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Pharmacy Practice IV > Random Important Things for the Final > Flashcards

Random Important Things for the Final Flashcards

1
Q

Contrast cultural humility and cultural competence:

A

Humility is a process that requires life-long learning as self-reflection is constantly engaged in. Competence is the set of skills, attitude and behavior that enable organizations to work effectively in cross-cultural situations.

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2
Q

CAGE questioning:

A 
Cutting down
Annoyance with questioning
Guilty feelings
Eye openers
(2 or more positive answers may indicate substance abuse problem)
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3
Q

3 dimensions of cultural humility:

A
  1. Self-awareness
  2. Respectful communication
  3. Collaborative partnerships
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4
Q

What are the four building blocks of ethics?

A

Nonmaleficence
Beneficence
Autonomy
Confidentiality

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5
Q

What are the 6 steps in clinical reasoning?

A 
Identify abnormal findings
Localize findings anatomically
Interpret findings
Make hypothesis
Test hypothesis
Develop plan agreeable to patient
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6
Q

What are the cardinal techniques of examination?

A

Inspection
Percussion
Palpation
Auscultation

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7
Q

What is the difference between objective and subjective information?

A

Whatever the patient tells you is subjective, and whatever you observe or collect during the visit is objective.

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8
Q

How do you increase Korotkoff sounds?

A

You place the cuff on the arm
Have patient raise their hand over their head
Inflate cuff to 60mmHg over the normal systolic
Have patient lower arm (cuff will deflate 30mmHg)
Continue as normal

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9
Q

What can the auscultatory gap cause?

A

It can throw off your BP measurements: for example, the systolic you could measure as way too low, or you could misread the diastolic as way too high.

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10
Q

Where are the places that you can measure BP?

A

On the brachial artery - upper arm
on the wrist or forearm
On the thigh - popliteal artery (prone patient)

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11
Q

How long should you measure the heart rate if RRR?

A

15 seconds times 4

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12
Q

How long should you take blood pressure?

A

30 seconds

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13
Q

How long should you take respirations?

A

1 minutes

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14
Q

What are the common and concerning symptoms?

A

Pain
Fevers, night sweats
Weight changes
Fatigue/weakness

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15
Q

How do vital signs change on the elderly?

A

Systolic BP and peripheral resistance will increase
Diastolic BP will drop
Arrhythmias and orthostatic hypotension more common

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16
Q

How do you assess for orthostatic hypotension?

A

You would have the patient sit for at least three minutes
Take BP
Have them stand up
Take blood pressure within 3 minutes
If there is a difference of at least 20mmHg systolic or 10mmHg diastolic (decrease) when they stand, it counts (will usually have symptoms and tachycardia as well)

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17
Q

What are the CHEM-7?

A

Na, K, Cl, Co2, BUN, SCr, Glucose

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18
Q

What is normal sodium?

A

135-145

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19
Q

What is a common cause of hyponatremia?

A

Excessive dilution

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20
Q

What would be some symptoms of hypernatremia?

A

Seizures, thirst, crankiness, coma

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21
Q

What is the normal potassium range?

A

3.5-5

22
Q

What comprises the CNS?

A

Brain and spinal cord

23
Q

What comprises the PNS?

A

Somatic nerves

Autonomic nervous system (sympathetic and parasympathetic)

24
Q

What cranial nerve does using the Snellen Chart test?

A

Optic - II

25
Q

What cranial nerve is tested when a patient puffs out cheeks, frowns, raises eyebrows? Says b, m, p, w?

A

Facial - VII

26
Q

What cranial nerves are tested when light is shined and causes the pupils to react the light? (PERLA)

A

III, IV, VI Oculomotor, Trochlear, and Abducens

27
Q

What nerve would chewing test?

A

Trigeminal V

28
Q

What nerve would be tested when you ask patient to push against pressure with face and shoulders?

A

Spinal Accessory, XI

29
Q

What nerve would be tested with sticking out the tongue or speaking l, t, d, n?

A

Hypoglossal XII

30
Q

What is the difference between a symptom and a sign?

A

A symptom is something experienced by the individual, while a sign can be seen by someone other than the individual. (Anxiety, pain and fatigue are all symptoms)

31
Q

What are the three D’s?

A

Delirium
Dementia
Depression

32
Q

What scale is muscle strength graded on?

A

0-5 (no muscular contraction detected to contraction against resistance)

33
Q

What is tested by toe tapping or flipping hands over?

A

Rapid rhythmic movement (proprioception and cerebellar function)

34
Q

What is tested by finger sequences and touching finger to nose with eyes closed?

A

Accuracy of movement (proprioception and cerebellar function)

35
Q

What is tested with Romberg, pronator drift, and proprioception?

A

Balance (proprioception and cerebellar function)
Romberg is standing with eyes closed.
Pronator drift is standing with eyes closed and tapping the arms down - they should return to same position if requested.

36
Q

What is tested with walking heel to toe?

A

Gait (proprioception and cerebellar function)

37
Q

What is Kerning?

A

A meningitis exam

38
Q

What would cerebellar disease look like?

A

Slow movement, nystagmus, decreased muscle tone, clumsy and uncoordinated in pointing to nose, fails gait test, heel-to-shin test, Romberg

39
Q

What are the techniques for assessing level of consciousness?

A
  1. Alertness - Can speak to patient normally
  2. Lethargy - Speak to patient in a loud voice (often falls asleep after you speak)
  3. Obtundation - wake patient as if waking a sleeper - gently
  4. Stupor - apply painful stimulus to wake. Verbal responses are slow or absent
  5. Coma - after repeated painful stimuli, patient is still asleep
40
Q

What is the difference between muscle bulk and tone?

A

Muscle bulk is the size and contour of a muscle. If it is concave it may suggest atrophy (atrophy of hands is normal as we age)
Muscle tone is the slight tension maintained even in a relaxed muscle. Can assess in arms and legs.

41
Q

What are the two screening questions for depression?

A
  1. Have you been feeling down or depressed in the past 2 weeks?
  2. Have you felt little or no pleasure in doing things?
42
Q

What is the prevalence of delirium in patients over 70 in the hospital? How much of these are undetected?

A

30%. 50% is often undetected.

43
Q

What are the 7 common or concerning neurological symptoms?

A 
Headache
Dizziness and vertigo
Weakness
Numbness
Loss of consciousness
Seizures
Tremors/involuntary movements
44
Q

What is the difference between and ischemic stroke and TIA?

A

Ischemic stroke: infarction of CNS tissue that may be symptomatic or asymptomatic

TIA: transient episode of neurological dysfunction. Not an infarction.

45
Q

What are some risk factors for stroke?

A 
Hypertension
Smoking
Dyslipidemia
Diabetes
Weight
(Lack of) exercise
Alcohol use
Carotid artery disease
Atrial fibrillation
46
Q

What is the difference between primary and secondary prevention of a stroke?

A

For primary prevention, focus on the risk factors. For secondary prevention (of someone that has already had a stroke) focus on the cause of the first stroke.

47
Q

What is Kerning’s sign?

A

Pain and increased resistance to extending the knee are positive. Sign of meningitis.

48
Q

What is Brudzinski’s sign?

A

Flexion of hip and knees during neck flexion

49
Q

What are the 5 components of a mental status exam?

A 
Level of consciousness
Posture and motor behavior
Dress, grooming, and personal hygiene
Facial Expression
Manner
50
Q

What are the four A’s of monitoring?

A

Analgesia
Activities of daily living
Adverse effects
Aberrant drug-related behaviors

Pharmacy Practice IV (12 decks)

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