| What does ischaemic mean | Blood flow (and thus oxygen) is restricted or reduced in a part of the body |
| what are the 3 ways of measuring pain in children? | Self report (what they say), Behaviour, Physiological (clinical observations) |
| What does the pain assessment tool PQRSTU stand for? | Provocation (what makes in better/worse), Quality/Quantity (burning,shooting,dull,sharp etc), Region, Severity, Timing, affecting You |
| What happens to most meds when taken? | Metabolised by liver and excreted in urine |
| What effects the BBB? | Hypertension, raised ICP (intracranial pressure), inflammation, microwaves, trauma, infection |
| Name 3 principles of would care | Dry wounds need moisture, patient comfort, apply flat dressing centre -outwards |
| what does HEIDI stand for and when is the assessment used? | Assessment of a wound - History, examination (T.I.M.E) (tissue, infection, moisture, edge of wound), investigation, diagnosis, intervention |
| Name 5 factors effecting wound healing | age, genetics, meds, mobility, stress etc |
| What can adverse childhood experiences (ACE) cause? | Toxic stress, behavioural changes (drugs, smoking), education |
| Name 3 types of wound dressings | Film dressings, foams, hydrogels |
| Name 4 tissues types of wound healing | Epithelial (process of epidermis regenerating over a partial-thickness wound surface or in scar tissue forming on a full-thickness wound is called epithelialization), Slough (yellowish, soft and is composed of pus), Granulation (red, fills in a wound that is healing by secondary intention), Necrotic (dead tissue, must be removed for healing) |
| What is Bradykinin mediator? | Bradykinin is a peptide that promotes inflammation. |
| Difference between Triglycerides and Cholesterol is...? | Triglycerides store unused calories and provide your body with energy. Cholesterol is used to build cells and certain hormones. |
| How many of the depressive symptoms does someone need to have in the same two week period to be diagnosed with MDD? | At least 5 |
| What is hypomania? | similar to mania, but no significant impairment in social or occupational function |
| What is perfusion? | Perfusion is the flow of blood through arteries and capillaries delivering nutrients and oxygen to cells and removing cellular waste |
| What are the 3 types of circulation? | Systemic, Pulmonary, Coronary |
| What does cardiac output measure? | the amount of blood that is pumped out of the heart in one minute |
| Difference between hydrostatic and osmotic pressure? | Hydrostatic pressure = Force substances out of the capillary
Osmotic pressure= brings the substances back in (dependant on the concentration gradient of water-salt) |
| Name3 assessments to do for someone with hypertension: | Urinalysis (kidney function), blood cell count, cardiovascular risk assessment (bp, cholesterol levels, smoker age etc) |
| What is hyperlipidaemia? | Elevation of one or more lipoproteins in the blood (Cholesterol is transported to cells by lipoproteins that are either low density (LDL) or high density (HDL) ) |
| What is the the primary indicator of optimum lipid management? | Lowering of LDL-cholesterol |
| What is the difference between unstable angina and stable angina? | unstable angina is chest pain and doesnt have a pattern (can be sleeping or running etc) stable agina/angina pectoris is chest pain that occurs the discomfort it often predictable and due from stress/exercise and can get better with rest |
| What is acute coronary syndrome? | Any unstable condition brought on by a sudden reduction of blood flow to the heart. |
| What is Myocardial infarction? | (AKA heart attack) is when there is extended interruption of blood flow that results in myocyte necrosis (death of cardiac cells) resulting in myocardial infarction |
| Name the 3 imbalances that occur in heart failure | Acid base imbalances (Hearts failure to pump blood and perfuse tissue), Electrolyte imbalances (Overstimulation of the RAAS), Fluid imbalances |
| Name 2 nursing considerations for health failure: | Educate them (diet, exercise, meds etc), get good patient history |
| Name 3 modifiable and 3 non-modifiable risk factors of hypertension | Modifiable = Obesity, High alcohol intake, stress
Non modifiable = Family history, Gender, Age |
| How does hyperlipidaemia cause atherosclerosis and angina? | Extra cholesterol circulating in the bloodstream forms the basis for plaque lining the arteries. Plaque slows the flow of blood through the arteries |
| What are the categories of consciousness and what is an assessment? | Assessment: AVPU (alert, verbal, pain, unresponsive)
Alert (responds immediately),
Confused (disoriented to time or place),
Delirious (disoriented to time, place, and person),
Lethargic (state of drowsiness),
Obtunded (displays dull indifference to external stimuli),
Stuporous (aroused only by vigorous and continuous external stimuli), Comatose (Vigorous stimulation fails) |
| What might effect level of consciousness | 1 = Hypoxia,
2 = drugs,
3= trauma
4= Excessive pressure within the skull (raised ICP) |
| What does raised ICP mean and what are signs of it? | raised inter cranial pressure - signs are altered mental state, headache, vomiting, pupil changes |
| What does motor assessment include and why is it used? | Neurological assessment: Posture, Balance, Gait, Abnormal involuntary movements, Muscle strength, Movement against resistance (Each side is assessed individually and compared with the other) |
| what does neurological assessment include? | Level of consciousness, motor function, pupillary function, respiratory function, vital signs |
| What is the paediatric age group cover? | 0-16 |
| What 3 things are in the Paediatric Assessment Triangle (PAT) and why would you need to perform it? | For ill children
1- Appearance: Muscle tone, consolability, spontaneous movements, speech or cry, distress level
2- Work of Breathing: effort, Respiratory distress, abnormal airway sounds
3- Circulation to skin: Skin color, such as pale, mottled, cyanotic, or flushed, bleeding, sweating |
| What is NICE tool for children assess? | Identify seriously ill children under 5 who present with fever (traffic light system - green low risk, orange intermediate risk, red high risk) |
| What is treatment for asthma in paediatrics? | Short acting beta2-agonists (SABAs) known as 'relievers' e.g salbutamol OR oral corticoids |
| Sudden Unexplained Death in Infancy (SUDI) risk factors | being around smoking, co-sleeping |
| What are the signs/symptoms of dementia? | impairment in memory, decision making/judgment, thoughts, planning, mood (stage 1 is mild, stage 2 is enhanced symptoms, stage 3 need more assistance as they lose control eg eating, mobility, hygiene and becomes a global physical problem) |
| what happens in the brain with alzheimer's disease? | A progressive disease that destroys memory and other important mental functions.
