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OSCE's > Student topics > Flashcards

Student topics Flashcards

1
Q

Antiemetics - Ondansetron - indication and common ADR?

A

Nausea rt chemo, post op n+v. ADR = constipation

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2
Q

Antiemetics - Cyclizine - indication and common ADR?

A

indic for motion sickness - causes drowsiness. ADR - addictive effects w alcohol

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3
Q

Antiemetics - metoclopramide - indication and common ADR?

A

indic short term use. relieves heartburn symptoms w reflux. good w diabetes. ADR - drowsiness

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4
Q

Non pharm management options?

A

Diet, Exercise, Reg check ups with GP, stress management, smoking cessation managing alcohol intake

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5
Q

x4 L’s with alcohol?

A
  1. Liver - causes inflammation (hepatitis) worse if co morbid e.g. hep c. causes scarring and cirrhosis
  2. Lover - domestic disputes
  3. Livelihood - poor performance @ work. CNS changes e.g. dementia. depression and anxiety, alcohol affects serotonin binding
  4. Law
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6
Q

Tips to reduce alcohol harm

A

0% alts e.g. sodas, 0% beers
Plan drinking time and alcohol free days ea week
Between alcohol drinks drink water or have food
Involve friends and family
Keep accountable - diary
Prepare plan for relapse
Socialise in low/no alc enviros

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7
Q

Why use spacers with inhalers

A

Reduce side effects and inhaled meds 50% more effective

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8
Q

SABA’s action

A

bronchodilation for asthma

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9
Q

SSRI’s examples and biggest ADR

A

fluoxetine, sertraline, citalopram

seritonin syndrome - tremors, shivers, swets, tachy, HTN.

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10
Q

Morphine (A CNS DEPRESSANT) - what obs and type of monitoring are you doing and what ADR’s it can cause

A

Obs - sedation, pain, and RR. AVPU.
Monitoring - stay by bedside 5 mins after admin. obs recorded at 5 mins then 15 mins
Can cause RR depression, HR less than 50bpm and hypotension

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11
Q

Pt education for morphine paitents

A

Avoid alcohol and other CNS depressant
No OTC drugs unless approved by physician
Caution with driving
Do NOT breastfeed

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12
Q

Smoking cessation - NRT advice

A

Gum and patches come in different strengths to suit you, roughly takes 8-12 weeks to ween off dependence, patches deliver background nicotine. NRT is subsidised

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13
Q

VTE - Venous thromboembolism, DVT. Who is at risk for this? Common medication used (remember injection from A5)

A

Clexane.

Not moving for long time. Post op. Pregnancy. Cancer. Smoking. Birth control pills

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14
Q

Clexane inidcations

A

Post op - DVT prevention
Tx of pulmonary emboism
Tx of unstable angina and NSTEMI

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15
Q

Risk factors for VTE

A 
Age
Immobility/Inactivity
Obesity
Family hx of clotting disorders
Trauma
Previous DVT/VTE
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16
Q

Risk factors for CVD

A 
Unhealthy diet
Limited exercise
Obesity
Diabetes
Snoking
Alcoho
Stress
Genetics / Maori or PI
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17
Q

GTN. Angina action plan?

A
  1. Tell someone how ur feeling. Take 1 puff of GTN spray or 1 tab under tongue
  2. After 5 mins, take 1 puff of GTN spray, after another 5 mins repeat if symptoms aren’t relieved
  3. If not relieved call 111 for ambo. chew an aspirin unless advised not to
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18
Q

How long for GTN to take effect?

A

20-30mins

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19
Q

Action of GTN

A

Increases blood flow to heart. Heart is working less hard therefore decreased chest pain

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20
Q

Stress lowering techniques

A 
Deep breathing - reduces anxiety ctivates PNS
Exercise
Sozialise
Go into nature
Sleep hygiene - low stimuli
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21
Q

GCS - what is it and the categories

A

6 - motor response
5 - verbal response
4 - eye response

Test to ax brain injury and LOC

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22
Q

Metoprolol what is it what does it do

A

beta blockers
heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.

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23
Q

Differnce between RHF and LHF and treatments

A

LHF - systemic issue, left ventricle fails. blood builds up in pulmonary system causing Pulmonary congestion and oedema - inc RR, SOB
HTN

RHF - dysfunction of right heart structures mainly the right ventricle - oedema, SOB, fatigue

treatmets incl diuretics to remove fluid overload & ace inhibitors to dilate blood vessels

24
Q

mechanism of GTN? and common side effects

A

increase blood flow to heart, heart works less and less chest pain

side effects
n+v, ankle oedema, tachy, HTN - due to vasodilation

25
Q

Adrenaline - how much to administer, what does the person look like in an allergic reaction

A

0.5mg IM

puffy eyes rash itching SOB anxiety stridor

26
Q

Nursing considerations on morphine?

A

ABPU, sedation Sp02, PR above 50, systolic above 100mmhg. vitals at 5 mins then 15 mins for first hour

27
Q

which diabetics use insulin?

