| What is an intervention for anxiety disorders? | Psychoeducation therapy (provides info and support for patient and their family to better understand and cope with illness) |
| What is first line treatment for a UTI and whats its mode of action? | Nitrofurantoin =
Bactericidal
Inactivates protein synthesis
Inhibits DNA synthesis
Inhibits RNA synthesis
Inhibits cell wall synthesis |
| What is Pyelonephritis and what is it causes by? | Pyelitis–inflammation of walls of the renal pelvis (kidneys) due to UTI |
| What is first line treatment for Pyelonephritis and its mode of action? | Amoxicillin clavulanate=
Beta lactam antibiotic
combination of amoxicillin and clavulanic acid
Clavulanic acid acts to reduce drug resistance when used in combination - it has minimal antibacterial action but is a potent inhibitor of beta-lactamase produced by some bacteria
Inhibits cell wall synthesis causing cell lysis = bactericidal |
| What are the definistions of the following: Stress incontinence, Urgency incontinence, Overactive bladder syndrome, Mixed incontinence, Overflow incontinence | Stress= when urine leaks out at times when your bladder is under pressure ( cough or laugh)
Urge incontinence = when urine leaks as you feel a sudden, intense urge to pee, or soon afterwards.
Mixed = both urge and stress
Overactive= sudden need to urinate
Overflow= bladder fills up and you need to go suddenly |
| What is what is Benign Prostatic Hyperplasia (Hypertrophy) BPH? | Age-associated prostate gland enlargement that can cause urination difficulty. |
| Signs and symptoms of Pyelonephritis: | High fever (fever > 38c)
Intense pain
Loin pain
Nausea & vomiting
Diarrhoea
Blood cells & pus in urine |
| what are the 2 main stress response pathways? | Short term: Sympathomedullary Pathway (SAM) = Hypothelamus - sympathetic nervous system - adrenal medulla - noradrenaline & adrenaline release - fight flight response
Longer term: Hypothalamus-pituitary-adrenocortical (HPA) axis = Hypothalamus - CRH - pituitary gland - ACTH - adrenal gland - cortisol secretion - stress |
| What is a diagnostic tool for anxiety? | SIT = severity (of symptoms they experience), impact (does it impact on social life etc), time (how much time do they feel anxious for) |
| What are the key features and symptoms of generalised anxiety disorder (GAD)? | - most common of anxiety disorders
- features = worry is out of proportion to the event/issue, Difficulty controlling the worry, Found to cause the most interference with life
- Symptoms = restlessness, fatigue, concentration difficulty, irritability |
| What is a panic disorder and what is characterised by? | - Characterised by intense recurrent surges of anxiety (panic attacks)
- Panic attacks are unexpected periods of intense fear or discomfort triggered by a perceived threat – fight or flight response |
| Whats the difference between Agoraphobia and specific phobia? | Agoraphobia = Anxiety in situations where the person perceives their environment to be unsafe.
Specific phobia = Excessive or unreasonable fear of objects or situations e.g. spiders, flying etc... |
| Name 3 key symptoms of PTSD: | hyperarousal, Persistent avoidance of trauma stimuli and Mood/cognitive alterations |
| What are the 4 main classes of meds used to treat anxiety disorders? | Antidepressants = long term management (block reuptake of neurotransmitters through selective receptors)
Benzodiazepines = Short term management of acute anxiety systems (GABA agonist binds to GABA receptors to block its action
Hypnotics = Used to treat short-term or transient insomnia and reduces time it takes to fall asleep (Benzodiazepines & Cyclopyrrolones both act on GABA receptors but in diff parts of brain)
Beta blockers= treats palpitations, sweating and tremor |
| Name 5 ways for fluid loss in the body | Vomiting, diarrhoea, excessive urination, haemorrhage, sweating/fever |
| Name 3 ways the body may accumulate too much fluid | Excessive sodium intake, renal failure, cirrhosis in the liver |
| Name 5 factors that can increase the risk of fluid or electrolyte imbalace: | Diabetes, Hypertension, heart failure, elderly population, renal failure, infants |
| Name 3 meds that can cause fluid and electrolyte imbalance: | Diuretics = promote fluid excretion by the kidneys and excess loss of sodium and potassium
Ace inhibitors = elevated potassium
Glucocorticosteroids = elevates sodium levels |
