week4

Question 1

common side effects furosemide

Answer 1

• mild GI disturbances
• postural hypotension
• electrolyte disturbances
• hypersensitivity reactions

Question 2

risk of metformin with kidneys

Answer 2

risk of lactic acidosis if metformin given with renal impairment

metformin to be avoided if eGFR < 30ml/min/1.73

Question 3

what is a rescue pack for COPD exacerbation

Answer 3

supply of steroids or antibiotics

to be started if the person with COPD notices an increases shortness of breath affecting their ADLs
or
have more or discoloured sputum

Question 4

what may suggest an acute exacerbation of COPD

Answer 4

• acute confusion
• marked reduction in ADLs
• pursed lip breathing
• marked breathlessness + tachypnoea
• new onset cyanosis
• peripheral oedema
• use of accessory muscle at rest

Question 5

bacterial causes of COPD acute exacerbation

Answer 5

• Streptococcus pneumoniae
• Staphylococcus aureus
• Haemophilus influenza

Question 6

viral causes of COPD acute exacerbation

Answer 6

• influenza
• parainfluenza
• rhinovirus
• RSV

Question 7

Pollutants that can cause acute exacerbation COPD

Answer 7

• sulphur dioxide

- nitrogen dioxide

Question 8

For acute exacerbation of COPD; consider hospital admission if the person has any of…

Answer 8

• severe breathlessness, rapid onset of symptoms, acute confusion, cyanosis, worsening peripheral oedema or impaired consciousness
• person is unable to cope or lives alone
• reduction in ADL, confined to bed, on LTOT
• significant comorbidities
• low o2 sats (<90% on pulse oximetry)

Question 9

management of a patient with COPD exacerbation with low o2 sats < 90% on pulse oximetry

Answer 9

• Give oxygen while awaiting transfer to hospital: 28% venturi mask flow rate 4 L/min aiming for sats 88-92%

if remains < 88% –> nasal cannulae 2-6 L/min OR simple mask at 5L/min and request emergency ambulance

• If o2 sats decreases after starting oxygen therapy change to a 24% venturi mask at flow rate 2 L/min

Question 10

4 main categories for abuse

Answer 10

• physical
• emotional
• sexual
• neglect

Question 11

what is SENCO

and their role

Answer 11

Special Educational Needs Co-ordinator

role = children with disabilities and special educational needs get the support they need in school

Question 12

shared care protocol is ?

Answer 12

an agreement between primary and secondary care to share responsibility for managing a medicatoon prescribed to a patient