Bloody ass PCB cards Flashcards
1
Q
Diabetes Mellitus is defined as a group of __________ __________ by abnormal glucose metabolism, with the key feature of elevated ________ __________.
A
metabolic disorders, blood glucose
2
Q
Insulin is secreted by the ______ cells in the Islets of Langerhans in the _________
A
beta, pancreas
3
Q
In a normal person, insulin helps glucose move from the bloodstream into the ______.
A
Cells
4
Q
In diabetes, the body is unable to effectively use the __________ produced.
A
Insulin
5
Q
An increase in blood glucose level is known as ______________.
A
hyperglycaemia.
6
Q
In Type 1 Diabetes Mellitus, the ___________ system attacks and destroys insulin-producing cells.
A
immune
7
Q
In Type 2 Diabetes Mellitus, the body doesn’t make enough insulin or the cells don’t respond normally to ___________.
A
pancreas
8
Q
___________ Diabetes develops during pregnancy.
A
Gestational
9
Q
A potential acute complication of diabetes is ____________, which is low blood sugar.
A
hypoglycaemia
10
Q
A potential acute complication of diabetes is _______________, which is high blood sugar.
A
hyperglycaemia
11
Q
Diabetic ____________ is a chronic complication affecting the eyes.
A
retinopathy
12
Q
Diabetic ______________ is a chronic complication affecting the kidneys
A
nephropathy
13
Q
Frequent urination is also known as ___________.
A
Polyuria
14
Q
Excessive thirst is also known as ___________.
A
Polydipsia
15
Q
Excessive hunger is also known as ___________.
A
Polyphagia
16
Q
If a patient is alert and conscious during hypoglycaemia, you can serve them?
A
Glucose drink – 15gm of glucose powder, 100mls of water
17
Q
List 3 signs and symptoms of Diabetes Mellitus
A
Poor wound healing, Polyuria, blurred vision
18
Q
Explain 4 differences between Type 1 and Type 2 Diabetes Mellitus. (Draw a table format).
A
Type 1:
a. Diagnosed in childhood/ adolescence
b. Not related with excess body weight
c. Sudden onset of signs and symptoms
d. Totally dependent of subcutaneous insulin injection for survival
Type 2:
a. Diagnosed in adults over 40 years of age
b. Often related to excess body weight
c. Gradual onset of signs and symptoms
d. May require either oral hypoglycaemic medications or administer subcutaneous insulin injection to control blood glucose
19
Q
Describe 5 nursing interventions a patient with a knowledge deficit related to diabetes management. Support your answer with rationale.
A
a. Explain the importance of inserting the needle 90^ to the skin – to ensure deep subcutaneous administration of insulin.
b. Explain the injection sites should be at least 2 finger spacing apart & to rotate the injection sites – Injections at the same site may result in hardening of the skin.
c. Guide patient on how to accurately withdraw insulin from the vital using insulin syringe – To build patient’s confidence & to ensure accurate dosage of insulin is withdrawn for administration.
d. Teach patient to check expiration date on insulin vital & when to discard after opening – Insulin will lose its efficiency when it’s past expiry date.
e. Educate patient on proper storage of insulin – Extreme temperature will make isulin lose its efficiency.
20
Q
Outline 5 health education on diabetic foot care. Support your answer with rationale.
A
a. Avoid applying moisturisers between the toes – Excess moisture between the toes can promote fungal growth.
b. Avoid massage machine, foot reflexology, acupuncture & food massage walking path – To minimize chances of injury.
c. Never Walk barefoot – Increases the risk of injury.
d. Always wear a pair of cotton socks or stockings with your shoes – To minimize infection due to dampness.
e. Wear comfortable & well fitted covered shoes – Proper footwear reduces pressure point & friction thus minimize cut or injury.
21
Q
Define hyperglycaemia.
A
Elevate blood glucose level of more than 10mmol/L due to relative or absolute insulin deficiency.
22
Q
Identify 5 signs and symptoms of hyperglycaemia.
A
Muscle cramps, dry mouth, polydipsia, blurred vision, sweet fruity smelling breath
23
Q
Outline briefly 2 medical management for hyperglycaemia.
A
a. Monitor patient’s blood glucose level every 15 minutes as ordered by doctor
b. Blood specimen for urgent blood glucose if ordered.
24
Q
Define the term hypoglycaemia.
A
Abnormally low blood glucose level, less than 4mmol/L.
25
State the 5 signs and symptoms of hypoglycaemia.
Extreme fatigue, irritability, slurred speech, tachycardia, drowsiness
26
State 3 causes of diabetes mellitus.
Hereditary, autoimmune diseases, insulin resistance, pancreatic damage and hormonal imbalance
27
Identify 3 chronic complications of DM.
Diabetic retinopathy, diabetic nephropathy, cardiovascular disease
28
Identify 3 acute complications of DM.
Hypoglycaemia, Hyperglycaemia, diabetic ketoacidosis
29
Identify 3 nursing care after administering insulin.
a. Tell patient to consume meal within 30 mins after insulin injection - prevent hypoglycaemia.
b. Monitor for adverse effects – Monitoring for adverse effects is essential for patient safety.
c. Inspect the injection sites for redness, swelling or pain to prevent infection or irritation.
30
Stella is a 45-year-old woman who was recently diagnosed with type 2 diabetes mellitus. She was prescribed with insulin by her doctor. One day, she didn’t eat her breakfast after her regular dose of insulin as she was late for work. Later, she developed signs of severe hypoglycaemia and was eventually admitted to the hospital for further monitoring.