| What are the Causes of hyponatraemia and hypernatraemia? (sodium) | Hypo = fluid retention due to cardiac or renal or hepatic failure
Hyper = anything that leads to excessive water loss or salt gain such as vomiting or diarrhoea |
| Causes of hypokalaemia and hyperkalaemia are? (potassium) | Hypo = decreased oral intake, increased renal – usually associated with diuretic use, GI loss (diarrhoea) of potassium
Hyper = excessive intake, tissue damage eg - burns injury, potassium sparing diuretics, renal failure |
| Causes of hypomagnesaemia and hypermagnesaemia (magnesium) are? | hypo = Crohn’s disease, diarrhoea, over 70s, diabetes, liver disease, Loop diuretics (such as frusemide), alcohol dependence
hyper = Renal disease, renal failure, hypothyroidism, Addison's disease, drugs containing magnesium, such as some laxatives and antacids |
| Causes of hypocalcaemia and hypercalcaemia are (calcium)? | Hypo = parathyroid disease, vitamin D deficiency, malnutrition, some medications, renal failure
Hyper = parathyroid disease, dehydration, renal disease, lithium, some cancers |
| Causes of hypophosphataemia and hyperphosphataemia (Phosphate)? | Hypo = Alcoholism, anorexia (severe malnutrition), severe burns, renal disease, hyperparathyroidism, chronic diarrhea, diuretics, glucocorticosteroids
Hyper = Renal disease, hypocalcaemia, other metabolic or respiratory causes of acidosis, Vitamin supplements, lactic acidosis
Medications - laxative abuse, Vitamin D, bisphosphonates |
| Causes of hypochloraemia and hyperchloraemia (chloride) are? | hypo = Vomiting, excessive sweating, Addisions disease BUT most commonly associated with hyponatraemia
hyper = Diuretics, glucocorticosteroids, Cushings disease/syndrome |
| Name 4 indications for fluid balance monitoring: | wound drains, vomiting, diarrhoea, urinary catheterisation, med conditions that effect fluid balance (eg dehydration) |
| Name 3 assessments to do on patients when administering of IV fluid: | weight chart, fluid balance chart, OBS, underlying health issue, clinical presenation |
| What are the 5 R's for IV fluid adminitration? | Resuscitation = undertaking ABCE assessment, administration of fluid therapy
Routine maintenance =
Replacement = mostly electrolytes (if its imbalanced it has knock on effect)
Redistribution =
Reassessment = |
| What is plasma composed of? | Primarily water but it also contains proteins (albumin, globulin and clotting factors/fibrinogen), electrolytes, gases, nutrients and waste. |
| What are the 3 types of blood cells and their function? | Erythrocytes (RBCs) = primary function is oxygen transportation
leucocytes (WBCs) = involved in protecting the body from infection
thrombocytes (platelets) = promote blood coagulation. |
| what are Four components that contribute to normal haemostasis? | vascular response,
platelet plug formation,
the development of the fibrin clot, and
lysis of the clot |
| what is cystic fibrosis? | An inherited life-threatening disorder that damages the lungs and digestive system. Affects CFTR gene (the cells that produce mucus), which is located on chromosome 7. It causes these fluids to become thick and sticky. |
| Symtoms/signs of cystic fibrosis in the respiratory system are? | Chronic cough
Thick mucous
Haemoptysis (coughing up blood)
Atelectasis (Complete or partial collapse of a lung)
Wheeze
Persistent or recurrent pneumonia
Inflamed nasal passages and blocked nose |
| what happens with cystic fibrosis in GI system? | Thick mucous blocks pancreatic ducts
Decreased ability to secrete gastric enzymes
Impaired absorption of fats, proteins and vitamins A, D, E & K
Pancreas does not make enough bicarbonate to neutralise stomach acid |
| signs/symptoms of cystic fibrosis in GI system? | Abdominal pain and cramps
Increased flatulence
Greasy stools
Constipation
Gastric reflux
Poor weight gain and growth
Jaundice if liver affected
Gallstones |
| Whats the difference between aerobic and anaerobic metabolism? | Anaerobic (without o2) = the creation of energy through the burning of carbohydrates in the absence of oxygen (Glucose = lactic acid, Fats = ketoacids)
Aerobic (with o2) = the creation of energy through the burning of carbohydrates, amino acids, and fats in the presence of oxygen Protein= amino acids, Fats = fatty acids, Phosphorus = phosphoric acid) |
| What is the Arterial blood gas analysis (ABGs) test for? | A diagnostic test
uses a sample of arterial blood from an arterial puncture
assesses the effectiveness of ventilation.
