Communications skills Flashcards
explaining what is COPD
“Chronic obstructive pulmonary disease or COPD is a common condition affecting your lungs, making it harder for you to breathe. It includes conditions such as emphysema and chronic bronchitis.”
“In COPD, there is inflammation in the lungs (chronic bronchitis), which causes narrowing of the small tubes in your lungs. This makes it more difficult to breathe. In addition, the inflammation causes your lungs to produce lots of mucous, which you cough up as phlegm.” - also not fact that harder for air to enter ans stale air to leave = inc risk of lung infections
“Also, in COPD, the walls of air sacs in the lungs called alveoli are destroyed (emphysema) . This makes it harder for your body to absorb oxygen from the air in the lungs.”
Explaining the causes of COPD
“COPD is caused by long-term exposure to harmful irritants that damage the lungs over time.”
“The most common cause of COPD is smoking. This risk increases the more you smoke and the longer you’ve been smoking.”
“Some other things that cause COPD include breathing in chemical fumes, air pollution or rarely an inherited genetic condition.”
explaining problems/complications of COPD
Explain to patients that COPD develops over several years and their symptoms may not be noticeable until recently. These symptoms worsen over time and make their activities of daily living more difficult, however, treatment can help slow the progression of COPD.
common sx
breathlessness and wheeze
chronic cough
chest infections
also infections and excerbations
management of COPD
STOP SMOKING
Vaccines
pul.rehab - excercise and education
inhalers
steroids and abx in exacerbation
oxygen therapy if chronic low o2 (aim to improve breathing and extend life)
closing consultation
discussed a lot today ie sx might experience and how condition is managed so heres leaflet
safety net - sx worse, v SOB w tx = seek care
anything youd like me to go over ?
any other qs?
direct to further websites and leaflets
explaining a disease
normal functioning
what disease is
cause
problems/complications
management
Informations sharing structure
brief hx
understanding
concerns
explanation
summarise
brief hx ws
what has brought the patient in to see you today
what are ur sx
any risk factors/ worse or better
understaning qs
what do you think is causing your sx
what do you know about x
what has been explained to you about acne so far
Concerns
what are you worried about regarding your sx
what are you hoping to get out of the consultation today
acne explaining nromal what it is and cause
skin is like barrier w sebum to protect in acne = too much sebum = spots
can be caused by hormones, bacteria, meds like steroids and glands blocked bc make up
acne problems/ complications
Sometimes once the spots have healed you can be left with scarring on the skin or changes to the normal colour of the skin. This is why it’s important to try and treat acne well. But if you do develop these problems there are potential treatments available.”
“Acne can also often make people feel self-conscious or worried about their appearance. If this is happening to you then it’s really important that you talk to someone about it.”
acne explain mx
topical tx:
- creams the counter salicylic acis and benzoyl peroxide to unblock and get rid of bact
moderate = topical retinoid - reduces sebum but can dry skin
if those dont work book another apt and we can see = other options oral COCP and Abx
problems/ complications of psoriasis
persistent disease and sx
anxiety and depression bc psychosocial burden of the disease
reduced quality of life
development of asx conditions eg psoriatic arthritis
severe flare - pustular blisters or painful itchy rashes
management of psoriasis
emollients; ointments, cream, gel
(different types so pick what works best ie trial and error)
topical corticosteriouds dont use on face and wash hands
if not succesful other options
top - tar prep. calcipotrol (vit Danalogue)
systemic - MTX or retinoid
phototherapy
what is asthma
more common lung condition - sensitive and inflamed airways = more narrow than normal
sx wheeze chest tightness SOB maybe not all same time come and go in responcse to triggers - important to take meds everyday to reduces chance of sx or becoming unwell
common triggers pollen pets stress infection smoking and sudden temp changes
different for each person so need to work it out as avoiding is key part of management
problems and complications
asthma attack (worsenig sx and inhalers not helping)
persistant sx - ie affeccts adls. waking up breathless, peak flow lower then normal- seek care maybe alter meds
aims of asthma managment
reduce impact on day to day life ie
