Exam prep 1
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| 🇬🇧 | 🇬🇧 |
| What does ischaemic mean | Blood flow (and thus oxygen) is restricted or reduced in a part of the body |
| What is alzheimer's disease | A progressive disease that destroys memory and other important mental functions. Brain cell connections and the cells themselves degenerate and die, eventually destroying memory and other important mental functions. |
| 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 |
| What is a primary dressing? | Comes in contact with the wound. They can either: - Maintain adequate moisture - Absorb excess moisture - Add moisture |
| Name 3 types of wound dressings | Film dressings, foams, hydrogels |
| What should a wound assessment include? | Identification of cause, Type of wound & location, Type of healing Clinical appearance, Pain, Impact on patient |
| 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 a secondary dressing? | Dressings that cover a primary dressing or secure a dressing in place |
| 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 does Parkinsons disease effect neurotransmission? | Through the neurotransmitters acetylcholine (excitatory) and dopamine (inhibitory), neurons relay messages to the motor centres. Parkinson's disease decreases dopamine levels resulting in less inhibitory neurotransmitters leading to an imbalance of voluntary movement |
| What is hypomania? | Similar to mania, but no significant impairment in social or occupational function |
| What is a mixed episode? | Where features of mania and depression such as agitation, anxiety, fatigue or irritability occur simultaneously |
| 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 |
| What is a diagnostic criteria for Mania? | Three (or more) symptoms need to have persisted and been present to a significant degree |
| What is vascular resistance? | The resistance present in the blood vessels |
| 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 |
| Name at least 3 complications as a result of hypertension: | Angina, coronary artery disease, stroke, heart failure |
| 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 |
| Name 4 complications of hyperlipidaemia: | Atherosclerosis, Angina, Myocardial Infarction, Stroke |
| Name 3 treatments of angina | Statin, beta blockers, calcium channel blockers |
| 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 |
| When does perfusion of the heart muscle occur? | During diastole |
| 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 is unstable angina? | Reversible myocardial ischaemia |
| 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 acute cardiovascular diagnoses? | Pericarditis = (Inflammation of pericardium (sack that surrounds the heart) Endocarditis = (Inflammation on endocardium (related to bacteria on heart valves effecting ability to open/close) Myocarditis = (Inflammtion in Mycardial) Cardiac tamponade= (associated with pericarditis) |
| 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 asthma? | Asthma as a disease characterized by recurrent attacks of breathlessness and wheezing |
| What is treatment for asthma in paediatrics? | Short acting beta2-agonists (SABAs) known as 'relievers' e.g salbutamol OR oral corticoids |
| What is bronchiolitis? | Acute inflammation of epithelial cells in the bronchioles in young children and infants. Bronchiolitis is almost always caused by a virus |
| Sudden Unexplained Death in Infancy (SUDI) risk factors | Being around smoking, co-sleeping |
| What is coronary heart disease/myocardial ischeamia? | Damage or disease in the heart's major blood vessels. The usual cause is the build-up of plaque. This causes coronary arteries to narrow, limiting blood flow to the heart. |
| 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 |
| How does hyperlipidemia cause atherosclerosis | A disease of the arteries characterized by fatty material on their inner walls. |
| How does hyperlipidaemia cause angina | Extra cholesterol circulating in the bloodstream forms the basis for plaque lining the arteries |
| 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 be checked for a neurological assessment? | Cerebral function, Cerebellar function, pupils, Check pain levels, Sensation in peripheries (age dependant) |
| 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 |
| Explain the Neuroendocrine post op stress response | Starts with injury/stress, hypo is stimulated to produce CRH, TRH and GNRH then this goes to the anterior pituitary which releases ACTH which goes to the adrenal gland, and TSH to the thyroid. The adrenal gland releases cortisol and adrenaline and the thyroid release thyroxine. OR injury – nociceptors – sensory nerves – spinal cord – pancreas secretes glucagon and insulin |
| 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 |
| 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, |
| What is asthma and its symptoms? | A chronic inflammatory airway disorder that triggers the airway inflammation, mucus production, bronchospasm and bronchoconstriction. On exposure to a trigger heaps of IgE is released which cause release of inflammatory mediators. Symptoms= wheezing, coughing, tightness of the chest, and shortness of breath, irritable cough at night especially in children (this may be the main symptom) |
| What is COPD? | Is an airflow obstruction that is permanent, irreversible, disabling and progressive. Umbrella term for Chronic bronchitis - inflammation causes chronic bronchial secretions and narrowing of the bronchi Emphysema - a permanent destructive enlargement of the airspaces within the lung Irreversible Asthma |
| 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) |