assesses overall acid-base balance |
| what does PaCO2 stand for and whats the normal range? | partial pressure of carbon dioxide. 35 to 45 |
| What is does HCO3 stand for and whats its normal range? | Bicarbonate - 22-26 mEq/L. |
| What is the normal pH range and what is it? | 7.35-7.45 - a figure expressing the acidity or alkalinity of a solution |
| what does PaO2 stand for and whats the normal range? | partial pressure of oxygen - 80-100 mmHg |
| what does spO2 stand for and whats the normal range? | oxygen saturation as detected by the pulse oximeter - 95%-100% |
| How do you know if its a respiratory or metabolic problem when assessing acid base status in someone? | resp = opposite (pH and co2 are going in opposite direction)
Metabolic = Same direction (pH and co2 are going in same direction) |
| What is a A.L.L.O.W used for and what does it stand for? | When working with people that may have experienced sexual assault
Ask = permission to ask but be direct
Legitimizing = normalize, use statistics, provide information
Limitations = role and what is possible, brief intervention, sexual history and refer on
Open conversation = psychosocial model
Working together to follow up = (work in partnership) |
| What are some effects that alcohol consumption during pregnancy can cause? (results of Foetal Alcohol Spectrum Disorders) | poor growth/small size,
facial abnormalities,
failure to thrive,
heart defects,
brain damage,
developmental delay
and social, emotional, behavioural and mental disabilities |
| what are Attention Deficit Hyperactivity Disorder (ADHD) symptoms? | difficulty paying attention and staying focused (inattention), difficulty controlling behavior (impulsivity), and hyperactivity (over-activity) |
| what is the HEEADSSSS mnemonic? | Home,
Education and Employment,
Eating and Exercise
Activities and peers,
Drugs,
Sexuality,
Suicide and depression,
Safety,
Spirituality |
| Whats the difference between gender and sexuality? | Gender = socially constructed
Sex = biologically determined |
| What is an Autistic Spectrum Disorder? | On a spectrum (ranges from asburgers to severe autism with itilectual disability), its a disability rather than disorder and
affects communication, social interaction and is associated with a lack of flexibility in thought and action.
BASICALLY = difficulty in making sense of their world |
| What is conduct disorder? | BASIC: VIolent to others, bullying, bad to animals, breaking rules etc...
A clustering of behavioural difficulties that is dissimilar to age-appropriate norms. These behaviours include hostility to others, aggression and rule infractions, defiance of adult authority and violations of social and cultural norms |
| Whats the difference between Truancy and school phobia? | truant children = are bored with school, or angry about having to go (poor educational achievement, this can occur with people with ADHD)
school refusal = caused by anxiety disorders, social phobia or anxiety, depression etc... |
| What are some nursing responses to stop people from harming themselves (emotional distress/disregulation) | Do:
Show compassion, Listen, even if it makes you uncomfortable, Encourage them to use their voice, rather than their body as a means of self-expression, Encourage them to seek mental health support.
Suggest:
Write down thoughts then rip it up, mindfulness, icecubes/elastic bands (causes temporary pain but not harmful), scribbling,yelling into pillow if angry |
| what are the 2 things that Maudsley Anorexia Treatment for Adults (MANTRA) target? | Personality traits: Shy, anxious and perfectionistic
Thinking styles: Inflexibility, excessive attention to detail, fear of making mistakes,
A belief that anorexia is helpful in managing life’s challenges |
| Whats the difference between thrombus and embolus? | Thombus = A stationary clot attached to the vessel wall
Embolus = A thrombus that has detached from the vessel wall and circulates within the bloodstream |
| What are the 3 key nursing roles when it comes to coagulation therapy and explain them? | Screening =
Hhistory of medication compliance, memory impairment, family or care-giver support, and use of other medications
Education =
Addresses the importance of follow-up testing and care, risk avoidance, diet and alcohol advice, what to do if a dose is missed, or there is concurrent illness
Monitoring =
monitor for abnormal bleeding (Excessive bruising or prolonged bleeding from injection sites or cuts,
Bleeding gums even with a soft tooth brush, Spontaneous/prolonged nose bleeds, Heavy menstrual flow |
| what are the 3 major components when thinking about risk? | Likelihood: the probability and possibility
Adverse Outcome: different to chance
Time: how imminent is the event |
| what are the most commonly identified areas of risk? | risk to self (Suicide, self-harm or neglect), risk of violence to others and risk of victimisation. |
| (Likelihood = static risk factors + dynamic risk factors) what are static and dynamic risk factors? | static (does not change) = genetic make up, personality type (internal) and the person’s past environment such as childhood trauma (external) = propensity for long term risk
Dynamic = A change in mental state (internal) and current situational environment (external) = fluctuating nature of risk |
| What is included in a suicidal risk assessment? | suicide intent
the degree of planning involved
and availability and ease of access to means |
| Blood is a type of connective tissue that performs three major functions: | transportation, regulation and protection. |
| What is the most common inherited bleeding disease? | Von Willebrand's disease |
| what is the Virchow triad and what are the compontents? | Virchow triad shows the 3 major factors for developing spontaneous thrombi.
