EPR tips/key terminology Flashcards
Anuric?
When someone is not passing any urine
Oliguric?
When someone is only passing a small volume of urine, between 80mls-400mls a day
Key areas to check for pressure sores/skin assessment?
Elbows, heels, sacrum; if using oxygen check tops of ears/nose; also note bruising
How often do skin assessments need completing?
Daily, good to do during wash
How to check if all care plans are complete on EPR?
Go to request and prescribe, document in plan, then tick all boxes and answer required questions
Where to go on EPR to put in bladder scan results?
Genitourinary - GI
What does GI connote?
The organs that are involved in the GI tract are the mouth, esophagus, liver, stomach, gallbladder, pancreas, small intestine, large intestine, rectum and anus
What does GU connote?
The urinary and reproductive organs constitute the GU (genitourinary) tract
What does tract mean?
A major passage in the body, large bundle of nerve fibres, or other continuous elongated anatomical structure or region
What is hypertension?
High blood pressure
What is hypotension?
Low blood pressure
What does a high cholesterol mean?
When you have too much of a fatty substance called cholesterol in your blood it can block your blood vessels
- It makes you more likely to have heart problems or a stroke
What is acute rejection?
Occurs for everyone who receives a transplant, can occur between the first week and three months after transplantation - usually treated if caught early, and this type of rejection is often limited by immunosuppression drugs that weaken the immune system (and therefore the attack on foreign cells in the body).
What is chronic rejection?
When episodes of rejection continue to occur and occur over long periods of time after transplantation - over time, the barrage of attacks from the immune system weaken the new tissues or organ so much that it can lead to complete failure of the transplant
What is hyperacute rejection?
In some cases after the body might reject the new organ or tissue completely within the first few minutes after transplantation - when this happens, the transplant must be removed right away to prevent the recipient from dying
For insulin, which needle should the patient use on themself and which should the nurse use?
Patient use - purple needles
Nurse use - yellow needle
Where to find the insulin needles?
In the cupboard on the floor, left of the fridge
What things need to be done for giving insulin?
- Check BM
- ask patient how many units, tell them their bm also
- practice squirting out 2 units EVERY time
- get another nurse to observe you asking how many units the patient wants and to then counter sign (right click on the due insulin and press ‘record details’
- if patient does it themself, then they act as the second signature; still record this
Why might you be more at risk of blood clots?
if you’ve had a heart attack, unstable angina,
a stroke or “mini-stroke” (transient ischaemic attack or TIA),peripheral arterial disease, an operation on your heart or blood vessels, such as a coronary stent insertion
What is an anticoagulant?
A medicine which helps prevent blood clots
How often do lines need updating?
Every day and night shift - make sure to deactivate and add new or removed cannulas/catheters
When should you mention the NG feed on EPR?
Write them in your daily EPR notes, say the rate of the feed flow and the number marker visible on the outside of their nose
What is a vas cath?
A specialised central venous catheter used in dialysis. It is usually inserted via the subclavian or jugular vessels. The tip should lie in the superior vena cava just above the right atrium (vascular access)
What is the purpose of a venous catheter with two ports?
It is used for hemodialysis - there is usually one shaft that splits into two ports, one to carry blood to the dialyser and one to carry blood from the dialyser back to the patient
What are the long term forms of vascular access?
The arteriovenous (AV) fistula and the AV graft - AV fistulae are created at least 3-4 months before their anticipated use, patients will sometimes require temporary hemodialysis access while the fistula matures
What is the difference between the use of AV fistula and AV graft?
The AV fistula lasts longer and is less likely to get infected, but take 2-3 months to mature prior
to use. AV grafts can be used 2-3 weeks after surgery, but are more likely to clot and have infection
What is a picc line?
A thin, soft, long catheter (tube) that is inserted into a vein in your arm, leg or neck. The tip of the catheter is positioned in a large vein that carries blood into the heart. The PICC line is used for long-term intravenous (IV) antibiotics, nutrition or medications, and for blood draws.
What are the cons of a picc line?
Not routinely used for dialysis because of the potential loss of upper-extremity veins
- blood clots can form in the arms of patients with PICC devices, causing pain, blocking the IV line and, most dangerous of all, potentially breaking off and traveling to the lungs
What is bladder retention?
Urinary retention in the bladder due to its incapacity to void normally. It may occur because there is an obstruction or a loss of tone in the bladder muscles that fail to detect increased pressure exerted by urine. It is usually associated with pain and urge to urinate
What is CKD?
A condition characterized by a gradual loss of kidney function over time
Symptoms of worsening CKD?
tiredness swollen ankles, feet or hands shortness of breath feeling sick blood in your pee (urine)
What is AKI?
When your kidneys suddenly stop working properly. It can range from minor loss of kidney function to complete kidney failure, normally happens as a complication of another serious illness
Without quick treatment, abnormal levels of salts and chemicals can build up in the body, which affects the ability of other organs to work properly.
What is haematuria?
Blood present in the urine
What is dysuria?
Painful or difficult urination
What is oedema?
Swelling in the ankles, feet and legs is often caused by a build-up of fluid in these areas, called oedema. Oedema is usually caused by: standing or sitting in the same position for too long. eating too much salty food
Polyuric?
Too much urine
How to request and OT/PT?
Go on request and prescribe, search ‘refer to OT’
What is hypocalcemia?
A condition in which there are lower-than-average levels of calcium in the liquid part of the blood, or the plasma. Calcium has many important roles in your body: Calcium is key to the conduction of electricity in your body
What is hepatitis?
A disease characterized by inflammation of the liver
When should you start a sliding scale?
When ketone is more than 3
What is hypokalemia?
When blood’s potassium levels are too low. Potassium is an important electrolyte for nerve and muscle cell functioning, especially for muscle cells in the heart. Your kidneys control your body’s potassium levels, allowing for excess potassium to leave the body through urine or sweat
What is hypoglycemia?
A condition in which your blood sugar (glucose) level is lower than normal. Glucose is your body’s main energy source. Often related to diabetes treatment. But other drugs and a variety of conditions — many rare — can cause low blood sugar in people who don’t have diabetes
Symptoms of hypoglycemia?
Cold, maybe unconcious, confused, sweaty
What are the treatments for hypoglycemia?
Give 20% glucose via IV if unconcious
Give glucogen if concious
Check BM after 15 mins
After 3 doses stop - due to fluid overload
What is ketosydosis?
Diabetic ketoacidosis (DKA) is a serious complication of type 1 diabetes and, much less commonly, of type 2 diabetes. DKA happens when your blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body
When should you take ketone?
If BM is over 12 or if they’re not eating enough
Hypoxic?
Body or area of is deprived of adequate 02 supply
Infarction?
Tissue death (necrosis)
Ischaemia?
A restriction in blood supply to tissues, causing lack of 02 supply (which tissues need for cellular metabolism)