Amyloid plaques and neurofibrillary tangles are key pathological changes in Alzheimer’s. The hippocampus and memory formation are affected very early on (due to tangles) |
| What is frontaltemperal dementia? | Characterised by damage of the frontal cortex and front parts of the temporal cortex. Two key proteins are TDP-43 and tau, which abnormally accumulate in neural cells |
| What is Vascular dementia? | Associated with accumulated damage to blood vessels in the brain. White matter under the cerebral cortex is the most vulnerable area for this dementia |
| What are some Non Pharmacological Therapy for dementia? | Massage, music therapy |
| What happens in the body with delirium? | Systemic inflammatory cytokine response and neurotransmitter disruption and signs include altered arousal, disorganised thinking, perceptual disturbances, psychosis |
| Name 2 assessment tools for delirium | 4AT and CAM (the Confusion Assessment Method) |
| What should the management for delirium be? | Must be Multidisciplinary = maybe discontinuing a med, make environmental changes, clocks/calendars are helpful to have around, prioritise a calm/safe environment |
| What is the primary function of the HPH- Axis? | Regulate the stress response |
| How is the cytokine stress response stimulated? | by local tissue damage at the site of the surgery which release pro-inflammatory cytokines |
| Name 3 triggers of the Neuroendocrine and Cytokine Response in Patients After Surgery | Hypoxia, Local inflammatory tissue factors, especially cytokines, Noxious afferent stimuli (especially pain), shivering |
| What is the aim of post op care? | To return the individual to an optimal level of functioning and independence. Ensure comfort, hygiene, oxygenation, circulation of blood |
| Name 3 cardiovascular post op complications | Hypertension (stimulation of sympathetic NS: adrenaline/noradrenaline, pain, anxiety), Myocardial infarction (increased adrenaline: vasoconstriction prolonged tachycardia),
CVA/stoke (surgical stress response e.g increased coagulation or neurological/cardiac surgeries), Cardiac arrhythmias (surgical response, hypoxemia, electrolyte imbalance) |
| Name 3 respiratory post op complications | Hypoventilation (meds such as opioids, tight dressings), Airway obstruction , Pneumonia (aspiration), pulmanry oedema (fluid overload e.g treating haemorrhage. result of anaphylaxis) |
| Name 1 renal post op complication | Impaired cardiac output |
| Name 1 cognitive complication pre, intra and post op | Delirium |
| What can post op pain cause? | Enhances surgical stress response, reduced mobility, O2 demand increases, causes tachycardia and hypertension |
| Name 3 post op considerations | Increased BGL due to surgical stress, sore throat from intubation tube, falls risk from meds |
| What is a nerve block? | deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. |
| Name 2 assessments to do on someone with respiratory tract disease and what they measure | PEAK FLOW= Measures expiratory flow rate and is used for the diagnosis, monitoring and assessment of the severity of the condition, particularly in patients with asthma
SPIROMATRY = Looking at overall function of lungs (how well you inhale and forcfully exhale– based on age, gender, height, ethnicity used to diagnose, monitor and assess for COPD, asthma and other lung diseases |
| What is Allergic Rhinitis and its symptoms? | Hayfever - IgE-mediated hypersensitivity reaction to allergens
Symptoms = sneezing, runny nose, |
| Name 3 non-pharmalogical ways to manage COPD | Smoking cessation, regular exercise, pulmanary rehabilitation, action plan |
| What is pneumonia? | Infection that inflames air sacs in one or both lungs, which may fill with fluid or pus. |
| What is Tuberculosis (TB) and what is it causes by? | infectious bacterial disease that mainly affects the lungs. Caused by Mycobacterium tuberculosis, infection begins when the mycobacteria reach the alveoli and begin to replicate |
| What are the 4 elements of informed consent? | Effective communication between the parties (Right 5)
- unrushed communication
Provision of all necessary information to the consumer
- options, risks and benefits (Right 6)
The consumer's freely given consent (Right 7)
The consumer’s competence to consent (Right 7) |
| If a child is under 16 are they able to consent for medical treatment? | Typically no but If the child shows a clear understanding of the proposed treatment then yes |
| If a patient is not competent to make a decision in an emergency situation is the health provider able to follow through? | If the patient is not competent for making a decision and there is no one there legally allowed to make health decisions for them then the health consumer is able to follow through if it is in the patients best interest |