1. Injury to the blood vessel endothelium
2. Abnormalities of blood flow
3. Hypercoagulability of the blood |
| What is, VTE, DVT and PE and how are they related? | Venous thromboembolism (VTE) is a disorder that includes deep vein thrombosis and pulmonary embolism
DVT = a blood clot that remains attached to a vessel wall
PE= occlusion or partial occlusion of the pulmonary artery or its branches by an embolus |
| SSRI function with coagulation is...? | Platelets release serotonin in cases of vascular injury and serotonin contributes to coagulation by causing platelet aggregation.
SSRIs block the serotonin transporter which decreases clotting and increases risk of bleeding |
| What complications can diabetes cause? | Increased risk of heart attacks and stokes, food ulcers, infections, diabetic retinopathy (blindness), kidney disease (diabetes is leading cause for that) |
| What is metabolic syndrome? | When someone may have insulin resistance but not diagnosed with diabetes yet, important to know as it's a risk for cardiovascular disease. |
| How do you get Hyperglycaemia with type 1 and type 2 diabetes? | Type I diabetes = absolute insulin deficiency = hyposecretion = hyperglycaemia
Type II diabetes = insulin resistance = issue at receptor sites on cell membrane = hyperglycaemia |
| What are 5 signs and symptoms of hyperglycaemia? | Weight loss
Polydipsia
Polyuria
Recurrent infections
Visual changes/disturbance
Paraesthesia
Fatigue
Polyphagia (hunger) |
| What are some signs and symptoms of hypoglycaemia and what hormones increase in the body when that occurs? | • Autonomic activity in response to low plasma glucose causes hunger, sweating, nausea, warmth, anxiety, tremor
• Low glucose supply to the brain causes headache, blurred or double vision, confusion, difficulty speaking, seizures, and coma
Glucogen and adrenaline increase (bodies first line of defence), Cortisol (stress hormone) and growth hormone also increases |
| What is the main treatment for DKA? | IV FLUID REPLACEMENT!! And insulin |
| What is the insulin regime for people with type I diabetes? | Basal-bolus = use a short-acting insulin injected before or with meals and an intermediate/long-acting (basal) insulin injected once or twice daily
(A basal-bolus regimen, which includes an injection at each meal, attempts to roughly get how a non-diabetic person's body delivers insulin) |
| Name 2 devices for diabetes? | Blood glucose monitor, External insulin pumps |
| Who is at an increased risk of thyroid dysfunction? | elderly, history of it, type 1 diabetes, Addison’s disease, coeliac disease |
| What is one med that causes thyroid dysfunction? | lithium |
| What is adrenal dysfunction: cushing syndrome? | Excessive levels of cortisol in the blood |
| what is adrenal insufficiency: addisons disease? | A disorder in which the adrenal glands don't produce enough hormones (cortisol and aldosterone). |
| What are 3 side effects of steriods? | fluid retention, bruising, high/increased bp |
| What does someone with a complicated UTI require that an uncomplicated one doesnt? | People with complicated UTI require urine testing for culture and susceptibility testing. Uncomplicated requires no follow up |
| Whats the main bacteria involved in a UTI? | • Escherichia coli (E coli)account for 75% to 95% of cases |
| What does eGFR measure and what is a normal one? | eGFR (estimated glomerular filtration rate) is a measure of how well your kidneys are working.
normal is 90% and over |
| What is stress and anxiety? | A stressor can be defined as any internal or external stimulus that promotes a stress response within a person.