Outline 5 health education advice you would give to Stella. Support your answer with
rationales.
a. Educate hypoglycaemia signs and symptoms – early reconistion allows for prompt treatment, preventing progression to more severe hypoglycaemia.
b. Encourage regular blood glucose monitoring – enhance ability to manage hypoglycaemic condition proactively.
c. Educate patient to manage hypoglycaemic episode when it occurs, consume half cup of fruit juice or take some subjects – to respond immediately to symptoms, reducing the risk of severe hypoglycaemia.
d. Advise on regular medical follow up – to maintain health, leading to better long term control of blood glucose.
e. Teach importance of eating regular, balanced meals and snacks, especially when taking insulin or oral hypoglycaemic agents – maintain stable blood glucose levels, preventing hypoglycaemic episodes.
31
Identify the causes of hyperglycaemia.
Pancreatitis, total parenteral nutrition, pregnancy, disorder of islets of Langerhans, acute illness: infection, incorrect diet, chronic illness: renal disease, too little exercise, drugs, too little or omission of insulin
32
Outline 3 nursing interventions for a patient with severe hyperglycaemia.
a. Monitor blood glucose level strictly as ordered, early detection & appropriate treatment can benefit.
b. Encourage physical activity according to patient’s abilities physical activity helps reduce insulin resistance & can improve blood glucose control.
c. Administer insulin or oral hypoglycaemic agents as prescribed – helps control blood glucose levels by either increasing insulin production or improving insulin sensitivity.
33
Define hypothyroidism
A metabolic imbalance that results from decreased production of the thyroid stimulating hormones.
34
State 3 signs and symptoms of hypothyroidism affecting the integumentary system.
Cold intolerance, dry skin, goitre
35
Outline briefly 3 health teaching advice for Janet a 40 y.o with hypothyroidism. Support your answer with rationales.
a. Advise patient to continue taking medications as ordered. Observe for side-effects of medication to manage hypothyroidism and support metabolic function.
b. Advise on restriction or limit the amount of sodium intake – to support cardiovascular health, weight management and reduced fluid retention.
c. Emphasise on regular follow up – maintain health, preventing disease progression and ensuring timely intervention.
36
State 3 causes of hyperthyroidism.
Autoimmune disorder (graves disease), Chronic inflammation in thyroid gland (thyroiditis), overproduction of thyroid stimulating hormones
37
State 2 complications of hyperthyroidism
Thyroid storm and cardiac failure
38
Identify 5 signs and symptoms of hyperthyroidism.
Tachycardia, Dyspnoea, Exophthalmos, fatigue, unexplained weight loss
39
Rahman is a 50 year old man who was recently diagnosed with hyperthyroidism. He is non complaint to his medication regime given by his doctor. Outline 5 health teaching advice for Rahman. Support your answer with rationales.
a. Advise patient to continue taking medications as ordered. Observe for side effects of medication – To manage hyperthyroidism and support metabolic function.
b. Educate patient on recognising signs of elevated body temperature – Early recognition allows patient to seek medical help if needed and prevent complications
c. Encourage a balanced diet rich in fruits, vegetables and protein – To help support overall health and prevents further metabolic strain
d. Advise on restriction or limit the amount of sodium intake – To support cardiovascular health, weight management and reduced fluid retention.
e. Advise patient to follow-up with medical appointment regularly – To maintain health, preventing disease progression and ensuring timely intervention.
40
Metabolic syndrome, also known as syndrome __, is a group of risk factors that can cause serious chronic conditions such as ________ disease and __________.
X, heart, diabetes
41
Metabolic syndrome is diagnosed when a person has _______ or more of the following factors.
three
42
For a diagnosis of metabolic syndrome, the waist circumference should be more than ___ cm in men and ___ cm in women.
90, 80cm
43
A criterion for diagnosing metabolic syndrome is a blood pressure of ________________ mmHg or more, or being on treatment for _______ _________ ____________.
130/85, high blood pressure
44
A criterion for diagnosing metabolic syndrome is an impaired fasting blood glucose of 6.1 mmol/L or more, or on treatment for __________.
diabetes
45
________ resistance is one of the causes of Metabolic Syndrome.
Insulin
46
The prevalence of metabolic syndrome __________ with age.
increases
47
Two signs and symptoms of Metabolic Syndrome are ______ ______ & ____________.
central obesity and Hypertension
48
__________ modification is the treatment of choice for managing metabolic syndrome.
Lifestyle
49
A nursing diagnosis related to Metabolic Syndrome is _____________ related to excessive calorie intake and sedentary lifestyle.
imbalanced nutrition
50
Define metabolic syndrome.
Metabolic syndrome, also known as syndrome X, is a group of risk factors that can cause serious chronic conditions such as heart disease and diabetes.
51
Paul is a 55-year-old male patient is diagnosed with metabolic syndrome. His waist circumference is 95 cm, blood pressure is 140/90 mmHg, fasting glucose is 6.5 mmol/L, triglyceride level is 1.8 mmol/L, and HDL cholesterol is 0.9 mmol/L. He has a sedentary lifestyle and a family history of diabetes. Identify 5 criteria that determines Paul to have metabolic syndrome.
Central obesity (≥90cm), elevated blood pressure (≥ 130/85 mmHg), elevated fasting glucose (≥ 5.6 mmol/L), elevated triglycerides (≥ 1.7 mmol/L), low HDL cholesterol (< 1.0 mmol/L)
52
Paul is a 55-year-old male patient is diagnosed with metabolic syndrome. His waist circumference is 95 cm, blood pressure is 140/90 mmHg, fasting glucose is 6.5 mmol/L, triglyceride level is 1.8 mmol/L, and HDL cholesterol is 0.9 mmol/L. He has a sedentary lifestyle and a family history of diabetes.
