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NUR5079 > Week 3 > Flashcards

Week 3 Flashcards

1
Q

What percentage of live births result in a Ventricular Septal Defect?

A

25%

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2
Q

Identify the symptoms of Cardiac Failure in Infants

A
  • Poor feeding
  • Failure to thrive
  • Fatigue
  • Tachypnoea
  • Tachycardia
  • Hepatomegaly
  • Sweating
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3
Q

Talk through the common treatment pathway for VSD

A
  • Full PEWS observation in line with Trust observation and monitoring policy
  • Administration of medication
  • Accurate fluid balance monitoring
  • Liaison with MDT ( Cardiac Liaison Team & X-Ray / Echo )
  • Family Centered Care
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4
Q

Identify the Guiding Principles of Treatment for VSD

A
  • Surgery
  • Diuretics’
  • Fluid Restriction
  • Beta Blockers
  • Ibuprofen / Indomethacin
  • Prostaglandins ( keep some ducts open )
  • Transplant
  • Varies from case to case
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5
Q

What is a Ventricular Septal Defect?

A
  • `It is a common form of congenital heart disease

- It occurs when there’s a hole between the two ventricles

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6
Q

Identify the causes of Ventricular Septal Defect

A
  • Congenital
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7
Q

What are Milrinone Drains?

A
  • Used for short - term treatment of heart failure
  • Works by increasing the strength of the heart beat & relaxing certain blood vessels to increase the amount of blood that is pumped from the heart
  • Can help reduce: shortness of breath, tiredness
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8
Q

What are Mediastinal Drains?

A
  • They are inserted as standard postoperative practice following cardiac surgery to assist the clearance of blood from the pericardial space.
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9
Q

What are Cardiac Catheters?

A
  • A procedure where a catheter is guided through a blood vessel into the heart to diagnose or treat certain heart conditions.
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10
Q

Give an overview of how Milrinone works

A
  • Phosphodiesterase Inhibitor
  • Positive inotrope
  • Increase the contractibility of the heart
  • Vasodilators = Reduced SVR
  • PBE activity = Reduced cAMP level
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11
Q

What are the possible side effects of Milrinone?

A 
COMMON:
- Arrhythmia 
- Headaches 
- Hypotension
UNCOMMON: 
- Angina Pectoris 
- Chest Pain
- Hypokalemia 
- Tremor 
RARE:
- Anaphylactic Shock 
- Bronchospasm
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12
Q

What is an ECG?

A
  • Electrocardiography
  • It is the measurement of electrical activity in the heart, interpreting the diagnosis of complex arrhythmias and myocardial ischemia
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13
Q

Discuss the 6 Stage System involved in Cardiac Monitoring

A
  • Is there any electrical activity?
  • What is the ventricular ( QRS ) rate?
  • Is the QRS rhythm regular or irregular?
  • Is atrial activity present?
  • Is atrial activity related to ventricular activity and if so, how?
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14
Q

Talk me through Seizure Resus

A
  • Attach the Defibrillator as soon as it is available and Analyse the Rhythm (pause CPR for <5seconds during rhythm analysis)
  • Decide if the Rhythm is Shockable or Non- Shockable
  • Continue CPR immediately
  • If Shockable immediately initiate hands on charging
  • Pause only to deliver the shock (ensure no one is touching the patient)
  • If Non-shockable continue CPR
  • Analyse the Rhythm every two minutes
  • During each cycle consider which drugs are required
  • During each cycle consider reversible causes and relevant interventions
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15
Q

How do you treat a NON-SHOCKABLE RHYTHM ( asystole / PEA ) ?

A
  • Administer IV adrenaline 1mg immediately

- Once administered adrenaline is repeated every 3 - 5 minutes

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16
Q

How do you treat a SHOCKABLE RHYTHM ( ventricle fibrillation, pulseless ventricle tachycardia ) ?

A
  • If three shocks fail, administer

- 1mg IV adrenaline & 300mg IV Amiodarone, once administered adrenaline is repeated every 3-5 minutes

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17
Q

Talk through the AED Procedure Sequence

A
  • Check for risks to the victim, any bystanders, and yourself.
  • Assess the victim to be unresponsive and not breathing normally.
  • Send someone for the AED and to call for an ambulance (prehospital settings) or crash team (in hospital settings).
  • Start Cardio-Pulmonary Resuscitation (CPR) unless AED is immediately available with easy access to the patient’s chest (COVID-19 guidance state that CPR can only be performed once level 3 PPE has been donned).
  • Switch on the AED and attach the AED pads.
  • Follow the AED voice prompts.
  • Ensure CPR is stopped and that nobody touches the victim whilst the rhythm is being analysed.
  • Safely deliver a shock to the victim.
  • Resume CPR immediately, as guided by the voice prompts, starting with chest compressions
  • Minimise interruptions in chest compression
  • Continue as directed by voice / visual prompts until advanced help arrives
18
Q

How does Milrinone help to restore blood pressure?

A

It is a medication used to increase the heart’s contractility and decrease Pulmonary Vascular Resistance and so tends to lower arterial blood pressure.

19
Q

Identify possible health issues that may occur in individuals who have Down’s Syndrome

A
  • Heart Problems
  • Blood Disorders
  • Vision & Hearing
  • Thyroid
  • Constipation
  • Toilet Training
  • Coeliac Disease
  • Breathing ( Nasal Congestion )
  • Infections
  • Teeth ( often come through later )
  • Arthritis
  • Neck Instability
20
Q

What is PDA?

A
  • Patent Ductus Arteriosus

- It is a heart defect which is a result of the connection between the aorta and the pulmonary artery does not close

21
Q

What are the signs & symptoms of PDA?

