EPR tips/key terminology

Question 1

Anuric?

Answer 1

When someone is not passing any urine

Question 2

Oliguric?

Answer 2

When someone is only passing a small volume of urine, between 80mls-400mls a day

Question 3

Key areas to check for pressure sores/skin assessment?

Answer 3

Elbows, heels, sacrum; if using oxygen check tops of ears/nose; also note bruising

Question 4

How often do skin assessments need completing?

Answer 4

Daily, good to do during wash

Question 5

How to check if all care plans are complete on EPR?

Answer 5

Go to request and prescribe, document in plan, then tick all boxes and answer required questions

Question 6

Where to go on EPR to put in bladder scan results?

Answer 6

Genitourinary - GI

Question 7

What does GI connote?

Answer 7

The organs that are involved in the GI tract are the mouth, esophagus, liver, stomach, gallbladder, pancreas, small intestine, large intestine, rectum and anus

Question 8

What does GU connote?

Answer 8

The urinary and reproductive organs constitute the GU (genitourinary) tract

Question 9

What does tract mean?

Answer 9

A major passage in the body, large bundle of nerve fibres, or other continuous elongated anatomical structure or region

Question 10

What is hypertension?

Answer 10

High blood pressure

Question 11

What is hypotension?

Answer 11

Low blood pressure

Question 12

What does a high cholesterol mean?

Answer 12

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

Question 13

What is acute rejection?

Answer 13

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).

Question 14

What is chronic rejection?

Answer 14

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

Question 15

What is hyperacute rejection?

Answer 15

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

Question 16

For insulin, which needle should the patient use on themself and which should the nurse use?

Answer 16

Patient use - purple needles

Nurse use - yellow needle

Question 17

Where to find the insulin needles?

Answer 17

In the cupboard on the floor, left of the fridge

Question 18

What things need to be done for giving insulin?

Answer 18

• 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

Question 19

Why might you be more at risk of blood clots?

Answer 19

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

Question 20

What is an anticoagulant?

Answer 20

A medicine which helps prevent blood clots

Question 21

How often do lines need updating?

Answer 21

Every day and night shift - make sure to deactivate and add new or removed cannulas/catheters

Question 22

When should you mention the NG feed on EPR?

Answer 22

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

Question 23

What is a vas cath?

Answer 23

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)

Question 24

What is the purpose of a venous catheter with two ports?

Answer 24

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

Question 25

What are the long term forms of vascular access?

Answer 25

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

Question 26

What is the difference between the use of AV fistula and AV graft?

Answer 26

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

Question 27

What is a picc line?

Answer 27

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.

Question 28

What are the cons of a picc line?

Answer 28

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

Question 29

What is bladder retention?

Answer 29

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

Question 30

What is CKD?

Answer 30

A condition characterized by a gradual loss of kidney function over time

Question 31

Symptoms of worsening CKD?

Answer 31

tiredness
swollen ankles, feet or hands
shortness of breath
feeling sick
blood in your pee (urine)

Question 32

What is AKI?

Answer 32

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.

Question 33

What is haematuria?

Answer 33

Blood present in the urine

Question 34

What is dysuria?

Answer 34

Painful or difficult urination

Question 35

What is oedema?

Answer 35

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

Question 36

Polyuric?

Answer 36

Too much urine

Question 37

How to request and OT/PT?

Answer 37

Go on request and prescribe, search ‘refer to OT’

Question 38

What is hypocalcemia?

Answer 38

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

Question 39

What is hepatitis?

Answer 39

A disease characterized by inflammation of the liver

Question 40

When should you start a sliding scale?

Answer 40

When ketone is more than 3

Question 41

What is hypokalemia?

Answer 41

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

Question 42

What is hypoglycemia?

Answer 42

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

Question 43

Symptoms of hypoglycemia?

Answer 43

Cold, maybe unconcious, confused, sweaty

Question 44

What are the treatments for hypoglycemia?

Answer 44

Give 20% glucose via IV if unconcious
Give glucogen if concious
Check BM after 15 mins
After 3 doses stop - due to fluid overload

Question 45

What is ketosydosis?

Answer 45

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

Question 46

When should you take ketone?

Answer 46

If BM is over 12 or if they’re not eating enough

Question 47

Hypoxic?

Answer 47

Body or area of is deprived of adequate 02 supply

Question 48

Infarction?

Answer 48

Tissue death (necrosis)

Question 49

Ischaemia?

Answer 49

A restriction in blood supply to tissues, causing lack of 02 supply (which tissues need for cellular metabolism)