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Year 1 OSCE > NEWS 2 Tool > Flashcards

NEWS 2 Tool Flashcards

1
Q

What does the Nursing and Midwifery Council Code (NMC, 2018) require from nurses and midwives?

A

Accurately identify signs of worsening physical health in the person receiving care.

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2
Q

What can compromise the safety of patients according to Grant & Crimmons (2018)?

A

Variations in practice and assessment.

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3
Q

How can early warning scores assist healthcare professionals?

A

Help appropriately respond to a patient’s condition and escalate to the medical team if indicated.

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4
Q

What is the estimated number of lives that could be saved annually in hospitals in England through standardized assessment tools?

A

1800 lives.

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5
Q

What monitoring system did NICE recommend for adult patients in acute hospital settings in 2007?

A

‘Track-and-trigger’ monitoring systems.

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6
Q

What is the purpose of the National Early Warning Score (NEWS)?

A

Standardise assessment of, and response to, acute illness in those over 16 years old.

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7
Q

What are the key improvements in the NEWS2 update from 2017?

A
  • Restructured physical measurements to align with ABCDE assessment
  • Improved identification of patients likely to have sepsis
  • Improved scoring for patients with hypercapnic respiratory failure
  • Recognition of new-onset confusion or delirium.
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8
Q

What does the RCP published supplementary guidance for NEWS2 focus on?

A
  • Assessment of new confusion
  • Monitoring frequency for elevated NEWS2 scores
  • Use of appropriate oxygen scale
  • Use of NEWS2 scores during patient transfers
  • Actions for incomplete NEWS2 measurements.
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9
Q

In which patients is NEWS2 not used?

A

Patients with spinal cord injury and pregnant patients.

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10
Q

What is being developed for patients under 16 years old in relation to early warning systems?

A

A national paediatric early warning system scoring tool.

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11
Q

What has been reported since the introduction of NEWS?

A
  • Reduced length of hospital stays
  • Reduction in mortality from sepsis and acute illness
  • Reduction in cardiac arrest rates.
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12
Q

What are the advantages of digital NEWS systems over paper-based charts?

A
  • Minimise human error
  • Save time taken to complete observations by 30%.
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13
Q

Is NEWS2 a replacement for clinical judgement?

A

No, it is an assessment aid and does not replace experienced clinical judgement.

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14
Q

What physiological measurements are taken for the NEWS2 assessment?

A
  • Temperature
  • Level of consciousness and new confusion
  • Pulse rate
  • Systolic blood pressure
  • Oxygen saturation (SpO2)
  • Respiration rate.
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15
Q

What is an important exclusion in the NEWS2 assessment?

A

Urine output.

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16
Q

What is the scoring system based on for the NEWS2 chart?

A

An alert colour-coding system where:
* White range = 0
* Yellow range = 1
* Orange range = 2
* Red range = 3.

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17
Q

What should be done if no decision has been made about which SpO2 scale to use?

A

Always choose scale 1 as the default and record this decision in the patient’s notes.

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18
Q

What do high scores in NEWS2 indicate?

A

Potential deterioration in a patient’s condition.

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19
Q

Fill in the blank: The NEWS2 assessment aims to help detect deterioration in adults by triggering _______.

A

[review, treatment and escalation of care where appropriate].

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20
Q

True or False: The NEWS2 chart uses a single oxygen saturation scoring scale.

A

False.

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21
Q

What does the NEWS2 chart record after each measurement?

A

Record it immediately on the NEWS2 chart.

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22
Q

What should you do if the respiratory rate falls within a red box?

A

Record the number of breaths per minute within this box.

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23
Q

What is the target oxygen saturation range for patients in hypercapnic respiratory failure?

A

88-92%

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24
Q

What does the systolic blood pressure score use?

A

Only the systolic BP.

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25
Q

What does a score of 3 indicate for systolic blood pressure?

A

≥220 mmHg

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26
Q

How should the patient’s oxygen saturation be recorded?

A

Mark the corresponding box using a dot or record the value in the inset.

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27
Q

What is the ACVPU scale used for?

A

To assess the patient’s level of consciousness.

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28
Q

What does the ‘A’ in the ACVPU scale stand for?

A

Alert: Spontaneous opening of eyes, responds to voice and has motor function.

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29
Q

What is indicated by a new onset of confusion in a patient?

A

Potentially serious clinical deterioration.

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30
Q

What is the scoring for a temperature above 39.1°C?

A

Score of 2.

31
Q

Fill in the blank: The NEWS2 scoring system uses _______ to assess respiratory rate.

A

breaths per minute.

32
Q

True or False: The diastolic blood pressure recording affects the NEWS2 score.

A

False

33
Q

What should be documented if an observation cannot be obtained?

A

Document the score but mark it as incomplete.

34
Q

What is the significance of peripheral temperature assessment?

A

Cold and clammy extremities may indicate hypoperfusion.

35
Q

What does a score of 0 on the NEWS2 indicate?

