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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
Adrenaline - how much to administer, what does the person look like in an allergic reaction
0.5mg IM puffy eyes rash itching SOB anxiety stridor
26
Nursing considerations on morphine?
ABPU, sedation Sp02, PR above 50, systolic above 100mmhg. vitals at 5 mins then 15 mins for first hour
27
which diabetics use insulin?
T1DM
28
For wound dressings - provide examples of dressings
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
S1 and S2 sounds are?
The first heart sound (S1) represents closure of the atrioventricular (mitral and tricuspid) valves The second heart sound (S2) represents closure of the semilunar (aortic and pulmonary) valves
30
where is the dorsal pedal pulse?
top of foot
31
where is the posterior tibial pulse?
INSIDE OF ANKLE at the back of ball
32
what two assessments would u use for wounds
TIME and CDHB wound ax tool
33
TIME wound ax stands for
tissue infection moisture edges
34
pressure injury stages?
1 - erythema 2 - partial thickness skin loss 3 - full thickness skin loss 4 - full thickness tissue loss
35
stages of wound healing plus explain
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
slough, looks like puss, whats important to do when wound dressing
remove the slough prior to redressing
37
clinical manifestations in anaphylaxis - what is the response in skin neuro cgastro resp cardiac
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
apart from adrenaline whats another way to manage anaphyhlaxis
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
what is preclampsia and what are signs and symptoms
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
ectopic pregnancy - signs of this what is it and nursing management
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
breastfeeding complications - mastitis what is this
inflammation and swelling of breast tissue rt infection
42
breastfeeding complications - how would you provide pt ed
wear comfortable fitted bras empty out milk fully when breastfeeding apply cool compresses or ice packs to breasts after feeding
43
normal temp range
36.1-37.2
44
patho of anaphylaxis
antigen binds to antibodies on mast cells and basophils causing systemic release of inflammatory mediators which cause the anaphylactic response
45
what are the associated factors
``` family hx medical hx past surgeries, traumas alcohol drugs OTC exercise diet ALLERGIES smoking/vaping occupation habits/sleeping/bowels/ stress relieving activities ```
46
describe auscultory areas for cardiac
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
pre-elampsia risk factors - there is no cause for preclampsia its still being explored \what are the 3 essentials for diagnosis of preclampsia
risk factors obesity, diabetes, family hx of preclampsia, htn, over 35 and first pregnancy diagnosis proteinuria high BP oedema
48
what are the tx options for preclampsia
rest hospitalisation fo ronitoring of bp etc delivery of baby medication eg aspirin - decreased risk of symptoms and abruption of placenta
49
patho of breastfeeding
prolactin reflex promotes milk production, assisted by nerve impulses from sucking oxytocin reflex promotes milk ejection, also known as let down reflex
50
why is breastfeeding promoted by WHO
effective in child health and survival, contains antibodies which protects child from common childhood illnesses
51
difference between mastitis and breast abcess
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
predisposing factors of mastitis
smoking, hx of mastitis, not appropriate fitting bras, sore or cracked nipples
53
recommendation for women with mastitis
wear loss clothes and well fitted bras feed from infected breast first as baby will suck more vigorously see gp if any lumps
54
four stages of emergency delivery
one - onset of contractions two - full dilation delivery of fetus 3 - expulsion of placenta and membrane 4 - post delivery 48 hrs
55
DVT patho
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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