| what does the mental health act provide? | provides a legal framework for those who require compulsory psychiatric assessment and treatment for people experiencing a mental illness. focusses on the patient rights and ensures workers follow the law relating to the assessment and treatment of the person experiencing mental distress |
| Explain the health and disability act | It is aimed at protecting the dignity of persons with disabilities and ensuring their equal treatment under the law including the right to health, education and employment. |
| What does the glasgo coma scale measure? | A person's level of consciousness. Based on their ability to perform eye movements, speak, and move their body. (lowest score 3 and highest score 15) |
| Difference between assessment of arousal and awareness? | Arousal = patient’s ability to respond to verbal or noxious stimuli in an appropriate manner (lowest level of consciousness)
Awareness = evaluating the patient’s orientation to person, place, time, and situation |
| Why is a neurological assessment important? | Identify neurological problems, Determine changes (improvements, deterioration, stability) |
| what is naloxone? | The med that minds to opiod receptors and rapidly blocks the effect of other opiods - once administered a patient can feel pain and withdrawal symptoms |
| difference between agonist and antagonist? | Agonist = drugs that activates receptors and produce desired response
Antagonist = drugs that prevent receptor activation and block response |
| what are the 3 systems of pain in perception phase? | The reticular system: This is responsible for the autonomic and motor response to pain and for warning the individual to do something
Somatosensory cortex: This is involved with the perception and interpretation of sensations
Limbic system: Responsible for the emotional and behavioural responses to pain |
| what can cause hypoxia and what is it? | lack of oxygen in the tissues effecting the bodily functions, caused by COPD heart disease/failure |
| what is microbial resistance | when the infection,fungi, virus etc change in a way that makes the med no longer effective or as effective (e.g. if you take too much antibiotics or panadol it becomes ineffective and you still feel the pain) |
| What are the core principles of ANTT? (asecptic non-touch technique) | A= always clean hands
N= non touch technique used at all times
T= touch non key parts with confidence
T= take appropriate infection prevention precautions |
| What are 2 complications of peripheral IV therapy? | Haematoma (collection of blood in tissue due to break in vessel wall) and infection |
| What are 2 high risk meds through IV? | Opiods, anticoagulants |
| Name the 4 phases of wound healing and what occurs during those periods | Haemostasis = (vasoconstriction, platelete plug formation and coagulation)
Inflammation = (increased blood flow to clear wound of pathogens)
Proliferation = (new blood vessels begin to grow)
Maturation = (regaining the strength the skin previously had) |
| What medication group has meds ending in "Pril" ? | ACE inhibitors |
| What medication group has meds ending in "Pine" ? | Calcium channel blockers |
| What medication group has meds ending in "tan" ? | Angiotensin receptor blockers (ARB) |
| What medication group has meds ending in "lol" ? | Beta blockers |
| Name the 3 diuretics | Thiazide, loop and potassium sparing diuretics |
| What medication group has meds starting with "Nitro" ? | Vasodilators |
| Side effects of IV potassium is? | If administered too fast could cause cardiac arrest, increase/decrease in urination, pain in chest |
| What is the normal function of the lymphatic system? | removing cellular waste, protecting body from foreign invaders, maintaining body fluid levels |
| Function of lymph fluid | Transports antigens to lymph nodes via lymph vessels where they are killed due to lymph nodes containing immune cells |
| Function of tonsils | Stop bacteria from entering mouth as they contain WBC which kill bacteria |
| CHIME is an acronym for mental health recovery - what do the letters stand for? | connectedness, hope, identity, meaning and empowerment |
| What does acidosis mean? | Build up of acids in the blood stream |
| signs and symptoms of pneumonia | Coughing, fever/chills, difficulty breathing |
| COPD causes | untreated asthma, SMOKING, environments (eg damp/mouldy housing), dust |
| Common symtoms of COPD and what are the phases? | mild, moderate, severe - chest tightness, wheezing, shortness of breath, chronic cough (due to mucus) - as copd progresses it gets harder to simply walk up stairs or walk |
| Nursing consideration for ACE inhibitors | take 1 hour before or 2 hours after food, warn patient to avoid dehydration as it may lead to a greater fall in bp |
| Nursing considerations for calcium channel blockers | No grapefruit |
| What does CPR stand for | cardio pulmonary resuscitation |