A

No clinical deterioration.

36
Q

What is the purpose of early warning system technologies in the context of NEWS2?

A

To automatically capture vital signs and calculate the NEWS score.

37
Q

What does the ‘P’ in the ACVPU scale stand for?

A

Pain: The patient responds only to a painful stimulus.

38
Q

What should be done if the equipment fails to record an observation?

A

Trigger an immediate response and take the parameter manually.

39
Q

What does a score of 1 for pulse rate indicate?

A

101-110 beats/min.

40
Q

What is the lowest temperature range that can be recorded on the NEWS2 chart?

A

c35.0°C

41
Q

What does a systolic blood pressure of ≥220 mmHg score on the NEWS2 chart?

A

3

42
Q

What is the score for a pulse rate of 91-100 beats per minute?

A

1

43
Q

Fill in the blank: A temperature of ≥39.1°C scores _____ on the NEWS2 chart.

A

3

44
Q

What is the scoring for oxygen saturation of 92-93% on SpO2 Scale 1?

A

2

45
Q

True or False: A NEWS2 score of zero is equivalent to normal values.

A

False

46
Q

What does a NEWS2 score of 5 or more indicate?

A

Urgent response threshold

47
Q

What is the minimum monitoring frequency for a NEWS2 score total of 1–4?

A

4–6 hourly

48
Q

What should be considered if a patient with a NEWS2 score of 5 or more shows signs of infection?

A

Immediate escalation of care

49
Q

What does the NEWS2 scoring system assess?

A

Respirations, SpO2, blood pressure, pulse, consciousness, temperature

50
Q

Fill in the blank: A pulse rate of ≥131 beats per minute scores _____ on the NEWS2 chart.

A

3

51
Q

What is the significance of new-onset confusion in a patient?

A

Potentially serious clinical deterioration

52
Q

What should be done if a patient scores below the lowest SpO2 value on scale 1 or scale 2?

A

Document and assess individual threshold daily

53
Q

What is the response for a NEWS2 score total of 7 or more?

A

Emergency response threshold

54
Q

What is the target oxygen saturation range for patients with hypercapnic respiratory failure?

A

88-92%

55
Q

What is the first step in calculating the NEWS2 score?

A

Take a full set of physical measurements

56
Q

What must be recorded in the ‘NEWS TOTAL’ box?

A

The sum of individual scores

57
Q

What does a score of 3 in a single parameter trigger?

A

An urgent response

58
Q

Fill in the blank: A respiratory rate of 18-20 breaths per minute scores _____ on the NEWS2 chart.

A

0

59
Q

What should be monitored more frequently than recommended according to NEWS2?

A

Patients critically unwell or at risk of sudden deterioration

60
Q

What is the target oxygen saturation range for Donald?

A

88–92 per cent

This range is important for managing his respiratory condition.

61
Q

What physiological measurement scale must be used for Donald’s SpO2?

A

SpO2 scale 2

This scale is specifically indicated for his condition.

62
Q

What condition has been confirmed for Donald through arterial blood gas analysis?

A

Hypercapnia

Hypercapnia indicates a high level of carbon dioxide.

63
Q

What was Donald’s last NEWS2 score recorded?

A

4

This score indicates a need for a ward-based response.

64
Q

How often should Donald’s physiological measurements and NEWS2 score be monitored?

A

Every 4 hours

Regular monitoring is essential for assessing his condition.

65
Q

What does a NEWS2 score of 4 indicate?

A

Requires a ward-based response

This score suggests that the patient is at risk and needs further observation.

66
Q

What can be inferred about Donald’s response to treatment?

A

He has responded well to treatment

This response likely includes all interventions, not just oxygen.

67
Q

What is the significance of the National Early Warning Score 2 (NEWS2)?

A

It is used to assess the clinical status of patients and determine the level of care needed.

Developed by the Royal College of Physicians in 2017.

68
Q

In the NEWS2 scoring system, how is the blood pressure measured?

A

Using systolic BP only

This method focuses on the upper number of blood pressure readings.

69
Q

What is the minimum pulse rate that would score a 1 in the NEWS2 system?

A

41-50 beats/min

This scoring is part of the assessment for vital signs.

70
Q

Fill in the blank: The NEWS2 score uses __________ for assessing consciousness.

A

Alertness and new onset of confusion

This helps determine cognitive status.

71
Q

True or False: A patient with a temperature of 38.1-39.0°C scores a 2 in the NEWS2 system.

A

True

This temperature range indicates a moderate fever.

72
Q

What is Donald’s full name and date of birth?

A

Donald Russell, 20/3/1955

Personal information is crucial for patient identification.

73
Q

What does a SpO2 reading below 88% indicate for Donald?

A

Potential respiratory failure

This is critical for decision-making regarding interventions.

74
Q

What is the NEWS total score recorded for Donald?

A

4

This total is important for evaluating ongoing risk.

Year 1 OSCE (8 decks)

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