Practical 1 Flashcards
What are the first steps of patient introduction?
Introducing yourself by name and role
Sit squarely and similar heigh
do not not cross arms or legs
maintain reasonable and comfortable eye contact
tone and volume of voice
don’t speak to fast or slow
No jargon
What do you do before an examination?
Explain the purpose of your interaction to the patient.
If you are undertaking a particular procedure, explain the procedure
before seeking consent.
What is patient consent?
Consent to treatments means a person must give permission before they receive any type of medical treatment
How is consent valid?
Must be voluntary and informed and the person consenting must have capacity to make the decision
What does voluntary mean?
the decision to either consent or not to consent to treatment must be made by the person, and must not be influenced by pressure from medical staff, friends or family.
What does informed mean?
the person must be given all of the information about what the treatment
involves, including the benefits and risks, whether there are reasonable alternative
treatments, and what will happen if treatment does not go ahead
What does capacity mean?
the person must be capable of giving consent, which means they understand the
information given to them and can use it to make an informed decision.
Can consent be obtained verbally and in written format?
yes
verbal is where -
written is where a patient signs a legal document
What are vital signs?
Pulse, respiration, temperature, blood pressure
What is a pulse rate?
Can be determined via palpation of the radial artery and is the number of pulses detected in 1 minute
Typically 15 seconds x 4 - BPM
What is normal pulse rate?
60-100 bpm
What is Bradycardia?
Low BPM below 60 bpm
What can cause bradycardia?
B-blockers, alcohol, opioids
What is tachycardia?
Over 100 BPM
What can cause tachycardia?
Anaemia, caffeine, alcohol, stress
What can we determine when assessing pulse rate?
Rhythm - irregular can be due arrhythmias, atrial fibrillation, ventricular fibrillation
can be triggered by viral illness, alcohol, tobacco, exercise, caffeine
Amplitude/Strength
Strong (bounding): increased stroke volume (fever anaemia) high stiffness (atherosclerosis)
Weak (Thready): reduction in stroke volume, (heart failure, hypovolemia); increase resistance (cold, heart failure)
What is respiration?
Rate at which breathing occurs.
Breaths per min - brpm
Primarily influenced by changes in blood o2 and co2
What is normal brpm?
14-18 brpm
What is Bradypnea?
Decrease in respiration rate. Less that 12 brpm
Causes could include opioids, hypothyroidism, carbon monoxide, head injury
What is Tachypnea?
high respiration rate - higher than 18brpm
causes could include anxiety, obstruction, asthma, COPD, exercises, fever, anaemia
How do you assess respritation rate?
Whilst still palpating the radial artery, but not counting, assess the patients respiration - look at peak of chest - one out and one in = 1 breath
assess over 30 seconds x 2
What is Temperature with regards vital signs?
Body temp gives insight into the body’s immune system
Temp varies - can vary via gender, recent activity, food and fluid consumption, time of day, stage of of menstrual cycle
How can temperature be measured?
Orally, Skin, Axillary, Tympanic- ear, Rectal, Oesophageal
What is normal temperature?
36c - 37.9c
What is classed as low temperature?
Low temp - less than 36c - reasons could include environmental, hypoglycaemia, hypothyroidism, pneumonia
What is classed as high temperature?
above 38c
Causes include environmental, exercise, infections, malaria, typhoid, yellow fever, DVT, PE
What are Oxygen saturations (sats)?
Pulse oximetry is a non invasive method of examining peripheral oxygen saturation (SPo2) within blood
What is normal SP02?
95-100%
What is hypoxemia?
decrease in the partial pressure of oxygen (Pao2) in the blood
causes can include, COPD, altitude, cardiac shunt, apnoea, hypoventilation, ventilation/perfusion mismatch (area of lungs that is struggling to inflate i.e infection/fluid)
In addition to lowered sp02 what other symptoms can there be?
blue/purple colouring around lips and finger nails
dyspnoea
tachypnoea
Tachycardia
light headedness
nausea
loss of coordination/cognitive function