A
  • Continuous Murmur
  • Tachycardia
  • Bound Peripheral Pulses
  • Tachypnoea
  • Poor Feeding & Poor Weight Gain
  • Sweating whilst feeding
22
Q

Walk through the first aid procedure for seizures

A
  • Assess danger ( safety is priority )
  • Shout / call for help
  • Only move the individual if they are in danger or move objects that may cause the individual to hurt themselves.
  • Note the time ( it is important to note how long seizures last for )
  • Gently support the individual’s head or place something soft underneath, such as: a jumper
  • Loosen any tight clothing ( alleviate restrictions )
  • Prevent crowding
  • DO NOT hold them down, allow the seizure to happen
  • DO NOT put any objects in their mouth, they will not swallow their tongue, and this may cause trauma.
    ( IMMEDIATELY POST SEIZURE )
  • Check for signs of life ( A – B – C ) for 10 seconds, start CPR if no signs of life
  • If not fully conscious place them in recovery position, ensuring patent airway
  • If possible, wipe face and over any incontinence
  • Keep NBM until fully conscious, avoid aspiration
  • Stay with them
23
Q

Identify the 7 different types of seizures

A
  • Focal Aware Seizures
  • Focal Impaired Awareness Seizures
  • Focal To Bilateral Tonic Clonic Seizures
  • Absence Seizures
  • Tonic & Atonic Seizures
  • Myoclonic Seizures
  • Tonic Clonic & Clonic Seizures
24
Q

Define Focal Aware Seizures

A
  • the individual is conscious and usually know that the seizure is happening
  • it could be an unusual smell or taste, twitching of an arm, strange rising feeling in the stomach etc
25
Q

Define Focal Impaired Awareness Seizures

A
  • they affect more of the brain and consciousness is affected, may be confused or not know what is happening.
  • the individual may wonder around, behave strangely, pick up objects or make chewing movements.
  • can last a couple seconds or a few minutes
26
Q

Define Focal To Bilateral Tonic Clonic Seizures

A
  • sometimes affects both sides of the brain.

- it usually warns them that a tonic Clonic seizures may follow

27
Q

Define Absence Seizures

A

the person becomes unconscious for a short time, they may look blank and stare, not responding to what is happening around them

28
Q

Define Tonic & Atonic Seizures

A

Tonic: person’s muscles become stiff, falling if they stood
Atonic: person’s muscles suddenly relax and become floppy - usually falling forwards

29
Q

Define Myoclonic Seizures

A
  • Muscle Jerking

- The seizures involve jerking of a limb or part of a limb

30
Q

Define Tonic Clonic & Clonic Seizures

A
  • the person goes stiff ( tonic ) and usually falls to the ground, shaking or jerking ( clonic )
  • breathing can be affected, they can go pale or blue, particularly around their mouth
  • they might bite their tongue
31
Q

Define Status Epilepticus

A
  • Is when a seizure lasts longer than 5 minutes.
  • Is when seizures occur one after another without recovery in the interim.
  • Can happen in any type of seizures.
  • Can be convulsive or non-convulsive.
  • Can be very dangerous and can increase the risk of death.
32
Q

Identify the risk factors for Dementia

A
  • Age ( 10 - 30% prevalence in over 65% )
  • Sex ( more common in females )
  • Brain Injury ( TBI leads to increased risk
  • Osteoarthritis
  • Lifestyle / Modifiable Factors
    ( smoking / hypertension / diabetes / mental health / diet )
33
Q

Identify the barriers to Incontinence

A
  • Learning/cognitive disability
  • Mobility
  • Ability to communicate
  • Environmental factors
  • Clothing
  • Anxiety
  • Attitudes
34
Q

What can incontinence be caused by?

A
  • Urinary tract infections (UTI)
  • Constipation
  • Medications
  • Alcohol, Nicotine, and caffeine
  • Abdominal Surgery
  • Pregnancy and childbirth
  • Excess weight
  • Prostate Complications (In Men)
  • Functional incontinence (caused by physical or psychological inhibiting factors)
35
Q

Identify possible questions to determine your patient’s continence

A
  • How often the person goes to the toilet to urinate and whether this is a change to their normal routine
  • Current or previous medical history (including pregnancy and urine infections)
  • Possibility of physical or sexual abuse, including FGM (female genital mutilation)
  • A rough estimate of the amount of urine passed
  • If there is leakage of urine
  • Information about diet and fluid intake
  • Any medications being taken (both prescribed and over the counter)
  • Lifestyle factors, including recreational drugs, alcohol, smoking and weight
  • Ability – for example, whether the person can feed, dress and bathe on their own
  • Mobility – physical or environmental factors
  • Capacity – does the person recognise the need to go to the toilet or do they forget where the toilet is?
36
Q

What are the RCPCH Growth Charts?

A
  • The Roya College Of Pediatrics & Child Health
  • They allow healthcare professionals to plot and measure child growth, allowing for comparisons with healthy children of the same age and gender
37
Q

What is The Care Act 2014?

A
  • It requires local authorities to ensure the provision or arrangement of services, facilities or resources to help prevent, delay or reduce the development of needs for care and support.
38
Q

What is the main principle of The care Act 2014?

A
  • to help to improve people’s independence and wellbeing and for care providers and givers to promote a person-centred approach to the care and support they provide.
39
Q

What is the Transition Assessment identified in The Care Act 2014?

A

It is an assessment that takes place in the transition from children’s to adult services

40
Q

What is the DESC Framework?

A

Describe
Express
Specify
Consequences

41
Q

What is the purpose of DESC Framework?

A

To develop assertiveness in communication

NUR5079 (5 decks)

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