Outline briefly 5 health teaching for your patient. Support your answer with rationales.
a. Encourage exercises within patient’s tolerance level - Exercises improve emotional well-being and helps to lower blood pressure, thus prevent type 2 diabetes.
b. Emphasise on regular medical follow-up - Stress the importance of regular medical check-ups to monitor blood pressure, blood sugar and lipid level.
c. Advise on reduce alcohol consumption - Advise on limiting alcohol intake as it can contribute to high blood pressure, high triglyceride and obesity.
d. Encourage to quit smoking - Smoking increase the risk of cardiovascular disease. Encourage to participate in smoking cessation program.
e. Educate on diet care - Suggest including variety of foods in diet. A balanced diet with adequate fruits, vegetables and whole grains can reduce the risk of chronic diseases.
53
Define Rheumatoid arthritis
Chronic systemic autoimmune disease that causes inflammation of the connective tissues, primarily in the joints
54
State 5 signs and symptoms of Rheumatoid Arthritis.
Deformities of hands,
Swelling, warmth, erythema and lack of function,
Symmetric joint pain and morning joint stiffness lasting longer than 1 hour,
Systemic symptoms- low grade fever, weight loss, fatigue, anaemia, lymph node enlargement and Raynaud’s phenomenon,
Commonly affect the small joints of the hands and wrists
55
State 3 complications of Rheumatoid Arthritis.
Joint Deformity, Cardiovascular diseases (Stroke, AMI), Osteoporosis
56
Miss Pamela is recently diagnosed with rheumatoid arthritis. She was admitted to your ward and has difficulty performing her daily activities. Outline 3 nursing interventions you can do for Miss Pamela.
a. Advise patient to gradual increases in physical activity, encouraging the patient to engage in short, frequent sessions of activity instead of long periods of exertion - Gradual increases can help build endurance and strength without overwhelming the patient, allowing them to improve their activity tolerance over time.
b. Teach the patient energy conservation techniques, such as prioritizing tasks, using assistive devices, and planning for rest periods - Educating patients about energy conservation can help them manage fatigue and maintain independence in daily activities, reducing the risk of worsening their condition.
c. Advise patient to attend physiotherapy program that considers the patient's capabilities and limitations - Physiotherapy exercises can improve strength and flexibility which are essential for managing activity intolerance and promoting overall functional mobility.
57
Systemic Lupus Erythematosus (SLE), also known as __________, is a chronic ___________ disease that occurs when the body’s immune system attacks its own tissues and organs.
Lupus, autoimmune
58
SLE causes widespread ______________ and tissue damage in multiple organs such as the _________, _______, _______, _______, _______.
inflammation, kidneys, joints, skin, brain, and heart
59
Environmental factors such as ____________ light, ________, certain medications, and ___________ may trigger SLE.
ultraviolet, stress, infections
60
The characteristic _________ rash and _______ are common signs and symptoms of SLE due to immune-mediated damage to the skin.
butterfly, fever
61
SLE can lead to inflammation of the heart lining, which is called ___________, or inflammation of the blood vessels, which is called ___________.
pericarditis, vasculitis
62
Non-Steroidal Anti-Inflammatory drugs (NSAIDS) or Aspirin are used to control _______________ and reduce ______for ______pain/swelling
inflammation, pain, joint
63
Patients with SLE are
______________, and exposure to __________light can trigger flares or worsen skin symptoms like rashes
photosensitive, ultraviolet
64
The _________ (butterfly-shaped rash) is a hallmark symptom of SLE, often appearing on the _____.
malar, face
65
A 50-year-old woman experiences involuntary urine leakage when coughing or laughing
Stress incontinence
66
Dribbles urine throughout the day, feels like the bladder is never fully empty
Overflow incontinence
67
Patient with arthritis has difficulty removing his pants in time to pass urine
Functional incontinence
68
Diagnosed with urinary tract infection and has urge to urinate
Transient incontinence
69
Leaks urine when laughing and often feels sudden & intense urge to urinate
Mix incontinence
70
Experiences and overwhelming urge to urinate
Urge incontinence
71
Prostatomegaly refers to an ____________ of the prostate gland surrounding the male
urethra.
enlargement
72
The majority of males with prostatomegaly have a condition that is benign, referred to as _____________________(BPH).
benign Prostatic Hyperplasia
73
Prostatomegaly often occurs after the age of ___ years.
50
74
A common symptom of prostatomegaly is increased frequency of urination, particularly during the _____ (nocturia).
night
75
A sensation of ______________ bladder emptying is a sign and symptom of prostatomegaly.
incomplete
76
________ _________ is a common complication of prostatomegaly, which can lead to hypertrophy of the detrusor muscle.
Urinary retention
77
A diagnostic procedure for prostatomegaly is a _________ ___________ examination.
digital rectal
78
Medications for prostatomegaly may help to relax the muscles of the _________ ______ or to help ________ size of prostate.
bladder neck, reduce
79
Two common nursing diagnoses related to prostatomegaly are _______ ___________ and acute _____.
urinary retention, pain
80
Patients with prostatomegaly should limit their intake of caffeine and _________ because these beverages increase the urgency to urinate.
alcohol
81
Identify 3 causes of BPH
Unknown, related to hormonal mechanism and old age (>40 years), genetic or familial link
82
State 5 signs and symptoms of BPH
Dribbling of urine, Difficulty initiating urination, Sensation of incomplete bladder emptying, Weak urinary stream, Urge incontinence
83
State 3 complications of BPH
Bladder calculi, Urinary retention, Bladder distension
84
Mr Tan is a 68-year-old man who has been experiencing symptoms of BPH for the past few months
Outline 5 health teaching for Mr Tan. Support your answer with rationales.
a. Limit caffeine and alcohol intake - These beverages increased urgency to urinate.
b. Teach patient to do pelvic floor exercises regularly - This exercise will strengthen the pelvic floor muscles for better urine control.
c. Advise patient to comply to medication prescribed such as 5-alpha reductase inhibitors (e.g. Dutasteride) - This medication will help to shrink the prostate size and improve urine flow.
d. Teach patient to recognize the signs and symptoms of acute urinary retention such as dysuria, suprapubic pain or bladder distension - Acute urinary retention requires immediate medical attention.
e. Educate patient to avoid intake of large amount of fluid at any one time - A single intake of a large amount of fluid can lead to rapid bladder filling and increases the risk of urinary retention.
