P3 - Advanced CVR Assessment Flashcards
what is the subjective assessment made up of?
- 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
What should you ask if the patient has a chronic condition?
How past treatment has worked or not worked.
Why is it important to assess how past treatment has worked in chronic conditions?
To guide future treatment plans and identify any ineffective interventions.
What emotional or psychological aspects should you assess in a patient?
Mood of the patient – Are they in happy spirits, engaged, showing low mood, or feeling sorry for themselves?
What should you assess regarding the patient’s mood?
f they are happy, engaged, have a low mood, or appear to feel sorry for themselves.
Why is the patient’s mood important in a subjective assessment?
It can influence their engagement with treatment and overall well-being.
What kind of information should you gather from the MDT team?
Details about behaviour patterns, ongoing investigation concerns, or additional insights.
What should you ask the MDT team regarding the patient’s investigation or behaviour?
Are there ongoing investigation concerns? What behaviour patterns have been observed?
Why is it essential to consider the biopsychosocial model in an assessment?
To ensure the patient’s physical, psychological, and social factors are considered in their care plan.
What is the biopsychosocial model?
An approach that considers biological, psychological, and social factors in a patient’s care.
What other services should you consider referring the patient to under the biopsychosocial model?
Mental health support, psychological help, or physical support services.
What types of external support might be needed when using the biopsychosocial model?
Referrals to mental health support, psychological help, or physical support services.
When should mental health support be considered in a subjective assessment?
When the patient is showing signs of low mood, anxiety, or other psychological distress
How can psychological support benefit a patient with a chronic condition?
It can help them cope with the emotional burden of long-term illness and improve treatment engagement.
When should physical support services be considered?
If the patient has physical limitations that impact their daily life or treatment adherence.
What does an objective assessment begin with?
General observations of the patient, such as their position, breathlessness, anxiety, and posture.
What should you observe about a patient’s position in bed/chair?
Are they slumped, leaning to one side, or sitting upright?
Why is a slumped position problematic for a patient?
A slumped position can impair breathing and lead to poor posture, affecting overall health.
What position should you aim to leave a patient in?
In a comfortable, upright, and supported position to aid breathing and circulation.
What is the first thing to assess regarding the patient’s airway?
Is the airway patent/clear? Listen for secretions, raspy voice, or stridor/wheeze.
How can you tell if a patient’s airway is clear?
If they can speak clearly, have no raspy voice, and no secretions or abnormal sounds.
What additional checks should be made regarding the airway?
Is it their own airway, or do they have a false airway in place? Are the mucous membranes dry?
What is important to assess regarding the patient’s breathing?
Oxygen amount (FiO2), oxygen delivery (dry or humidified), respiratory rate (RR), oxygen saturation (SpO2), and work of breathing (WOB).
What is the benefit of using humidified oxygen over dry oxygen?
Humidified oxygen helps prevent dryness in the airways, reducing discomfort and mucus buildup.
What does accessory muscle use and upper limb fixing suggest in a patient?
It indicates increased work of breathing, suggesting respiratory distress.
What should be noted during auscultation of the lungs?
Listen for any differences from normal breath sounds, such as crackles or wheezes.
What does equal chest expansion indicate?
It suggests that both lungs are functioning properly and there are no obstructions.
What does the resonance of a percussion note tell us about the lungs?
Resonance can indicate air-filled (normal) or dullness (possible fluid or consolidation).
What is tactile fremitus and what does it tell us?
It’s the palpable vibration of the chest when the patient speaks, indicating airflow through the lungs.
What are key features to assess regarding a patient’s cough?
Whether the cough is productive or dry, and if sputum is produced.
What should you note about sputum in a respiratory assessment?
Color, amount, consistency, and whether the patient can expel it by themselves
Why is spirometry alone not helpful?
Spirometry results need to be compared with previous readings to track changes.
What key factors are assessed under circulation?
Heart rate (HR), blood pressure (BP), temperature, urine output (UOP), and fluid balance.
What is the normal urine output in 24 hours?
500-1000 ml per 24 hours
What are some blood tests to monitor circulation?
Hemoglobin (Hb), white cell count (WCC), C-reactive protein (CRP), and platelets.
What is cyanosis and how is it classified?
Cyanosis is bluish discoloration of the skin due to low oxygen. It can be central (mouth) or peripheral (toes, fingers).
What does pallor indicate?
Pallor can indicate anemia or circulatory problems. The patient may appear pasty or flushed.
What is the AVPU scale used for?
Assessing consciousness – Alert, Voice, Pain, Unresponsive.
What is the Glasgow Coma Scale (GCS) used for?
Evaluating a patient’s level of consciousness.
What should you check for under “disability” in an objective assessment?
Consciousness levels, pain, and if any sedative agents are being used.
What should you look for under “exposure” in the assessment?
Any attachments (catheters, IVs), bruising, or bleeding under the sheets.
Why is it important to check for hidden attachments or issues under the sheets?
To ensure nothing is missed that could impact the patient’s health or treatment.
What are ABGs and why are they important?
Arterial blood gases, which measure oxygen, carbon dioxide, and pH levels in the blood to assess respiratory and metabolic function.
What imaging results might be considered in an objective assessment?
MRI, CXR, CT, PET, nuclear scans, ultrasonography, and V/Q scans.
What does a Chest X-Ray (CXR) help assess?
It helps detect abnormalities in the lungs, heart, and chest cavity
What does spirometry assess?
Lung function by measuring the volume and flow of air during inhalation and exhalation.