no daytime or nightime sx
no excercise/acitivty limitations
limite meds SE
types of asthma inhaler
reliever (salbutamol) blue - max 3 times a week for sx
two puffs 30 secs inbetween
preventer inhaler (beclometazone) use every day dont miss doses and rinse mouth out
asthma management
inhalers
refer for more if dont work
peak flow meter
2x a day
personal asthma management plan
annual review and vaccinations
diabetes problems / complications
high levels of sugar in the blood can damage the blood vessles of:
the kidneys - mkidney failure
the heart - inc risk of heart attacks
the brain - inc risk of stroke
the eyes - loss of vision
the nerves of the lower limbs - peripheral neuropathy
also slow healing wounds ie inc risk of diabetic ulcers
also DKA
things pt can do for diabetes
lifestyle change - healthy food low sugar lose wt regular excercise
stop smoking
tight glycaemic control
attending diabetic checks
encourage good foot care and regular podiatry appointments
things dr will do for diabetes
regular check ups - to screen for complications
reg blood tests to check blood sugar levels
counselling on metformin or oral hypoglycaemics
managing complications as they arise
management of GORD in kids
breastfed - 1-2week trial of gavscon
formula fed -
1-2 week trial smaller more freq feeds (still maintaining appropriate amount of milk )
1-2 week trial feed thickeners
the gaviscon
all fail
= 4 week trial PPI
red flags GORD in kids same day admission
rarely can result in bleeding in the stomach and food pipe = blood in vomit and black stools
types of dialysis
haemodialysis (fistular, graft or line in emergency)
peritoneal dialysis (continuous, or automated{overnight])
haemodialysis positives and negatives
+ve
centre = social aspects
dialysis free days
home haemodialysis can be altered
-ves
restricted diet and fluid intake (bc linger time between blood cleanse)
SEs: low BP. ,uscle cramps feeling itchy
needs vasc access which may have own complications
home haem; space for machines and supplies, trained family member
peritoneal dialysis +ves and -ves
+ve
less food and fluid restriction
no needles
in charge of own tx so can be flexible to fit with routine
and easier to organise travel
CAPD - dont need machine, can fit w schedule, done anywhere as long as can hand wash and clean
APD - no dialysis during the day
-Ve
everyday
permenant cath in abdo
risk of peritonitis
need to be super clean
thickening and scarring of peritoneum
be careful w constipation
CAPD - fluid exchanges every 4 hours can disrupt routine and always have fluid in abdo 7 days a week
APD - space for machine and supplies and being connected to machine 8-10hrs a night can limit movement
types of peritoneal dialysis
continuous ambulatory peritoneal dialysis (CAPD)
constantly fluid in abdomen through cath in abdo lining
pt perform dialysis fluid exchange themself
4 times daily each one 20-30 mins
Automates peritoneal dialysis
performed by machine overnight while pt is asleep
connect before bed and need to be attached for 10 hrs
risks of blood transfusion
indentification
reactions during ie rash and fever/chills
build of fluid - SOB
infection w blood virus (v low risk 1 in a million)
formation of autoantibodies
iron overload in long term programs
cant donate blood if received transfusion
causes for blood in stool
bowel cancer
crohns
UC
gastroenteritis
anal fissures
haemorrhoids
how often and how do bowel ca screening then what happens
every 2 years between ages 60-74 and thos w family hx colorectal ca
use fit test kit - collect single stool sample in small plastic sample bottle then post back to lab for testing to check for small amouts of blood in poo
results within 2 weeks
abnormal result = colonscopy – just bc result doesnt mean bowel cancer could be due to a large no. of conditions many of which are treatbale
explaining procedure start
i would like to give you more info about x, ill discuss why its used, what happens during treatment and benefits and risks of tx. any qs ant any point pls feel free to ask, anything else you want me to cover today ?
what is ECT what happens
psychiatric tx - pt put to sleep GA then electrical energy directed towards brain through electrodes to induce seizure
meds given to relax muscles so seizure activity minimised in body
pt monitored throughout
though to reorganise networks that are disordered in mental illness
muscle relaxant used in ect
suxamethonium
ECT course SEs
twice weeky for 6-12 week course
short term memory loss (and before n after ect)
post ect headache
post ect muscular aches
usually mild and most pts return to baseline post tx course
risks of ECT
GA risks - airway issues, reaction to anaethestic, dental damage
prolonged seizure
no response to tx