85
Mr Tan is a 68-year-old man who has been experiencing symptoms of BPH for the past few months.
His symptoms have gradually worsened which affected his quality of life. He went to see a specialist and he was advised to go for TURP. Post surgery requires him to have continuous bladder irrigation.
Outline briefly 5 nursing interventions for Mr Tan who is on continuous bladder irrigation. Support your answer with rationales.
a. Check irrigation rate regularly to ensure proper flow - Prevents complications and ensures adequate irrigation.
b. Check catheter position and security or for kinking and blockage - Maintains effective drainage and prevents complications.
c. Watch for signs of bleeding, clotting or infection - Early detection prevents serious complications.
d. Explain activity limitations - Promotes patient safety and independence.
e. Record irrigation flow rates and output amounts - Enables tracking of treatment effectiveness.
86
Outline briefly 5 nursing care for a patient with urinary catheter. Support your answer with rationales.
a. Keep drainage system closed and prevent contamination of insertion site - Prevents urinary tract infections.
b. Prevent traction on catheter and allow adequate catheter length - Prevents catheter displacement and urethral trauma.
c. Check for signs of urinary tract infection and assess drainage characteristics - Early detection of infection.
d. Keep drainage bag below bladder level, prevent kinking of drainage tube and empty drainage bag regularly - Ensures proper urine flow and prevents complications.
e. Inspect skin around insertion site and keep catheter site clean and dry - Maintains skin integrity and prevents complications.
87
________ ________are stones that form in any part of the urinary tract.
Renal calculi
88
________ stones are associated with urinary tract infections
Struvite
89
_____________ is a complication of renal calculi that causes increased pressure and distention of the urinary tract behind the obstruction.
Obstruction
90
____________ uses focused sound waves to break kidney or ureter stones into smaller pieces.
Lithotripsy
91
Patients with gout are at risk for developing _____ ______ stones
uric acid
92
State 3 signs and symptoms a patient with renal calculi might experience
Colicky pain (if calculi pass into ureter), dysuria, Haematuria
93
List 4 potential causes of renal calculi
Family history, Urinary tract infection, Dehydration, metabolic factors
94
Outline 3 health teaching advice for a patient with renal calculi
a. Advise to increase fluid intake to at least 2.5 to 3 litres/day unless contraindicated - This will help the body to flush out the small stones as soon as possible. It also helps to prevent recurrence of stone formation.
b. Advise to reduce intake of oxalate– rich foods such as spinach, nuts, sweet potatoes and soy products - To reduce the risk of stone formation.
c. Educate patient with gout to consume low purine diet. Limit intake of organ meats, sardines and other high-purine foods - To reduce the risk of uric acid stone formation.
95
Define Acute Glomerulus Nephritis
Glomerulonephritis is a degenerative inflammation of the glomeruli and most commonly results from a previous streptococcal infection usually of the respiratory tract.
96
List 3 potential causes of Acute Glomerulus Nephritis
Systemic Lupus Erythematosus (Lupus), Viral infections, Bacterial endocarditis
97
Identify 5 signs and symptoms of Acute Glomerulus Nephritis
Headache, Oliguria, Fatigue, Oedema, Hypertension
98
State 2 possible complications of Acute Glomerulus Nephritis
Retention of metabolic waste products and Impairment of kidney functions
99
Outline 3 medical management for a patient with Acute Glomerulus Nephritis
a. Medications (Diuretics such as frusemide, Antibiotics such as penicillin, Corticosteroids such as prednisone)
b. Fluid restriction
c. Dietary restriction
100
Mr Arshad, a 28-year-old man had just recovered from a strep throat infection three weeks earlier. He began to experience fatigue and swelling around his eyes a week later. One morning, he woke up to find his urine was dark brown, almost like cola, and his legs felt swollen. He visited the doctor and he was diagnosed with Acute Glomerular Nephritis (AGN).
Outline 5 health teaching advice for Mr Arshad. Support your answer with rationales
a. Educate patient on the dietary advice on high calorie, low protein, low sodium and low potassium diet - This diet will prevent fluid retention in the body. Carbohydrates should be provided to provide energy and prevent breakdown of protein.
b. Educate patient to observe for signs and symptoms of urinary tract infections such as frequency and urgency, cloudy and foul-smelling urine and dysuria - Early identification and treatment of infection is important to prevent systemic complications.
c. Advise patient to continue with prescribed medication such as anti-hypertensive medication - This is to maintain blood pressure within normal ranges.
d. If patient developed signs of oedema, advise patient to reduce fluid intake as ordered by doctor - This will help to reduce fluid retention and improve condition.
101
Define Acute Kidney Injury
Sudden decline in kidney function causing rise in serum creatinine and/or blood urea nitrogen levels with or without a decrease in urine output.
102
List 3 cause of AKI (pre-renal)
Hypovolemia, hypotension and dehydration
103
List 3 complications of AKI
Fluid overload, chronic kidney disease, end stage renal disease
104
State 5 signs and symptoms of AKI
Oliguria (less than 400ml/day), oedema in LL, nausea & vomiting, SOB, muscle weakness, fatigue
105
Define Chronic Kidney Disease.
Gradual loss of functional nephrons
106
List 3 causes of CKD
Poorly controlled DM- diabetic nephropathy, poorly controlled HTN, polycystic kidney disease
107
State 5 signs and symptoms of CKD affected the cardiovascular system
Periorbital oedema, pitting oedema (hands, feet), hyperkalemia, hypertension, SOB
108
State 5 signs and symptoms of CKD affected the neurological system
Weakness and fatigue, Inability to concentrate, Confusion, Disorientation, Seizures
109
State 5 signs and symptoms of CKD affected the gastrointestinal system.
