General Principles Guide Flashcards
List some ways to ensure professionalism and safety is achieved in the exam.
Use hand hygiene Examine correct patient Clear explanation in language patient understands Clear instructions Check patient comfort throughout Preserve patient dignity Respectful of patient Consider offering a chaperone
What are standard precautions?
A group of infection prevention practices that apply to all patients, irrespective of confirmed or suspected infection status, in any setting in which healthcare is provided.
List examples of standard precautions.
Hand hygiene PPE Respiratory Hygiene - cough etiquette Patient Care Equipment - safe use, handling and disposal of equipment likely to be contaminated Environmental cleaning
5 moments of hand hygiene.
Before touching patient After touching patient After touching patient surroundings Before aseptic procedure After bodily fluid exposure
When do we wash our hands with soap?
Advised to do so
Buildup of rub on hands
Hands are visibly soiled
Dealt with vomiting/diarrhoea
What do we report in reporting findings to other health professionals?
Introduce patient - name, age, gender, occupation
Outline presenting problem including biomedical and px perspective
Background info
Exam findings
Succinct summary
List the places where temperature can be assessed.
Oral
Tympanic
Axillary
Rectal
What variables affect temperature values?
Age, gender, time of day, ovulation
List circumstances where temperature is higher than normal.
Higher in a child
Ovulating women
Hot environment
Temp is low in morning, peaks in evening
What value of temperature indicates a fever?
Higher than 38.5 degrees
Below 34 degrees = hypothermic
Which temperature most accurately represents core temperature?
Rectal
Pros vs cons of tympanic temperature.
Quick and easy
Tricky with small ear canals, hearing aids
Pros vs cons axillary temp
Used in small babies
Difficult to keep thermometer in place if patient is mobile
Takes longer than tympanic or rectal sites
Oral temp pros vs cons
Difficult to keep in position
Can be affected by recent hot/cold drinks
Takes longer than tympanic/rectal sites
Rectal temp pros vs cons
Useful when assessing hypothermia
Useful in infants
Quick
Care needs to be taken for cultural views
Which pulse do we usually use? What other pulse can be used and in which circumstances?
Usually use radial pulse
Carotid pulse can be used for patients with low blood pressure
What do we assess for pulse?
Rate and rhythm
Pulse rate
55-95 beats/min
Bradycardia
Tachycardia
15s x 4
Pulse rhythm
Regular
Irregular - regularly irregular, irregularly irregular
Normal RR
12-20 breaths/min
Tachypnoea
Greater than 25 breaths/min
Bradypnoea
Less than 8 breaths/min
RR assessment
30s x 2
Assessed with pulse (patient is not made aware)
One minute if irregular
Systolic BP
Peak pressure in the artery during ventricular systole
Diastolic BP
Trough pressure in artery during ventricular diastole
Hypotension
Lower than acceptable BP, usually symptomatic
Hypertension
Higher BP, usually asymptomatic
Which organs are affected by ischaemia due to low BP?
Brain and kindeys
Which organs are affected by high BP and end organ damage?
Eyes, heart, brain, kidneys
What must be noted in BP recordings.
Which arm was used, position of patient (sitting or supine)
What is used to measure BP
Sphygmomanometer
What are the Korotkoff sounds?
Turbulent nature of blood flow through partially compressed artery
When can korotkoff sounds be heard?
Pressure is between systolic and diastolic
Korotkoff sounds and meaning
Phase 1 = systolic pressure Phase 2 = more intense sound Phase 3 = softer sound Phase 4 = muffling sound as diastolic BP is approached Phase 5 = sound disappears
Why do we take BP by palpation?
Gives you a good estimate of what pressure you expect to hear when you assess systolic blood pressure by auscultation
Cannot find the blood pressure = not in correct range
What is an acceptable BP?
Take into account medical history of patient
Less than 130/85
CVS risk = age, gender, ethnicity, smoking status, medial history, renal/CVS disease, family history
What BP should be treated?
Greater than 170/100
Two measurements at a single visit are sufficient for calculating CVS risk
How do we diagnose HTN?
2 measurements at three separate visits to diagnose HTN
What factors increase BP?
Stress/anxiety Whitecoat hypertension Pain Stimulants - aphetamine, cocaine, caffeine Exertion Over hydration Full bladder Salt/baking soda Liquorice
What happens if BP is too high?
Check cuff size - might be too small Check cuff is correctly placed Make sure arm is supported and relaxed Make sure patient is comfortable and relaxed Take BP again after 5 min of quiet rest
What factors lower BP?
Heat Dehydration Being relaxed Serious illness (septic shock, MI) Neurological conditions (Parkinsons) Endocrine conditions (Addisons) Prolonged bed rest Recent meal
What makes BP assessment incorrect?
Cuff too small - increases BP Cuff too big - decreases BP Cuff over clothing - incorrect BP Patient not relaxed - increases BP Device not calibrated - incorrect BP
What is the fifth vital sign and what does it show?
Oxygen Saturation
Indication of patients blood oxygen level
