W1: Workshop Flashcards
Define Antibiotics & provide an example
Helps to fight infection
Penicilin & Ceftriaxone
Define steroid or anti-inflammatory & provide an example
Reduces the inflammatory response
Hydrocortisone & aspirin
Define inotropes & provide an example
Increases blood pressure either by enhancing contractility of the heart or causing widespread vasoconstriction
Adrenaline, dobutamine or noradrenaline
Define anti-arrhythmia & provide an example
Stabilises cardiac muscle to control abnormal rhythms
Amiodarone
Define bronchodilators & provide an example
Relax the smooth muscles of the airways
Salbutamol, ventolin, bricanyl (& frusemide)
Define anti-emetics & provide an example
Reduce nausea and vomiting
Maxalon & Ondansetron
Define anti-hypertensive & provide an example
Reduce blood pressure through vasodilation
Catopril & Metoprolol
Define anti-coagulant and provide an example
Reduces the clotting levels of blood
Heparin, warfarin & aspirin
Define analgesic and provide an example
Impacts the reception of pain signals
Morphine, fentanyl, oxycodone & endone
Define sedative and provide an example
Reduces the alertness of a patient, often used in conjunction with analgesia
Midazolam & Diazepam
Define anti-mucolytic & provide an example
Breaks down proteins in sputum, which reduces the viscosity (thickness) of sputum and aids in its clearance.
Pulmozyme
Define diuretic and provide an example
Causes increased in urine production to reduce total body fluid load.
Lasix & Frusemide
What are the main markers for blood count?
Haemoglobin
WBC
Haematocrit
Red cell count
C Reactive protein
Neutrophils
What is haemoglobin? At what level may a patient require a blood transfusion? What if HB is low? Symptoms of low HB?
Carries oxygen
< 80 = blood transfusion
Heart has to work harder to meet 02 demands
Pale skin, dizzy, lightheaded, fatigue, low endurance
What do white blood cells do?
Protect from infection (if high likely to indicate this eg pneumonia)
**Does not contraindicate PT but can impact how the patient is feeling eg fever, feeling unwell, tired or lethargic).
What is haematocrit? What can influence these levels?
Ratio of RBC to total blood volume
**Dehydration or fluid overload can impact this.
Low red cell count can indicate?
Anaemia or renal failure
C-reactive protein is a marker of what?
Infection
Changes in coagulation factors may contraindicate what?
Aggressive chest PT due to bleeding risk
What markers represent coagulation?
Platelets
Partial thrombin time
International normalised ratio
What are platelets? Low platelets can be a contraindication for what? What do low levels indicate in terms of blood behaviour?
Blood clotting proteins
Low = contraindication for some manual techniques eg percussions & vibrations
Low = not clotting well
What does partial thrombin time indicate if it is higher?
Blood is taking a longer time to clot (can indicate a bleeding risk)
What does a longer international normalised ratio suggest? What is the normal?
Taking longer to clot eg elderly patients who are on medications to thin their blood. Must consider this that if they were to fall they may continuously bleed for an extended period.
Normal INR is 0.8-1.2?
What are the cardiac biomarkers?
Troponin
Creatine kinase
Lactate
What is troponin? What would elevated levels suggest?
Proteins that assist in regulating contractions within skeletal and cardiac muscle fibres.
Elevated troponins are often indicative of myocardial infarction and Troponin peak about 24 hrs after AMI
NOTE: Elevated troponins may be a contraindication for mobility – may wait until trending downwards. If this is too high unlikely to mobilise as there is already too much strain on the heart. Will need to get clearance from a doctor or ensure that it this level is trending downwards.
What is lactate?
Substrate released by muscles, RBCs, brain & other tissues when there is insufficient oxygen to aid 02 production
What are the electrolyte panel markers?
Potassium
Sodium
Calcium
Chloride
What is potassiums role? If its high or low what may this contribute to?
Mineral required for normal functioning of excitable cells (nerves, muscles & heart)- helps pump the heart. If high or low it can affect electrical signals resulting in potential development of heart arrhythmias.
What is the role of sodium?
Regulating agent determining the amount of water in and around cells.
What is the role of calcium?
Mineral required for bone formation, cell division & growth, blood coagulation, muscle contraction & release neurotransmitters. Contracts smooth muscle.
What are the kidney markers?
- Blood urea nitrogen
- Serum Creatine
- Glucose testing
What is blood urea nitrogen?
Waste product of protein metabolism, produced in the liver and eliminated by kidneys. (H) with impaired kidney function. dehydration,
What is serum creatine?
Waste product of metabolism and represents the balance between production by muscles and clearance by kidneys. (H) with impaired kidney function.
What is glucose testing?
To test for blood sugar and diabetes. Often beneficial to test before exercise and monitor for symptoms of low blood sugar.
What are the three types of precautions?
Contact
Droplet
Airbone
Transmission & PPE for contact precaution
Methods used to contain diseases that are spread by direct or indirect patient contact.
Gloves & Gown
Transmission & PPE for droplet precaution
Prevents transmission of diseases spread by large respiratory droplets through coughing, sneezing, or talking.
Eg: influenza, pertussis
Surgical mask
Transmission & PPE for airborne precaution
Prevents transmission of infectious agents that are very small and remain viable and suspended in the air over long distances.
Eg: measles, tuberculosis, chicken pox.
N95 or P2 mask
What is a sequential compression device (calf compressor?)
- Used to help prevent blood clots in the deep veins of the legs.
- The devices use cuffs around the legs that fill with air & squeeze your legs.
- This increases blood flow through the veins of your legs and helps prevent blood clots.
What is an indwelling urinary cathether?
- To drain the bladder prior to, during, or after surgery.
- To accurately measure the urine output.
- To relieve retention of urine.
- To relieve urinary incontinence when no other means is practical.
What is a nasogastric tube?
- Provides nutrition eg if they are sedated
What is a central venous catheter or central line?
- Receive fluid (eg IV), blood or medications directly
What is an intercostal catheter?
- Chest drain –> someone has blood/fluid or pus in their chest cavity.
What is a backslab?
- First line treatment for a fracture to control swelling or following surgery (simplest and safest form of plaster splint)
What is ICP monitoring?
- Monitoring the intercranial pressure (amount of pressure surrounding the brain).
Physiological and behavioural observation: accessory muscle use?
Accessory muscle use is defined as contraction of any muscle other than the diaphragm (or intercostals) during inspiration or use of any muscle during expiration.
This includes using other muscles such as the scalenes, sternocleidomastoid, pecs, lats, etc to produce breath.
Physiological and behavioural observation: clubbing of hands? What is its cause?
Define normal nail, digital clubbing and distal phalangeal depth?
Is a symptom of disease often of the heart or lungs commonly as a result of low blood levels of oxygen.
- Normal nail: from skin to nail is flat
- Digital club¬bing *Note that the angle between the nail and the proximal skin exceeds 180 degrees.
- Distal phalangeal depth (DPD) > interphalangeal depth (IPD).
Physiological and behavioural observation: Surgical scar - how do fresh vs old scars present?
Older or mature scars are generally paler, flatter and softer. Immature scars may be red in appearance.
Physiological and behavioural observation: Cyanosis of lips - what is it?
Blue-purple hue to the skin – occurs when the oxygen bound to hemoglobin is very low and may indicate inadequate oxygen delivery to the peripheral tissue.