Ammonia odour to breath, nausea and vomiting, LOA, Metallic taste, Mouth ulcers
110
List 3 medical management for AKI
Treat underlying causes: IV and catheterization, Fluid and electrolyte management (strict IO and fluid restriction), Initiate dialysis if needed
111
List 3 medical management for CKD
Manage HTN, Fluid restriction, Kidney replacement therapy (Haemodialysis or peritoneal dialysis or kidney transplant)
112
List 3 complications of CKD
Anaemia, Coma, End stage renal disease
113
Outline 5 nursing interventions for CKD. Support your answer with rationale.
a. Perform regular nutritional assessment- assess for nutritional deficiencies and monitor progress.
b. Encourage small frequent meals- smaller meals are more manageable and mat help increase caloric intake especially for patient with reduced appetite making easier to meet nutritional needs.
c. Monitor fluid intake and adhere to fluid restrictions as ordered- prevent complication like fluid overload which can worsen health issues.
d. Encourage light physical exercises- helps in stimulating appetite and improve overall wellbeing.
e. Assess skin daily for skin breakdown- CKD patients are prone to skin breakdown due to poor tissue perfusion and dry skin.
114
Outline 5 health teaching advice for CKD. Support your answer with rationale.
a. Comply to renal diet with low sodium, controlled protein, low potassium and phosphorus as recommended by dietitian and doctor- prevent accumulation of waste products and electrolytes that the kidneys can no longer manage, reduce damage to kidneys
b. Advise patient to comply to fluid restrictions as ordered- reduce fluid overload as the kidneys are no longer able to excrete excess fluid
c. Advise patient to comply to anti-hypertensive meds- to manage BP to help protect kidney functions and reduce risk of cardiovascular disease
d. Advise to attend regular follow up appointments and blood tests- help detect changes in kidney function allowing timely adjustments to treatment plans, medication and dietary plan
e. Advise patient to practise good hygiene, maintaining good skin care of moisturization and avoid scratching due to pruritus- prevent the compromising of skin integrity from edema and pruritus causing infection
115
Heat exhaustion can lead to _____ ______ if not treated promptly.
heat stroke
116
Heatstroke is a condition caused when our body is _______________, usually because of prolonged exposure to or physical exertion in high temperatures
overheating
117
This most serious form of heatstroke can occur if our body temperature rises to __ ˚C or higher.
40
118
Excessive perspiration can lead to excessive loss of _____ and _____________
fluid and electrolytes
119
Wearing excess clothing can prevent _______ from evaporating easily and cooling your body.
sweat
120
Drinking excessive alcohol affects your body's ability to regulate _____ __________________
body temperature
121
A core body temperature of __ ◦C and above is a sign and symptom of heat stroke.
40
122
Altered mental state or behaviour in heat stroke can manifest as restlessness, ___________, ____________or disorientation
irritable, confusion
123
Extreme cooling measures should stop once temperature is __ to __ degree Celsius.
38 to 39
124
A key nursing intervention is to nurse the patient in a _____ room, or a ventilated room with an electric fan.
cool
125
Special __________ blankets, cooling pads and ice packs can assist to bring down the patient’s body temperature
cooling
126
Monitor for a sudden or marked elevation of ______ _________dyspnoea and restlessness when administering intravenous fluid.
blood pressure
127
Encourage fluid intake _______ if not contraindicated
orally
128
Wear ______- colored and loose-fitting clothing to prevent heat stroke.
light
129
Ringworm is a superficial fungal infection of the skin that appears as scaly, red, rounded patches, often forming ______ - like shapes
ring
130
______ personal hygiene is a cause of fungal infection
poor
131
______________ is a fungal infection caused by a yeast called Candida.
Candidiasis
132
Oral thrush causes creamy _______ lesions, usually on the tongue or inner cheeks.
white
133
Vulvovaginal candidiasis causes irritation, __________ and intense itchiness of the vagina and vulva.
discharge
134
_________ antifungals are used to treat fungal skin and nail infections
Topical
135
A common investigation for fungal infections is a _____ exam, using potassium hydroxide
KOH
136
Scratching the skin to relieve intense itching may cause open skin lesions and will increase the risk for ___________
infection
137
Advise the patient to dry skin thoroughly, especially after washing between _____ , to prevent growth of fungal infections.
toes
138
Encourage the patient to adopt skin care routines to decrease skin irritation by using __________ water and mild soap
lukewarm
139
Identify 3 types of dermatitis, other than contact dermatitis
Atopic, seborrheic, stasis
140
State the causes of atopic dermatitis
Generic and environmental factors
141
State 3 signs and symptoms of atopic dermatitis
Skin dry, itchiness (pruritus), erythema on face, hands, elbows and behind knees
142
Molly is a 30 year old woman who has been diagnosed with atopic dermatitis. Outline 3 health teaching for Molly. Support your answers with rationales.
a. Avoid irritants- prevent flare-ups
b. Apply only a thin layer of corticosteriod cream to affected area- Too much may increase side effects like thinning of skin
c. Avoid scratching, rubbing and picking skin- it can aggravate affected area and open wounds and scars
143
Identify 3 types of non-complicated chronic wounds
Infected wound, Ischemis (Poor blood supply), Ulcerated (in skin, arteries or veins, usually in lower limbs like diabetic foot ulcer & pressure injury)
144
Identify 3 factors affecting wound healing
Blood circulation to wound, Condition of wound,Moisture of wound
145
Mdm Tan was admitted for diabetic foot ulcer.
