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SEMESTER 6: Chronic, Clinical, Emerg > Clinical FINAL > Flashcards

Clinical FINAL Flashcards

1
Q

What are the 6 stages of the Change Theory?

A
  • pre-contemplation
  • contemplation
  • preparation
  • action
  • maintenance
  • relapse
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2
Q

What is the emotional management tool used for?

A

identify the purpose of their unhealthy behaviour (e.g. smoking, emotional eating) and support a replacement function

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3
Q

What is the motivational enhancement tool used for?

A
  • determining clients readiness for change

- explore pros and cons of staying the same and changing the behaviour

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4
Q

What is the behaviour change tool used for?

A
  • Developing a SMART goal
  • stimulus control
  • reinforcement that it takes lots of time to change behaviours
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5
Q

How does exercise training help those with CHF?

A
  • helps to improve skeletal muscle function

- Pts are able to complete activities with reduced SOB and fatigue!!!

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6
Q

What kind of exercises are recommended for HF?

A
  • aerobic, anything to increase heart rate (e.g. walking)
  • Walking or stationary bike with NO resistance (perfect for beginners)
    - 10-15 mins, up to 30
  • include warm up and a cool down!!! (stretching)
  • strength-training
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7
Q

What is a good tip for HF pts during exercise if they are unable to complete an activity that is 15 mins?

A

try 2-3 sessions of 5 minutes instead

- toleration of sets is improved rather than increased time… they need breaks!

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8
Q

What is the “walk so you can talk” rule?

A

SOB is normal. If you find you cannot complete a sentence, you must slow down.

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9
Q

What activities must be avoided until approved by specialist?

A
  • lifting over 10lbs
  • shovelling snow
  • stretching both arms over head
  • saunas or hot tubs
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10
Q

What are some general exercise tips for those with HF?

A
  • avoid exercise after large meals
  • schedule exercise for when you feel the best
  • record exercise to monitor progress
  • avoid exercise in extreme temps or windy weather
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11
Q

What is ambivalence?

A

wanting to stop but also not wanting to stop

- common in addictions

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12
Q

What are the 5 general principles of motivational interviewing?

A
  • empathy
  • determine discrepancy between clients goals and their behaviour
  • avoid argument or confrontation
  • adjust to client resistance
  • support self-efficacy and optimism
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13
Q

What does LEARNS model stand for and what is it for?

A
  • listen
  • establish
  • adopt
  • reinforce
  • name
  • strengthen

facilitating client-centered learning

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14
Q

What is the most common chronic condition in children?

A

diabetes mellitus

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15
Q

What are some people that may be included in diabetes education for a child with T1DM?

A
  • dietician
  • pediatrician with diabetes expertise
  • mental health professional
  • social worker
  • diabetes nurse educator
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16
Q

What are some education topics that should be considered when providing education to a child with T1DM and their family?

A
  • insulin and administration
  • blood glucose and ketone monitoring
  • prevention of DKA
  • diet and nutrition
  • prevention/detection of hypoglycemia
17
Q

What child is suggested to have a slightly better outcome (less DKA risk, better mgmt skills))?

  • child with new onset of T1 presenting to hospital with DKA in which required a short stay at the hospital
  • outpatient education for a child with new onset of T1
A

Outpatient education!

  • less expensive than inpatient education and seems to have the more improved outcomes. Perhaps due to independency.
18
Q

What are the recommended glycemic targets for child/teen with T1?

A

less than 7.5%

19
Q

How can we reduce the progression of diabetes-related complications in those with T1?

A
  • sufficient knowledge of glycemic targets

- tight glycemic control

20
Q

What is the “honeymoon” period of T1DM?

A

the first 2 years after diagnosis, in which seems to be the time where glycemic control is easiest.
- after 2 years, tighter mgmt is required

21
Q

What is consisted of basal-bolus insulin regimens?

A
  • long-acting basal insulin (scheduled) and rapid-acting bolus (sliding scale)
22
Q

What is continuous subcutaneous insulin infusion (CSII)?

A
  • insulin pump, known for improved control and reduction of hypoglycemic episodes
23
Q

Which is better: basal-bolus insulin regimens or CSII pump?

A

both have their pros and cons, neither one is better than the other

24
Q

If a child is hypoglycemic and refuses oral fluids….

A

IV dextrose or mini doses of glucagon

25
Q

What is the most commonly used method for “diet” in T1DM children?

A

Carbohydrate counting

26
Q

If blood glucose has not increased in 20 minutes following a dose of glucagon, what do you do?

A
  • give an addition DOUBLE dose
27
Q

What is the minimum and maximum dose of glucagon that can be given?

A

2 units - 15 units

28
Q

A child comes in consistently with an A1C of over 10%, what do you do?

A

Perform a careful multidisciplinary assessment to identify potential causative factors such as:

  • eating disorders
  • low ses
  • low family support/family conflict
  • depression
29
Q

How can DKA be prevented?

A
  • through early recognition and initiation of insulin therapy
30
Q

Risk factors of cerebral edema during DKA treatment in children:

A
  • less than age 5
  • new-onset diabetes
  • greater acidity
  • IV bolus of insulin
  • failure of Na to rise during treatment
  • use of bicarbonate
31
Q

Complications of diabetes… (5)

A
  • chronic kidney disease
  • retinopathy
  • neuropathy
  • dyslipidemia
  • HTN
32
Q

What medication increases risk of developing gestational diabetes (GDM)?

A

corticosteroids

33
Q

When is a women screened for GDM?

A

24-28 weeks of pregnancy, if a high risk then it should be before 20 weeks

34
Q

What is the most common complication of pregnancy?

A

hypertension or preeclampsia

35
Q

What is the 100% treatment of preeclampsia?

A

birth of the baby

36
Q

What is the eligibility criteria for MAiD? (5)

A
  • informed consent
  • Canadian citizen
  • 18 yrs or older, mentally competent
  • voluntary request (no pressure)
  • death is reasonably foreseeable
37
Q

What are the 5 components of the MMSE?

A
  • orientation
  • registration
  • attention and calculation
  • recall
  • language

SEMESTER 6: Chronic, Clinical, Emerg (4 decks)

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