End sem Exam Flashcards
The cultural safety in health care for Indigenous Australians monitoring framework is structured around 3 modules, name these 3 modules.
Module 1: Culturally respectful health care services, Module 2: Patient experience of health care, and Module 3: Access to health care services.
List different types of respiratory patterns
Kusmals
Aggonal
Cheyne stokes
shallow
Apnoea
Bradypnoea
Sputum colours are linked to a cause, expand further
clear, white, or gray- healthy lungs.
Mucoid- Ashtma, coryza
dark yellow or green- Bacterial or viral infection, such as pneumonia, or cystic fibrosis, an inherited condition that involves excess mucus buildup.
pink can indicate pulmonary edema
red- Internal injury, lung cancer, or a pulmonary embolism (PE), lung cancer.
What is the difference between modifiable and modifiable risk factors
Nonmodifiable risk factors cannot be controlled. These include gender, race, family history and advancing age.
Modifiable risk factors can be controlled, or changed- Smoking, nutrition, alcohol consumption.
Describe delirium
An acute change in mental status that is often triggered by acute illness, surgery, injuries or adverse effects of medicines.
What are the principles of person-centred & family- centred care?
- Knowing the person as an individual
- Being responsive
- Providing care that is meaningful, coordinated and integrated
- Respecting the individual’s values, preferences and needs and putting
them at the centre of care - Fostering trusting caregiver relationships, with good communication,
information sharing and education - Emphasising freedom of choice with access to appropriate care when it is
needed - Promoting physical and emotional comfort
- Involving the person’s family and friends, as appropriate
- Ensuring continuity of care between and within healthcare services
What is a grommet ?
A small tube placed in the TM to allow ventilation and fluid drainage
What is Antimicrobial Stewardship
The appropriate use of antimicrobials to best treat infections and minimise antimicrobial resistance.
Oh Oh Oh To Touch And Feel Very Good Velvet AH,
12 cranial nerves
olfactory (I) - smell;
optic (II) - vision;
oculomotor (III) for eye movement and pupil constriction;
trochlear (IV) - downward and inward rotation of the eye;
trigeminal (V)- facial sensation and chewing; abducens (VI) - lateral eye movement;
facial (VII) - facial expressions and taste; vestibulocochlear (VIII)- hearing and balance; glossopharyngeal (IX)- taste and swallowing; vagus (X) controlling speech, swallowing, and heart rate; spinal
accessory (XI)- neck and shoulder movement; and lastly,
hypoglossal (XII) - tongue movement.
What is the primary pacemaker of the heart and where is it located?
SA node located in the R) atrium
Name some VTE prevention
TEDS, Flowtrons, administering low molecular weight heparin as ordered.
Oxygen devices and flow rates
Nasal canuals- 6L/min 5-6L/min- Low flow
Hudson mask- 5-10l/min- Low flow
Non-rebrether 10-15L/min- Low flow
Venturie mask-specific nozzles - High flow
STEMI
S-T elevation on ECG or new
Lowe Bundle Branch Block with full-thickness myocardial wall damage
Name shockable and non-shockable rhythms.
Shockable
Pulseless VT
VF- Ventricular fibrilation
Non- shockable
Asistole
PEA
Anatomical landmarks of the ECG electrode placement
V1- 4th intercostal, 2 finger space right ofsternum
V2- – 4th intercostal, 2 finger space left of sternum
V3- – between V2 and V4 (placed after V4 normally
V4- 5th intercostal at midclavicular line
V5- 5Th Intercostal space- left anterior axillary line
V6- 5th intercostal space- left mid-axillary
line.
limb leads
How to assess for LOC
AVPU
GCS
AVPU
Alert
Verbal
Pain
Unresponsive
PU- Do GCS
GCS Breakdown
1-15
Eyes- 4
Verbal- 5
Motor-6
Otalgia V Tinnitus
Oltiga is ear pain, and tinnitus is ear-ringing
AEIOUTIPS
Reasons for LOC.