Outline 5 health teaching advice for Mdm Tan on wound care. Support your answers with rationales.
a. Advise diet high in protein, vitamin and mineral- promote wound healing
b. Keep dressing clean and dry- prevent worsening of wound and minimise risk of infection
c. Educate on S&S of infection- Early treatment and prevent complications
d. Go for follow ups- evaluate effectiveness of treatment
e. Continue with antibiotics- help treat and prevent bacterial infection
146
Cholecystitis:
Inflammation of the gall bladder
147
Appendicitis:
Inflammation of the appendix
148
Peptic Ulcer Disease:
Localised area of erosion and ulceration. Has two types, duodenal ulcer and gastric ulcer
149
Hepatitis:
Inflammation of the liver, may be viral or non-viral in origin
150
Hepatitis is defined as _____________of the liver
inflammation
151
Hepatitis can be viral or ________ in origin.
non-viral
152
If hepatitis persists for a long time, it can result in liver _________ and chronic liver failure.
cirrhosis
153
Inflammation of the ___________ areas of the liver may interrupt bile flow.
pero-portal
154
Liver cell damage in hepatitis consists of hepatic cell _______________and necrosis.
degeneration
155
During the recovery stage of hepatitis, liver cells ___________ and resume their normal function.
regenerate
156
Hepatitis A is caused by the Hepatitis A virus, also known as _____________.
hepatovirus
157
Hepatitis A is typically transmitted via the ____________ route.
faecal-oral
158
Hepatitis B is caused by the Hepatitis B virus, also known as _______________________.
orthohepadnavirus
159
Hepatitis B is transmitted through blood and ______ fluids.
bodily
160
There is no vaccination currently available for __.
C
161
Vaccination against Hepatitis ___ can also protect individuals from the D strain of the virus.
B
162
Hepatitis E is transmitted via the ___________ route, similar to Hepatitis A.
faecal- oral
163
Common signs and symptoms of hepatitis include fatigue, jaundice, and ______ coloured urine.
dark
164
Patients with hepatitis may experience abdominal pain in the ______ upper quadrant due to liver enlargement.
right
165
A common complication of hepatitis is liver __________, which involves permanent scarring and hardening of the liver.
cirrhosis
166
A diagnostic investigation for hepatitis includes a liver function test, also known as
____.
LFT
167
Chronic HBV may respond to ________________ or other antiviral drugs.
interferon-alfa
168
A common nursing diagnosis related to hepatitis is altered nutrition: less than body
requirements, related to _________ and vomiting.
nausea
169
Patients with hepatitis should avoid _________ during and after the infection to reduce stress on the liver.
alcohol
170
Describe the modes of transmission for Hepatitis A,B,C,D and E.
Faecal food (contaminate food and water) & Blood and bodily fluids
171
List 4 signs and symptoms a patient with hepatitis might experience.
Fatigue, jaundice, headache and nausea & vomiting
172
Outline 3 health teaching advice for a patient with hepatitis A.
Refrain from alcohol, Regular follow ups, Proper cooking of shellfish
173
Outline 3 health teaching advice for a patient with hepatitis B.
Avoid multiple sex partners, Partner to go for screening and vaccination, Adhere to antiviral meds
174
A peptic ulcer is a localized area of __________ and ulceration occurring in the mucosa of the stomach or duodenum.
erosion
175
The two common types of peptic ulcer disease are ________ ulcer and __________ ulcer.
duodenal, gastric
176
Duodenal ulcers develop on the inside of the upper part of the small intestine, also
known as the ______ ______.
Peptic ulcer
177
_____________________________ is a common bacterium that can break down the protective mucous coating on the stomach and duodenum lining.
Helicobacter pylori (H. pylori)
178
Long-term use of __________ (such as aspirin and ibuprofen) can damage the stomach lining and increase the chances of developing peptic ulcers.
NSAIDs
179
Excessive consumption of ___________ increases stomach acid production and may cause peptic ulcers.
alcohol
180
In peptic ulcer disease, the protective lining of the stomach or duodenum is damaged, allowing stomach acid and digestive enzymes like _________ to cause an ulcer.
pepsin
181
____________ and ________________ form a barrier to protect the stomach lining.
Mucus and bicarbonate
182
______________ support mucus production, blood flow, and reduce acid in the stomach.
Prostaglandins
183
____________ block prostaglandins, reducing mucus and bicarbonate production.
NSAIDs
184
A 'burning' pain that occurs soon after eating (when the stomach is full) is indicative of a ________ ulcer
gastric
185
A 'burning' pain that occurs before eating (when the stomach is empty) is indicative of a ________ ulcer.
duodenal
186
Vomiting is more commonly associated with ________ ulcers
gastric
187
An increase in appetite is more commonly associated with ___________ ulcers.
duodenal
188
Haematemesis and melaena are signs of ______________ bleeding in patients with peptic ulcers.
gastrointestinal
189
An investigation for peptic ulcer disease includes a blood test known as a _________ ________.
Occult blood
190
_____________________________________ is a common endoscopic investigation used for peptic ulcer disease.
Esophago-gastro-duodenoscopy
191
_________ _____________ _______(medication) are used to reduce stomach acid and protect the stomach and duodenum lining.
Proton pump inhibitors
192
__________ protective agents coat ulcers and protect them against acid and enzymes, thus facilitating the healing process.