A

T1DM

28
Q

For wound dressings - provide examples of dressings

A

Foams - diabetic/pressure/venous ulcers, is comfortable and absorbent and less frequent changes

transparent - take away and add moisture, easy to see through, allows ventilation

hydrogels - for pressure injuries - replaces and adds moisture

29
Q

S1 and S2 sounds are?

A

The first heart sound (S1) representsclosure of the atrioventricular (mitral and tricuspid) valves

The second heart sound (S2) representsclosure of the semilunar (aortic and pulmonary) valves

30
Q

where is the dorsal pedal pulse?

A

top of foot

31
Q

where is the posterior tibial pulse?

A

INSIDE OF ANKLE at the back of ball

32
Q

what two assessments would u use for wounds

A

TIME and CDHB wound ax tool

33
Q

TIME wound ax stands for

A

tissue
infection
moisture
edges

34
Q

pressure injury stages?

A

1 - erythema
2 - partial thickness skin loss
3 - full thickness skin loss
4 - full thickness tissue loss

35
Q

stages of wound healing plus explain

A
  1. haemostasis - start of clotting
  2. inflammatory response - vasodilation and WBC arrive to clean debris
  3. periphelation - start of fibrin mesh
    4 - maturation - collagen fills space, scar tissue forms
36
Q

slough, looks like puss, whats important to do when wound dressing

A

remove the slough prior to redressing

37
Q

clinical manifestations in anaphylaxis - what is the response in skin neuro cgastro resp cardiac

A

skin - vasodilation sweating hives rash
resp - bronchoconstriction, cyanosis, weezing, stridor
xcardiac - peripheral vasodilation(inflammatory), tachy(high pr)and hypoxaemia
gastro - n+v, loose bowels
neuro - visual changes, dec LOC, confusion, seizures, anxiety,

38
Q

apart from adrenaline whats another way to manage anaphyhlaxis

A

give saline to increase bp
02 to compensate for hypoxaemia
reduce anxiety, breathing exercises
stop any procedure/exposure to allergen to limit the response
antihistamines - help releive allergy symptoms

39
Q

what is preclampsia and what are signs and symptoms

A

pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys

weight gain, HTN, oedema

40
Q

ectopic pregnancy - signs of this what is it and nursing management

A

when a pregnancy forms outside of the uterus, vaginal bleeding an pelvic pain.

monitor n+v, bleeding measuring, fluids, anxiety, pre o testing knowing what her blood type is incase of neecing blood transfusion

41
Q

breastfeeding complications - mastitis what is this

A

inflammation and swelling of breast tissue rt infection

42
Q

breastfeeding complications - how would you provide pt ed

A

wear comfortable fitted bras
empty out milk fully when breastfeeding
apply cool compresses or ice packs to breasts after feeding

43
Q

normal temp range

A

36.1-37.2

44
Q

patho of anaphylaxis

A

antigen binds to antibodies on mast cells and basophils causing systemic release of inflammatory mediators which cause the anaphylactic response

45
Q

what are the associated factors

A 
family hx
medical hx
past surgeries, traumas
alcohol
drugs
OTC
exercise
diet
ALLERGIES
smoking/vaping
occupation
habits/sleeping/bowels/
stress relieving activities
46
Q

describe auscultory areas for cardiac

A

Aortic area 2nd ICS on R side of pt
Pulmonic area 2nd ICS on L side of pt
BOTH CLOSE TO STERNUM

tricuspid area 5th ICS close to sternum on R of pt
mitral area is where apical is.

47
Q

pre-elampsia risk factors - there is no cause for preclampsia its still being explored

\what are the 3 essentials for diagnosis of preclampsia

A

risk factors
obesity, diabetes, family hx of preclampsia, htn, over 35 and first pregnancy

diagnosis
proteinuria
high BP
oedema

48
Q

what are the tx options for preclampsia

A

rest
hospitalisation fo ronitoring of bp etc
delivery of baby
medication eg aspirin - decreased risk of symptoms and abruption of placenta

49
Q

patho of breastfeeding

A

prolactin reflex promotes milk production, assisted by nerve impulses from sucking
oxytocin reflex promotes milk ejection, also known as let down reflex

50
Q

why is breastfeeding promoted by WHO

A

effective in child health and survival, contains antibodies which protects child from common childhood illnesses

51
Q

difference between mastitis and breast abcess

A

mastitis is inflammation of breast tissue mainly in milk ducts in breastfeeding women
abcess is a painful build up of pus in the breast caused by infection - hard red fluid mass on breast

52
Q

predisposing factors of mastitis

A

smoking, hx of mastitis, not appropriate fitting bras, sore or cracked nipples

53
Q

recommendation for women with mastitis

A

wear loss clothes and well fitted bras
feed from infected breast first as baby will suck more vigorously
see gp if any lumps

54
Q

four stages of emergency delivery

A

one - onset of contractions
two - full dilation delivery of fetus
3 - expulsion of placenta and membrane
4 - post delivery 48 hrs

55
Q

DVT patho

A

a blood clot forms in the deep vein which partially or fully blocks the vein, blocking blood flow to the heart

OSCE's (10 decks)

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