Communication skills Flashcards

1
Q

What is INR?

A
  • Derived from prothrombin time
  • 1.0 represents global average
  • monitors patients on warfarin
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2
Q

What is PT?

A
  • prothrombin time
  • measures how long it takes blood to clot via extrinsic pathway ( play tennis outside so PT = extrinsic)
  • 10-13 seconds
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3
Q

How do you open an INR consultation?

A
  • establish reason for being on warfarin and target INR range
  • Ask ICE, if they know what warfarin is
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4
Q

How do you explain warfarin to a patient?

A
  • warfarin is an anticoagulant
  • thins blood to prevent clots
  • used to treat prev clots in legs/lungs
  • prevent clots for high risk e.g. irregular heartbeat or heart valve
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5
Q

How do you explain INR to a patient?

A
  • measure of how long blood takes to clot
  • 1 in healthy people
  • target range is 2-3 (2.5)
  • monitor INR often and adjust warfarin
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6
Q

How should warfarin be taken?

A
  • same time each day
  • no skipped doses
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7
Q

What affects PT?

A
  • liver disease
  • vit K deficiency
  • warfarin levels
  • DIC
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8
Q

What should you ask about the patient’s daily life relating to warfarin?

A
  • impact on work, social
  • impact on mood
  • impact on sleep
  • weight change
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9
Q

What are abnormal INR symptoms?

A
  • clots
  • leg swelling
  • SOB
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10
Q

What dietary advice can you give regarding INR?

A
  • Lower consumption of foods high in Vit K - broccoli, kale, spinach. cranberry juice (interacts)
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11
Q

What other lifestyle advice should you give regarding INR?

A
  • limit alcohol to 1-2 drinks per day, no bingeing
  • take care brushing teeth or shaving
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12
Q

What is FEV1?

A
  • forced expiratory volume in 1s
  • vol exhaled in 1st second after deep inspiration and forced expiration
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13
Q

What is FVC?

A
  • total volume of air that pt can forcibly exhale in 1 breath
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14
Q

What are normal FEV1, FVC and FEV1/FVC ranges?

A
  • FEV1: >80% predicted
  • FVC: >80% predicted
  • FEV1/FVC ratio: >0.7
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15
Q

What are findings in obstructive lung disease?

A
  • reduced FEV1 <80% predicted
  • reduced FVC (to a lesser extent
  • FEV1/FVC ratio reduced <0.7
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16
Q

What are findings in restrictive lung disease?

A
  • reduced FEV1 <80% predicted
  • reduced FVC <80% predicted
  • FEV1/FVC ratio normal >0.7
17
Q

What changes should you ask about at a peak flow station?

A
  • new pets
  • moving house
  • changes in job
18
Q

What should you ask about previous resp diagnoses at a peak flow station?

A
  • cough
  • SOB
  • prev hospital admissions
  • inhaler technique
  • inhaler frequency
19
Q

What symptoms should you enquire about at a diabetes station?

A
  • polyuria and polydipsia
  • neuropathy
  • sleep disturbance
  • vision
  • weight change
20
Q

What social factors should you enquire about at a diabetes station?

A
  • alcohol and amount
  • mood and stress
  • impact on daily activities
21
Q

What should you ask about the patient’s diabetes diagnosis?

A
  • how long ago they were diagnosed
  • how they are managing to control their diabetes