Mucosal
193
In rare cases of peptic ulcer disease, surgery such as a ________ ______________ may be required to remove the entire stomach.
total gastrectomy
194
Poison may enter the body through breathing (__________), skin contact (____________/injection) or by mouth (__________).
inhalation, absorption,ingestion
195
At normal doses, the harmful byproduct (metabolite) of paracetamol is quickly neutralized by a substance in the liver called ____________.
glutathione
196
Taking an excessive amount of prescribed or over-the-counter drugs or mixing
incompatible medications is a cause of ____________
medication
197
Inhalation of ______________ gas from malfunctioning heaters, stoves, or car exhausts in enclosed spaces is a cause of poisoning.
carbon monoxide
198
__________ burns around the mouth if substance was ingested is a sign and symptom of poisoning.
Corrosive
199
Presence of __________ (indicates liver-cell necrosis) is a sign and symptom of poisoning.
jaundice
200
______ and Gastric contents for toxicological analysis is a type of investigation for poisoning.
Urine
201
If casualty is unresponsive and not breathing, start ______ __________________ and apply an AED.
chest compression
202
Consider ________ ________ and/or activated charcoal to decrease absorption of
ingested drugs (eg. paracetamol).
gastric lavage
203
________ airway patency and respiratory status frequently is an intervention for ineffective airway clearance.
Assess
204
Describe 3 differences in the signs and symptoms between gastric ulcers and duodenal ulcers.
gastric: duodenal, Pain after eating: before eating, Lose: Gain weight , Vomiting: Increased appetite
205
Outline 3 health teaching plan for a patient with peptic ulcer disease.
Take med as prescribed, Compliance to follow ups, Avoid NSAIDs
206
Define appendicitis
Acute inflammation of vermiform appendix
207
State 3 signs and symptoms of appendicitis
Fever, vomiting and acute pain at mid-abdominal later to LRQ
208
State 3 causes of appendicitis
Viral infection, Strictures and foreign body
209
Allan is a 25 year old man who had appendicitis and had undergone appendectomy.
Outline 5 health teaching advice for Allan on wound care. Support your answers with
rationales.
a. Keep surgical site clean and dry-Reduce risk of infection
b. Educate patient on S&S of infection like redness and pus-Reduce delayed healing
c. Educate patient on how to use aseptic technique when changing dressing- Prevent risk of infection
d. Advise patient to eat food high in protein, vitamin and minerals promote wound healing
e. Compliance to follow up appointments- Detect any potential problems
210
Define cholecystitis
Inflammation of gall bladder
211
State 5 signs and symptoms of cholecystitis
RUQ pain, nausea, fever, LOA, jaundice
212
Outline 3 health teaching advices for a patient with cholecystitis.Support your answer with rationales
a. Encourage low fat diet, frequent small meals-reduce workload
b. Follow ups - help identify ongoing issues
c. Signs and symptoms of complication- Early interventions
213
Define peptic ulcer disease. (PUD).
A condition characterized by open sores that develop in the lining of the digestive tract, specifically in areas exposed to stomach acid
214
State the differences between gastric ulcer and duodenum ulcer
One in duodenum and one in stomach
215
State 3 risk factors of PUD
Overuse of NSAIDs, smoking and alcohol consumption
216
Outline briefly 3 medical management for patients with PUD
Meds like PPIs, lifestyle change like quit smoking and surgery
217
Define hepatitis.
Inflammation of the liver, may be viral or non-viral in origin
218
State the mode of transmission for the following:
*Hepatitis A: Faecal food
*Hepatitis B: Bodily fluids
*Hepatitis C: Bodily fluids
*Hepatitis D: Bodily fluids
*Hepatitis E: Faecal food
Faecal food
Bodily fluids
Bodily fluids
Bodily fluids
Faecal food
219
Adnan is a 35-year-old man who was diagnosed with hepatitis C.
Outline 5 health teaching advice for Adnan. Support your answer with rationales.
a. Avoid multiple sex partners-prevent transmission
b. Educate partner to go for screening and vaccine-reduce risk of spreading infection
c. Avoid sharing needles-reduce risk of infection
d. Take antiviral meds-slow disease progression
e. Attend follow-ups-monitor liver function and overall health
220
State 5 signs and symptoms of Colorectal Carcinoma
Change in bowel habits, blood in stool, feeling very tired all the time, frequently feeling full or bloated, having nausea and vomiting.
221
Identify 5 causes of Colorectal Carcinoma
Family history, personal history of cancer, age, lifestyle factors, colorectal polyps
222
Outline 5 health teaching advice for a patient with Colorectal Carcinoma. Support your answers with rationales.
a. Cut down on food high in fat, cholesterol, and red meat- linked to increased risk of
colorectal cancer
b. Eat food high in fibre like fruits and vegetables- promote regular bowel movement
c. Importance of taking medication regularly- ensure effective treatment
d. Teach s&s of infection- prevent complications
e. Encourage cessation of smoking and alcohol- improve overall prognosis and health
outcome.
223
Outline briefly 5 nursing actions when performing blood glucose monitoring for patient. Support answers with rationale.
a. Remove one test strip from the container & recap immediately. Observe for discoloration – Prolonged exposure to humidity or temperature may inactive the strips.
b. Select appropriate site of finger (Alternate all sites) & clean with an alcohol swab – To minimize microorganisms.
c. Prick side of selected fingertip to obtain capillary blood specimen using a lancet of puncture device – Fewer nerve ending on the side of fingers.
d. Squeeze mid lateral position of the finger pad – To promote blood circulation to the puncture site.
e. Apply pressure to puncture site with a small piece of clean dry gauze – To stop bleeding.
224
Outline briefly 3 nursing assessments during blood glucose monitoring.
a. Assess patient’s previous blood glucose reading & last meal taken.
b. Assess the site of the most recent finger prick done.
c. Ensure that the test strip is within expiration date & has not been exposed to air.
225
State the purpose of performing monofilament test.
To detect early signs of peripheral neuropathy.
226
Outline briefly 5 nursing actions when administering insulin injection. Support answer with rationale.
a. Roll pen horizontally between both palms for at least 10 times – To mix the insulin evenly.
b. Assess injection site for inflammation, swelling, bruising – To avoid skin lesion & possible trauma to patients.
c. Select the insulin injection site (Abdomen, upper aspect of the arm or lateral aspect of the thigh & buttock) – Different sites can differ how long the medication is going to be absorbed.
d. Pinch skin gently at the site of injection with thumb and index finger to elevate tissue before needle penetration – To elevate subcutaneous tissue & lift adipose tissue away from underlying muscle.
e. Stable the syringe & needle. Insert needle fully at 90^ angle & inject medication slowly until dose selector returns to ‘0’ – Ensure medication is given into subcutaneous tissue to facilitate absorption & minimize pain.