Anxiety is an emotion to protect us from a stressor |
| what are common causes and symptoms of stress? | causes = money issues, job issues, life changes, family issues, relationship issues
Symptoms = anger, irritability, depression, anxiety |
| What can anxiety cause? | high levels of fear and thoughts of imminent danger and perception of risk
feeling of a lack of control and helplessness
negative thinking along with the exaggerated thoughts |
| Nursing consideration for panic attacks are... | Provide calm reassurance and a quiet low stimulus environment
Breath in and out of a paper bag
Coach client to use breathing techniques and it may be useful to do these with the client during an acute episode |
| What is OCD? | Obsessions:
Repetitive, intrusive and unwanted thoughts or impulses that cause anxiety
Compulsions:
Repeated actions or behaviours that the person is driven to do |
| Whats the difference between ASD and PTSD? | Only difference is its Diagnosed within a month of exposure to a traumatic event (rather than 3 months to a year) |
| What is adjustment disorder? | Significant and ongoing stress response to a life stressor such as a potential or an actual serious illness or to a significant event |
| whats two interventions as a nurse, you could do for people with anxiety disorders? | Ensure they have social support (Family, friends, wider community i.e social groups). As it can provide companionship, a sense of connection, increased access to resources and opportunities for engaging in activities that provide enjoyment.
Teach them mindfulness (The practice of being aware of each moment of your day as it happens)
It involves becoming aware of your thoughts, feelings and body sensations as you experience them |
| what are the 5 main classes of medications used for the treatment of anxiety disorders? | Antidepressants
Benzodiazepines
Non-benzodiazepine Anxiolytic
Hypnotics
Beta-blockers |
| Peoples experience of truama is based on the 3 E's which are... | Event; can be one off or ongoing, truamatic events can be death, abuse and so much more
Experience; different for everyone, support has a large impact on that
Effects; trauma can effect young kids development, peoples behaviors etc |
| What can Adverse Childhood Experiences (ACE) have impacts on? | Health (obesity, depression/suicide, STD, stroke, diabetes)
Behaviours (smoking, drugs, alcohol, anger, isolation)
Life potential (lost time from work, achievements in school) |
| What is emotional dyregulation? | Refers to the inability of a person to control or regulate their emotional responses to provocative stimuli. |
| What are the areas of the brain that are most affected by trauma exposure? | the structures that make up the stress response system (sympathetic nervous system and HPA axis). |
| What is trauma informed care? | A framework for human service delivery that is based on knowledge and understanding of how service usage |
| What are the 4 R's of trauma informed care? | Realises (impact it has and recovery pathways), recognises (signs and symptoms), responds (full knowledge of policies etc), resists (seeks to resist traumatisation) |
| What does A.L.L.O.W stand for when discussing sexual health with a patient? | Asking – permission to ask but be direct (Language, avoid euphemisms)
Legitimizing – normalizing, generalizing, use statistics, provide information
Limitations – role and what is possible, brief intervention, sexual history and refer on
Open conversations – psychosocial model
Work Together and Follow up; Reflect on own beliefs, values and impact on partnership |
| What are 5 some sources of fluid loss? | Diarrhoea
Haemorrhage
stool
Vomiting
Sweating/fever
Diuretics
Excessive urination |
| When may the body have too much fluid? | Excessive sodium intake
Congestive heart failure
Renal failure
High sodium intake
Cirrhosis of the liver
Over infusion of intravenous fluids |
| what are some signs/symptoms of Pyelonephritis? | chills.
fever.
pain in your back, side, or groin.
nausea.
vomiting.
cloudy, dark, bloody, or foul-smelling urine.
frequent, painful urination. |
| What are the 4 different classifications of fatty liver disease? | Non alcoholic fatty liver diease (NAFLD), Nonalcoholic steatohepitatis (NASH), fibrosis (abnormally large amount of scar tissue in the liver whenit attempts to repair damaged cells) and cirrhosis |
| Whats the difference between haemodialysis and peritoneal dialysis? | H = Strict fluid restriction (2-3 days of fluid is removed in over 4 hours)
P = Surgical insertion in the abdomen where catheter will be inserted |
| Whats the first line treatment of pyelonephritis? | Amoxicillin |
| What is insulin produced by? | Beta cells in the pancreas |
| What are complications of diabetes? | Retinopathy (disease in retina resulting in impaired eye site), Nephropathy (disease of kidneys), neuropathy (nerve damage), Cardiovascular issues such as stroke, Peripheral arterial disease (PAD)/peripheral vascular disease (PVD) |
| What are the main liver enzymes that are tested in blood for liver damage? | alt (when liver is damaged ALT is released into blood and levels increase)
ast (increased levels may indicate liver damage or disease)
alp (increased levels may indicate liver damage or disease) |
| Identify and explain one common complication of CKD: | Anaemia (Kidneys produce epo which stimulates RBC production in bone marrow which so when kidney function is decreased RBC cant carry the oxygen around the body) |