A- Alcohol
E- epilepsy
I- infectiom
O-opioids
U-Urates
T- Trauma
I- Insulin
P- Poisons
S- Shock/Stroke
Primary assessment
focused assessment and expand
Rapid A-E to rule out any lifethreatning issues - fluid- if you mess you reasess
A- Airway- patent? AVPU
B- Breathing- RATES, WOB, Colour of skin,
C- Circulation- Assess and compare the central and peripheral pulses, observe and palpate the skin for warmth, colour and moisture if circulation is absent. ECG.
D- Dissability- Neurological status using the GCS, check the BGL level, review the documentation (what interventions of medications have they received)
E- Exposure- Remove the patient’s clothing (if appropriate) to rapidly expose the body to assess for any other signs of illness or injury (rash, external bleeding), keep the
patient warm (apply warming methods) and assess their core temperature.
F-J
Secondary Assessment
process and once the life threats have been managed.
* Full set of vital signs and include the family involved.
* Get monitoring devices and give comfort
Review any laboratory studies (bloods), attach monitoring, consider the need for NGT/OGT insertion, Assess and apply oxygen and ETCO2, complete a pain assessment and manage accordingly
* History and head-to-toe
Inspect and palpate the body using a systematic approach from the head to the toes, assess the following:
* Head and face
* Neck
* Chest
* Abdomen and flanks
* Pelvis and perineum
* Extremities
* Inspect posterior surfaces
Don’t forget to roll your patient to review the posterior surfaces, if safe to do so
* Just continue to monitor and keep reevaluating Keep evaluating the vital signs, injuries and interventions, primary survey and pain
Understand the assessment techniques by applying HIPPA/HIAPP and expand on each of the components
History
Inspection
Percuss
Palpate
Ascultate
HIAPP for gartointestinal focused due to causing abnormal bowel sounds if pushing before listening.
Describe Coronary Heart Disease (CHD)
Presence of an atheromatous plaque
in a coronary artery causing:
➢ Haemorrhage into the plaque causing it to swell and restrict the lumen of the artery
➢ Contraction of smooth muscle within the artery wall, causing further constriction of the lumen
➢ Thrombus formation on the surface of the plaque, which may cause partial orcomplete obstruction of the lumen of the artery or distal embolism
What is a Cushings Triad and what are the hallmark signs ?
A Cushing’s triad is a late sign of increased ICP this presents as widening PP, bradycardia and irregular respiratory rate.
F.A.S.T and what is it used to detect?
Stroke
facial droop, arms, speech and time is tissue
Two types of strokes and thier difference?
Hemorrhagic- caused from bleeding,
Ischaemic stroke- is caused from a blockage
Steps of the Clinical Reasoning Cycle
Consider patient situation
Collect cues
Process information
identify problem/issues
Establish goals
Take action
Evaluate outcome
Reflect on process and new learning
Describe Hypertension
High blood pressure is when the force of the blood pushing
against the arterial walls is consistently high. Arteries can
become damaged and lead to serious complications (MI/stroke).
BP 130/80 mmHg (greater than 130/80 mmHg
* BP 140/90 mmHg
NSTEMI
Elevated serum troponin levels in the absence of ST elevation with partial thickness myocardial wall damage.
What is subjective data
Subjective data is information obtained from the patient and/or family members and can provide important cues about functioning and unmet needs requiring assistance.
What is objective data
Objective data is obtained during the physical examination component of the assessment process. Examples of objective data are vital signs, physical examination findings, and laboratory results.
What is OPQRST
Used to assess Pain
O- onset
P- Provocation
Q- Quality
R-Radiation
S- Severity
T- Timing
parts of a health history
Demographic information
Resons for seeking care
Own preception of health
PMHx, Surgical Hx, recent hospitalisation
Family Hx
immuninsation/exposure
Medications/ allergies
Developmental level
Psychological/ Sociocultural Hx
ALDS’s
R/V of systems
FLACC/ Wong baker
FLACC is a behavioural pain assessment- Peads
Wong baker- Sliding scale using the faces
Secondary Assessment
F- Full set of vital signs, get family involved
G- Get monitoring devices & Give comfort
H- History & Head to toe
I- Inspect posterior surfaces
J- Just keep monitoring & reevaaluating
D- Documentation
Aspects of Functional Health Assessment
- Health perception/ health pattern
- Nutrition- metabolic pattern
- Ellimination pattern
- Activity- excercise patter
- cognitive- perceptual pattern
- Self-perception/ self- concept pattern
- Sexulaity- reproductive pattern
- Coping/ stress pattern
- Value/ belief pattern
Considerations for disability
- Disability inclusion
- Accessibility
- Develop a personal connection
- Effective communication
- Physical and emotional needs
- Collaboration with MDT
- Best practice approach
- Advocacy
NSQHS Name them
7 standards
What is a focused assessment?
