Practical 1

Question 1

What are the first steps of patient introduction?

Answer 1

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

Question 2

What do you do before an examination?

Answer 2

Explain the purpose of your interaction to the patient.
If you are undertaking a particular procedure, explain the procedure
before seeking consent.

Question 3

What is patient consent?

Answer 3

Consent to treatments means a person must give permission before they receive any type of medical treatment

Question 4

How is consent valid?

Answer 4

Must be voluntary and informed and the person consenting must have capacity to make the decision

Question 5

What does voluntary mean?

Answer 5

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.

Question 6

What does informed mean?

Answer 6

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

Question 7

What does capacity mean?

Answer 7

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.

Question 8

Can consent be obtained verbally and in written format?

Answer 8

yes
verbal is where -
written is where a patient signs a legal document

Question 9

What are vital signs?

Answer 9

Pulse, respiration, temperature, blood pressure

Question 10

What is a pulse rate?

Answer 10

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

Question 11

What is normal pulse rate?

Answer 11

60-100 bpm

Question 12

What is Bradycardia?

Answer 12

Low BPM below 60 bpm

Question 13

What can cause bradycardia?

Answer 13

B-blockers, alcohol, opioids

Question 14

What is tachycardia?

Answer 14

Over 100 BPM

Question 15

What can cause tachycardia?

Answer 15

Anaemia, caffeine, alcohol, stress

Question 16

What can we determine when assessing pulse rate?

Answer 16

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)

Question 17

What is respiration?

Answer 17

Rate at which breathing occurs.
Breaths per min - brpm
Primarily influenced by changes in blood o2 and co2

Question 18

What is normal brpm?

Answer 18

14-18 brpm

Question 19

What is Bradypnea?

Answer 19

Decrease in respiration rate. Less that 12 brpm
Causes could include opioids, hypothyroidism, carbon monoxide, head injury

Question 20

What is Tachypnea?

Answer 20

high respiration rate - higher than 18brpm
causes could include anxiety, obstruction, asthma, COPD, exercises, fever, anaemia

Question 21

How do you assess respritation rate?

Answer 21

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

Question 22

What is Temperature with regards vital signs?

Answer 22

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

Question 23

How can temperature be measured?

Answer 23

Orally, Skin, Axillary, Tympanic- ear, Rectal, Oesophageal

Question 24

What is normal temperature?

Answer 24

36c - 37.9c

Question 25

What is classed as low temperature?

Answer 25

Low temp - less than 36c - reasons could include environmental, hypoglycaemia, hypothyroidism, pneumonia

Question 26

What is classed as high temperature?

Answer 26

above 38c
Causes include environmental, exercise, infections, malaria, typhoid, yellow fever, DVT, PE

Question 27

What are Oxygen saturations (sats)?

Answer 27

Pulse oximetry is a non invasive method of examining peripheral oxygen saturation (SPo2) within blood

Question 28

What is normal SP02?

Answer 28

95-100%

Question 29

What is hypoxemia?

Answer 29

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)

Question 30

In addition to lowered sp02 what other symptoms can there be?

Answer 30

blue/purple colouring around lips and finger nails
dyspnoea
tachypnoea
Tachycardia
light headedness
nausea
loss of coordination/cognitive function