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OSCE chronic disease management > Peak flow diary > Flashcards

Peak flow diary Flashcards

1
Q

What is peak expiratory flow, how is it measured and what is the purpose of this

A

the amount of air breathed out of the lungs
peak flow meter
checks health of lungs

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2
Q

What is spirometery

A

functional lung volumes- volume of air that can be exhaled and inhaled and residual air in lungs (all lung measurements)

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3
Q

What is obstructive lung disease

A

difficulty exhaling air out of the lungs

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4
Q

Causes of obstructive lung disease 4 and are they reversible?

A

reversible - Asthma
Irreversible- COPD
cystic fibrosis
bronchiestasis

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5
Q

FEV1 and FEV1/FVC ratio for obstructive lung disease

A

FEV1/FVC <0.7 with FEV1 <0.8 predicted

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6
Q

What is restrictive lung disease and what are two contributing factors to this

A

difficulty inhaling air
reduced volume and elasticity of lung

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7
Q

examples of restrictive lung disease 6

A

Pulmonary Fibrosis, Sarcoidosis, asbestosis, Gullian barre and myasthenia gravis, ankylosing spondylitis

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8
Q

FEV1/FVC ratio and FEV1 for restrictive lung disease

A

FEV1/FVC >0.8
both FEV1 and FVC are lowered

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9
Q

What is the general structure for peak flow? 7

A
  1. Ask about patient’s PC
  2. Checking patient’s understanding
  3. Ask about patient’s condition
  4. Ask the patient about their medication
  5. Effect of diabetes on patient
  6. PMH, DH, FH, SH
  7. ICE
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10
Q

What would you ask about patient’s presenting complaint regarding peak flow 4

A
  1. SOB
  2. cough/ sputum/ wheeze
  3. time of day that it worsens (day/ night/ winter)
  4. recent infections
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11
Q

What are the red flags you would ask about patient’s presenting complaint regarding peak flow 4

A
  1. cough/ wheeze getting worse
  2. affecting ADLs
  3. waking up at night with symptoms
  4. using reliever inhaler more often
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12
Q

What would you ask to check patient’s understanding regarding peak flow 3

A
  1. Do they understand what condition they have?
  2. Do they understand why we do peak flow diarys/ spirometry?
  3. Do they know importance of maintaining peak flow in a certain range
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13
Q

What would you ask about patient’s condition regarding peak flow 3

A
  1. How long they’ve had this condition
  2. how well controlled it’s been
  3. any episodes like PC before?
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14
Q

What would you ask about patient’s medications regarding peak flow 6

A
  1. When did they start taking their mediation
  2. adherence to medication
  3. side effects
  4. how effective their medication has been at controlling their condition
  5. INHALER TECHNIQUE
  6. BETA-BLOCKERS (contraindicated in asthma)
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15
Q

What would you ask about patient’s social history regarding peak flow 6

A
  1. travel
  2. new pets
  3. house (new/ damp)
  4. smoking + SECONDARY smoking
  5. alcohol
  6. occupation
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16
Q

What needs to be checked about how condition affects patient’s life regarding peak flow 5

A
  1. mood
  2. sleep
  3. diet
  4. ADL
  5. affecting work/ personal life
17
Q

What is one thing that needs to be checked throughout the peak flow chronic disease management

A

ICE

18
Q

How to ask 2 and advise 1 about inhaler technique

A

When was the last time you had your inhaler technique reviewed
Can you show me your inhaler technique please?

I think it’ll be useful to do an inhaler technique check with one of the nurses to get the most benefit/ relief out of your inhaler

OSCE chronic disease management (5 decks)

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