A targeted assessment specific to the area of complaint/ presenting issue
Ventilation
physical act of breathing
Inspiration
Air rushes into the lungs and chest size increases
Expiration
Air is expelled out of th elungs and chest recoils
Diffusion?
Passive movement of gasses from high concentration to low consentration
Perfusion
Movemtn of blood to and from the lungs and the delivery of oxygen around the body.
Symptoms of hypoxia
Restless
Dizzy
Pallor
Decresed LOC
Tachypnoea
Cyanosis
Describe the function fo the heart
to pump blood and oxygen around the body and deliver waste products (carbon dioxide) back to the lungs to be removed.
What is Angina
Angina is chest pain that results when there is insufficient blood and oxygen supply to the heart
- Stable (or chronic) angina – occurs when the heart is working harder than usual for example during exercise.
- Unstable angina – occurs when at rest and follows an irregular
pattern. - Variant angina (Prinzmetal) – occurs at rest without any
underlying coronary artery disease.
What caused a MI
Myocardial infarction
Sustained ischemia causing necrosis
- severe immobilising chest pain not relieved by rest, position change or nitrates.
- Increased troponin that rises over 4-6 hours- peak at 10-24hrs
1.
Compomnents of cardio assessment CRC related
HIPPA
ECG- cardiac monitoring- give to senior doctor for interpretation
IPPA
Assess jugular venous pressures
Document
Electrical pathway of the heart and locations
SA node- Right atrium
AV node- Right atrium
Bundle of Hiss- septum of the heart
Right and left Bundle braches
Purkinji fibres- base of heart flowing upwards
Stages of depolorisation and repolarisation
P wave- Atrial depolarization
QRS complex- Ventricular depolarisation
T wave- Vetricular repolarisation
What does water do in the cells
Acts as a solvent
* Carries nutrients and O2
* Removes waste
* Gives shape to the cells
* Regulates temperature
* Lubricates joints
* Cushions organs
* Maintain physical peak performance
Four developmental theroies and theorists
Freud- psychosocial
Vygotsky- psychosocial
Kohlberg- Moral
Erikson- psychosocial
Factors effecting LOC
A- alcohol
E- Epilepsy
I- Infection
O- Opioids
U- Urate
T- Trauma
I- Insulin
P- poison
S- Shock/Stroke
What makes up the CNS
Brain and spinal cord
How much oxygen does the brain require
20%
Peripheral Nervouse
System
Cranial and spinal nerves
Nervous system outside of the CNS.
Further broken into Somatic and Autonomic
Monro-kellie hypothesis..
Skull is a ridgid complartment
80% brain tissue
10%CSF
10% Intravascular blood
Volume remains costant- one increases the others decrease increasing ICP
What pressure requires medical attention in assesing compartment syndrome?
30mmHg
What are the 7P’s of NVO
Pain- Disproportionate to the injury- Compartment syndrome
Polkilothermia
Paresthesia
Paralysis
Pullselessness
Pallour
Pressure
List postoperative complications and their findings
Atelectaisi- Cracking in lung bases marginal SaO2
Pneumonia- Fevre, marginal SaO2, Cracklin gin bases of lungs
Dehydration- Fever, marginal SaO2, cracklies in lung bases
Wound infection- Fever
Phlebitis- Fever
UTI-Fever
Types of drains
Active- Closed- Bellovac/ Jackson Pratt
Passive- open - penrose/corogated
Describe diffusion
Movement of solutre from an area of high concentration to lower concertration
(moving down the concentration gradient)
Describe osmosis
Movement of fluid from an area of low solute ot high solute
