOHOL",352)=""
^AUTTEDT("D","ALCOHOL",612027)=""
^AUTTEDT("D","ALCOHOL",612086)=""
^AUTTEDT("D","BELT",13)=""
^AUTTEDT("D","BELT",345)=""
^AUTTEDT("D","BREAST",368)=""
^AUTTEDT("D","CARE",353)=""
^AUTTEDT("D","CARE",359)=""
^AUTTEDT("D","CATHETER",353)=""
^AUTTEDT("D","CESSATION",369)=""
^AUTTEDT("D","COMPLICATIONS",4)=""
^AUTTEDT("D","COMPLICATIONS",348)=""
^AUTTEDT("D","COMPLICATIONS",355)=""
^AUTTEDT("D","DIABETES",354)=""
^AUTTEDT("D","DIABETES",355)=""
^AUTTEDT("D","DIABETES",356)=""
^AUTTEDT("D","DIABETES",357)=""
^AUTTEDT("D","DIABETES",358)=""
^AUTTEDT("D","DIABETES",359)=""
^AUTTEDT("D","DIABETES",360)=""
^AUTTEDT("D","DIABETES",361)=""
^AUTTEDT("D","DIABETES",362)=""
^AUTTEDT("D","DIET",5)=""
^AUTTEDT("D","DIET",349)=""
^AUTTEDT("D","DIET",362)=""
^AUTTEDT("D","DIRECTIVES",9)=""
^AUTTEDT("D","DIRECTIVES",338)=""
^AUTTEDT("D","DISEASE",3)=""
^AUTTEDT("D","DISEASE",347)=""
^AUTTEDT("D","DISEASE",354)=""
^AUTTEDT("D","EDUCATION",16)=""
^AUTTEDT("D","EXAM",368)=""
^AUTTEDT("D","EXERCISE",6)=""
^AUTTEDT("D","EXERCISE",11)=""
^AUTTEDT("D","EXERCISE",15)=""
^AUTTEDT("D","EXERCISE",350)=""
^AUTTEDT("D","EXERCISE",356)=""
^AUTTEDT("D","EXERCISE",363)=""
^AUTTEDT("D","FALLS",367)=""
^AUTTEDT("D","FOLLOW",8)=""
^AUTTEDT("D","FOLLOW",352)=""
^AUTTEDT("D","FOLLOW",358)=""
^AUTTEDT("D","FOOT",359)=""
^AUTTEDT("D","HIV",364)=""
^AUTTEDT("D","HOME",367)=""
^AUTTEDT("D","HTN",15)=""
^AUTTEDT("D","HTN",16)=""
^AUTTEDT("D","HTN",17)=""
^AUTTEDT("D","IMMUNIZATIONS",365)=""
^AUTTEDT("D","LIFESTYLE",2)=""
^AUTTEDT("D","LIFESTYLE",340)=""
^AUTTEDT("D","LIFESTYLE",361)=""
^AUTTEDT("D","MEDICAL",612027)=""
^AUTTEDT("D","MEDICAL",612086)=""
^AUTTEDT("D","MEDICATION",17)=""
^AUTTEDT("D","MEDICATIONS",7)=""
^AUTTEDT("D","MEDICATIONS",351)=""
^AUTTEDT("D","MEDICATIONS",357)=""
^AUTTEDT("D","MEDICATIONS",366)=""
^AUTTEDT("D","NUTRITION",12)=""
^AUTTEDT("D","NUTRITION",16)=""
^AUTTEDT("D","NUTRITION",371)=""
^AUTTEDT("D","OBESITY",371)=""
^AUTTEDT("D","PROBLEMS",612027)=""
^AUTTEDT("D","PROBLEMS",612086)=""
^AUTTEDT("D","PROCESS",3)=""
^AUTTEDT("D","PROCESS",347)=""
^AUTTEDT("D","PROCESS",354)=""
^AUTTEDT("D","SAFETY",367)=""
^AUTTEDT("D","SCREENING",9)=""
^AUTTEDT("D","SCREENING",10)=""
^AUTTEDT("D","SCREENING",11)=""
^AUTTEDT("D","SCREENING",12)=""
^AUTTEDT("D","SCREENING",13)=""
^AUTTEDT("D","SCREENING",14)=""
^AUTTEDT("D","SCREENING",612086)=""
^AUTTEDT("D","SEAT",13)=""
^AUTTEDT("D","SEAT",345)=""
^AUTTEDT("D","SELF",368)=""
^AUTTEDT("D","SMOKING",369)=""
^AUTTEDT("D","SUBSTANCE",1)=""
^AUTTEDT("D","SUBSTANCE",2)=""
^AUTTEDT("D","SUBSTANCE",3)=""
^AUTTEDT("D","SUBSTANCE",4)=""
^AUTTEDT("D","SUBSTANCE",5)=""
^AUTTEDT("D","SUBSTANCE",6)=""
^AUTTEDT("D","SUBSTANCE",7)=""
^AUTTEDT("D","SUBSTANCE",8)=""
^AUTTEDT("D","SUNSCREEN",370)=""
^AUTTEDT("D","TOBACCO",14)=""
^AUTTEDT("D","TRANSMISSION",364)=""
^AUTTEDT("D","USE",13)=""
^AUTTEDT("D","USE",14)=""
^AUTTEDT("D","USE",345)=""
^AUTTEDT("D","USE",612027)=""
^AUTTEDT("D","WEIGHT",12)=""