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C2C > Clinical Skills > Flashcards

Clinical Skills Flashcards

1
Q

why do we test urine

A

aids diagnosis, helps identify UTI or urinary problems
changes in urine detect problem before proper effect
easy and simple
quick and reliable, cheap

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2
Q

what are the clinical indications of urinalysis

A

urinary symptoms (abdominal pain, dysuria, change in flow)
diabetes, renal diseases
particular unwell ness - part of sepsis screen
routine screening (pregnancy)

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3
Q

what are the difference specimen types of urinalysis

A

random
first morning
fasting (best for glucose)
timed (24 h)

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4
Q

what do these colours indicate in urine sample
red
yellow
brown

A

haemoglobin - dietary faros such as beetroot turn red
bilirubin
myoglobin - drug side affect

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5
Q

what do you look for when initial examination of the sample

A

colour
clarity
odour

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6
Q

why do you check for clarity of urine

A

suspended particles can cause hazy cloudy appearance

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7
Q

why does the odour change in urinalysis

A

infection - ammonia production

ketones - sweet or fruity

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8
Q

what type of strip do you use in urinalysis

A

ames reagent

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9
Q

what is the time frame for urinalysis

A

30 seconds to 2 minutes

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10
Q

what are common mistakes or reading dip sticks

A

they are out of date
reading them upside down
not reading at correct time

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11
Q

how long do you put stick in urine for

A

1 second then remove excess

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12
Q

what are the categories on a dip stick

A 
2 min 
leukocytes 
nitrite 
urobilogen 
protein 
pH
blood 
specific gravity 
ketone
bilirubin
glucose 
30 seconds
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13
Q 
how do you interpret glucose 
bilirubin
ketones
gravity 
blood 
in urine
A

GLUCOSE – NOT normally detectable. If present suggests elevated blood glucose (diabetes) or reduced renal threshold. Follow up with blood glucose check.
BILIRUBIN – Hepatic or biliary disease.
KETONES - Breakdown product of fatty acid metabolism: DKA, starvation, anorexia, nil by mouth, vomiting.
SPECIFIC GRAVITY – Hydration level, kidney function (osmolality), other substances (E.g Radio-opaque dye)
BLOOD – Renal/urological disease and/or infection, trauma (surgery or catheter), tumour, stones, toxins.

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14
Q 
how do you interpret 
ph 
protein 
urobilinogen 
nitrites and leucocytes 
in urine
A

pH - low fasting, high after meals, normal 4.8-8.5 (usually about 6)
PROTEIN- diabetes, hypertension, glomerular disease, infection. Trace=150mg/24hr=upper limit of normal.
UROBILINOGEN- normal in urine, but +++ may be liver disease or red cell destruction (haemolytic anaemia).
NITRITES & LEUCOCYTES – Infection (nitrites: gram neg bacteria). If positive send for urine microscopy, culture & sensitivity (M,C&S).

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15
Q

what are vital signs

A 
temperature 
pulse rate 
respiratory rate 
oxygen saturation 
blood pressure
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16
Q

what does the news scoring system observe

A 
temperature 
HR 
systolic BP
respiratory rate 
oxygen saturations 
respiratory support 
conscious level (AVPU)
17
Q

what is the normal range of body temp

A

36 - 37.5

18
Q

what is too high body temp or too low body temp called

A

pyrexia greater than 37.5

hypothermia less than 35

19
Q

what is pyrexia commonly due to

A

infections, immunisation inflammatory disease such as RA

20
Q

what can hypothermia be due to

A

acute or immersion hypothermia eg falling into cold water
exhaustion hypothermia
chronic hypothermia such as elderly people

21
Q

what is the normal adult HR range and what are two exceptions

A

60-80bpm but athletes or elderly have lower heart rate s

22
Q

what are the tachycardia / bradycardia ranges

A

greater than 100

less than 60

23
Q

what can tachycardia be du to

A

anxiety, exercise, fever, hypovolaemia

24
Q

what can brady cardia be due to

A

athletes
medication
heart block
raised intracranial pressure

25
Q

what are the four different aspects of arterial pulse to look for

A

rate
rhythm
volume - strength
character

26
Q

what is the most common cause of irregular heart rhythm

A

atrial fibrillation

27
Q

what is the average respiratory rate in healthy adults

A

12-20 breaths per minute

28
Q

what is the difference in average heart rate in children compared to adolescents

A

adolescences - 18-22

children - 22-28

29
Q

what causes the rate of breathing to change

A

faster - pain, anxiety, activity, fever

slower - CNS depression, sedation, opioids

30
Q

when someone is hyperventilating what actions might they be doing

A

neck muscles in inspiration
abdominal muscles in expiration
using arms to make tripod

31
Q

why do we measure PEFR and what diseases can be used to identify

A

assessment of respiratory function at a particular moment in time
asthma
COPD

32
Q

what is the difference in O2 saturation in a normal vs respiratory disease patient

A

greater than 95%

88-92%

33
Q

what is the average blood pressure

A

120/80

34
Q

when measuring pressure what are the names of the sounds you hear

A

korotkoff sounds

C2C (1 decks)

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