P3 - Advanced CVR Assessment

Question 1

what is the subjective assessment made up of?

Answer 1

• PC - presenting condition/ diagnosis
• HPC - history of present condition
• PMH - past medical history
• DH - drug history
• SH - social history
• MDT handover
• results from investigations/ imaging

Goals and expectation of the patient

Question 2

What should you ask if the patient has a chronic condition?

Answer 2

How past treatment has worked or not worked.

Question 3

Why is it important to assess how past treatment has worked in chronic conditions?

Answer 3

To guide future treatment plans and identify any ineffective interventions.

Question 4

What emotional or psychological aspects should you assess in a patient?

Answer 4

Mood of the patient – Are they in happy spirits, engaged, showing low mood, or feeling sorry for themselves?

Question 5

What should you assess regarding the patient’s mood?

Answer 5

f they are happy, engaged, have a low mood, or appear to feel sorry for themselves.

Question 6

Why is the patient’s mood important in a subjective assessment?

Answer 6

It can influence their engagement with treatment and overall well-being.

Question 7

What kind of information should you gather from the MDT team?

Answer 7

Details about behaviour patterns, ongoing investigation concerns, or additional insights.

Question 8

What should you ask the MDT team regarding the patient’s investigation or behaviour?

Answer 8

Are there ongoing investigation concerns? What behaviour patterns have been observed?

Question 9

Why is it essential to consider the biopsychosocial model in an assessment?

Answer 9

To ensure the patient’s physical, psychological, and social factors are considered in their care plan.

Question 10

What is the biopsychosocial model?

Answer 10

An approach that considers biological, psychological, and social factors in a patient’s care.

Question 11

What other services should you consider referring the patient to under the biopsychosocial model?

Answer 11

Mental health support, psychological help, or physical support services.

Question 12

What types of external support might be needed when using the biopsychosocial model?

Answer 12

Referrals to mental health support, psychological help, or physical support services.

Question 13

When should mental health support be considered in a subjective assessment?

Answer 13

When the patient is showing signs of low mood, anxiety, or other psychological distress

Question 14

How can psychological support benefit a patient with a chronic condition?

Answer 14

It can help them cope with the emotional burden of long-term illness and improve treatment engagement.

Question 15

When should physical support services be considered?

Answer 15

If the patient has physical limitations that impact their daily life or treatment adherence.

Question 16

What does an objective assessment begin with?

Answer 16

General observations of the patient, such as their position, breathlessness, anxiety, and posture.

Question 17

What should you observe about a patient’s position in bed/chair?

Answer 17

Are they slumped, leaning to one side, or sitting upright?

Question 18

Why is a slumped position problematic for a patient?

Answer 18

A slumped position can impair breathing and lead to poor posture, affecting overall health.

Question 19

What position should you aim to leave a patient in?

Answer 19

In a comfortable, upright, and supported position to aid breathing and circulation.

Question 20

What is the first thing to assess regarding the patient’s airway?

Answer 20

Is the airway patent/clear? Listen for secretions, raspy voice, or stridor/wheeze.

Question 21

How can you tell if a patient’s airway is clear?

Answer 21

If they can speak clearly, have no raspy voice, and no secretions or abnormal sounds.

Question 22

What additional checks should be made regarding the airway?

Answer 22

Is it their own airway, or do they have a false airway in place? Are the mucous membranes dry?

Question 23

What is important to assess regarding the patient’s breathing?

Answer 23

Oxygen amount (FiO2), oxygen delivery (dry or humidified), respiratory rate (RR), oxygen saturation (SpO2), and work of breathing (WOB).

Question 24

What is the benefit of using humidified oxygen over dry oxygen?

Answer 24

Humidified oxygen helps prevent dryness in the airways, reducing discomfort and mucus buildup.

Question 25

What does accessory muscle use and upper limb fixing suggest in a patient?

Answer 25

It indicates increased work of breathing, suggesting respiratory distress.

Question 26

What should be noted during auscultation of the lungs?

Answer 26

Listen for any differences from normal breath sounds, such as crackles or wheezes.

Question 27

What does equal chest expansion indicate?

Answer 27

It suggests that both lungs are functioning properly and there are no obstructions.

Question 28

What does the resonance of a percussion note tell us about the lungs?

Answer 28

Resonance can indicate air-filled (normal) or dullness (possible fluid or consolidation).

Question 29

What is tactile fremitus and what does it tell us?

Answer 29

It’s the palpable vibration of the chest when the patient speaks, indicating airflow through the lungs.

Question 30

What are key features to assess regarding a patient’s cough?

Answer 30

Whether the cough is productive or dry, and if sputum is produced.

Question 31

What should you note about sputum in a respiratory assessment?

Answer 31

Color, amount, consistency, and whether the patient can expel it by themselves

Question 32

Why is spirometry alone not helpful?

Answer 32

Spirometry results need to be compared with previous readings to track changes.

Question 33

What key factors are assessed under circulation?

Answer 33

Heart rate (HR), blood pressure (BP), temperature, urine output (UOP), and fluid balance.

Question 34

What is the normal urine output in 24 hours?

Answer 34

500-1000 ml per 24 hours

Question 35

What are some blood tests to monitor circulation?

Answer 35

Hemoglobin (Hb), white cell count (WCC), C-reactive protein (CRP), and platelets.

Question 36

What is cyanosis and how is it classified?

Answer 36

Cyanosis is bluish discoloration of the skin due to low oxygen. It can be central (mouth) or peripheral (toes, fingers).

Question 37

What does pallor indicate?

Answer 37

Pallor can indicate anemia or circulatory problems. The patient may appear pasty or flushed.

Question 38

What is the AVPU scale used for?

Answer 38

Assessing consciousness – Alert, Voice, Pain, Unresponsive.

Question 39

What is the Glasgow Coma Scale (GCS) used for?

Answer 39

Evaluating a patient’s level of consciousness.

Question 40

What should you check for under “disability” in an objective assessment?

Answer 40

Consciousness levels, pain, and if any sedative agents are being used.

Question 41

What should you look for under “exposure” in the assessment?

Answer 41

Any attachments (catheters, IVs), bruising, or bleeding under the sheets.

Question 42

Why is it important to check for hidden attachments or issues under the sheets?

Answer 42

To ensure nothing is missed that could impact the patient’s health or treatment.

Question 43

What are ABGs and why are they important?

Answer 43

Arterial blood gases, which measure oxygen, carbon dioxide, and pH levels in the blood to assess respiratory and metabolic function.

Question 44

What imaging results might be considered in an objective assessment?

Answer 44

MRI, CXR, CT, PET, nuclear scans, ultrasonography, and V/Q scans.

Question 45

What does a Chest X-Ray (CXR) help assess?

Answer 45

It helps detect abnormalities in the lungs, heart, and chest cavity

Question 46

What does spirometry assess?

Answer 46

Lung function by measuring the volume and flow of air during inhalation and exhalation.