227
Outline briefly 3 nursing assessment when administering insulin injection.
a. Check 5 rights of drug administration in the in – Patient Medication Record (IMR).
b. Verify of patient has any known drug allergy.
c. Determine whether patient is on NIL by mouth
228
Outline 5 nursing interventions when performing wound dressing for patient. Support answer with rationale.
a. Inspect the wound for union of stitches, signs of infection, exudates, inflammation and healing – To assess the condition of the wound and stage of healing.
b. Dressing should always cover the wound – To absorb excessive discharges.
c. Drape the surrounding area of the wound with sterile drapes if necessary – To maintain sterile field around exposed wound.
d. Cleanse the wound from the clean to the less clean area using a fresh swab each time – To keep microorganisms away from the wound.
e. Assist patient to a comfortable and appropriate position – Promote comfort and facilitates performance of the procedures.
229
Outline briefly 5 indications for wound dressing.
a. Apply medication to facilitate the healing process.
b. Provide sterile material for absorption of discharge.
c. Protect wound from any mechanical injury.
d. Promote haemostasis.
e. Prevent wound contamination from any source e.g. body discharge.
230
Outline briefly 5 factors that affect wound healing
a. Blood circulation to wound site.
b. Condition of the wound.
c. Moisture of the wound.
d. Individual general condition.
e. Individual nutritional status.
231
Outline briefly 5 nursing actions when inserting Indwelling catheter (IDC) for a female patient. Support answers with rationale.
a. Place patient to the dorsal position with thighs apart and knees flexed – To provide a clear view of the urethral meatus.
b. Check integrity of the balloon by inflating and deflating it with 10 ml of water for injection – Catheter with balloon that does not inflate or that leaks needed to be replaced before insertion.
c. Remove top part of plastic cover of the catheter. Lubricate the tip of the catheter (3 to 5cm) with a water-soluble lubricant and place it in the sterile thermoplastic tray – Lubrication facilitates catheter insertion and prevent trauma to urethra meatus.
d. Clean urethral meatus – To reduce the risk of introducing microorganisms from genital area to the urinary tract.
e. If catheter is to be left in situ, inflate the balloon via balloon port with sterile water – To anchor the tip of the catheter in place above the bladder neck. This is to prevent the catheter from slipping out.
232
Outline briefly 5 nursing considerations who has an IDC
a. Regularly check on the catheter tubing to ensure there are no kinks to promote flow of urine.
b. Record of intake & output chart for strict monitoring.
c. Perform perineal care twice daily and as needed, using standard precautions to prevent offensive odour, skin breakdown, urinary tract infection and promote comfort.
d. Ensure tip of the urine bag valve is not touching the floor at all times. This is to prevent urinary tract infection.
e. Urine bag should be emptied every 8 hours or whenever it is two-thirds full. To Prevent urine bag from getting over distended and cause backflow of urine.
233
Outline briefly 5 nursing interventions when caring for a patient with continuous bladder irrigation. Support answers with rationales
a. Regulate fluid flow using the roller clamp to the prescribed or appropriate rate according to the colour of the return flow – To ensure patency of the catheter.
b. Observe for any abdominal pain or bladder distension during the irrigation – It is possibly due to over stretching of the bladder, blockage of the catheter or sensitivity to the irrigation solution.
c. Replace the irrigation solution using aseptic technique as soon as the bag empties (Do not let the irrigation bag be completely emptied) – To prevent entry of air and subsequent bladder discomfort.
d. Connect the distal tip of the Y irrigation tubing to the irrigation channel using aseptic technique – To allow drainage to flow by gravity.
e. Close the roller clamp when solution reaches the distal end of the tubing – To prevent excess solution from draining through the tubing.
234
State the purpose for performing bladder scan
To determine a post-void residual urine (PVRU) by assessing bladder volume for patient with: Urinary incontinence (stress, functional, urge, mix, overflow, transient), urinary retention, urinary tract infection
235
Outline 3 health advises you would give on oral bowel preparation for patient going for colonoscopy. Support answers with rationales.
a. 3 days before procedure, patient should avoid eating fruits, vegetables, brown rice, red meat – Foods with high fibre content and difficult to fully digest may leave residue in the colon.
b. 2 days before procedure, patient should have a clear fluid diet only. (Clear soup, apple juice, rice water) – Clear fluids are easy to digest and leave very little residue in the digestive system.
c. 1 day before procedure, patient should avoid solid food but consume soft or liquid diet. To start on laxative oral bowel preparation – To ensure that the colon is completely empty, allowing for a clear and accurate examination.
236
Outline 5 nursing actions when changing stoma for patient
a. Gently dab dry the peristomal area. (No rubbing) – Rubbing leaves behind debris and upsets good adhesion.
b. Inspect the stoma and surrounding skin, muco-cutaneous junction and peristomal skin area. (Healthy should look pink or red in colour, moist, slightly shiny and free from excoriation) – Deviation from normal must be reported immediately so that appropriate care can be planned.
c. Measure the stoma with a stoma guide and trace the selected size onto paper backing of wafer (Ensure opening is 2mm to 3mm larger than the size of the stoma) – Obtain the exact size and to ensure that only minimum skin area is exposed to the discharge from stoma.
d. Cut the wafer according to the measured size and smoothen the rough edges – Prevent laceration or injury to stoma.
e. Fold the open end of the drainage bag over the clip. Press the clip firmly, until a ‘click’ sound is heard – To prevent any leakage.
