Nursing the person with deteriorating health (Past Papers)

The NEWS assessment categorises clinical observations onto a scale of 0-4. True or False?
False, they are scaled on a scale of 0-3
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What are the 3 P's of Prehospital care?
Preserve life, Prevent deterioration, Promote recovery
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What are the 5 R’s of fluid therapy?
Resuscitation, Routine maintenance, Replacement, Redistribution and Reassessment
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What are the 4 stages of shock?
Initial, compensatory, progressive and refractory
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Give three causes of hyponatraemia
*think 4 d's* Dehydration and overhydration, Diarrhoea, Diuretics, Drugs
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Define preload
Preload is the initial stretching of the cardiac muscle prior to contraction
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Define Afterload
Afterload is the force exerted by the arteries which the heart has to work against to contract and eject the blood.
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What are the normal breathing sounds?
Tracheal, bronchial, bronchovesicular, vesicular
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What are the abnormal breathing sounds?
Crackles, wheezes, stridor, rhonchi, plural rub,
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What are the abnormal breathing patterns?
Kussmaul, agonal, tachyapnea, bradyapnea, chennye-stokes
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What is non invasive ventilation?
Noninvasive ventilation (NIV) refers to the administration of ventilatory support without using an invasive artificial airway (endotracheal tube or tracheostomy tube)
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What is hypoxic respiratory drive?
When an idvidual is stimulated to breathe by low levels of oxygen rather than high levels of c02, occurs in a small number of COPD patients
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What actions would be required if someone you thought was choking?
Ask them to cough, 5 back blows, 5 abdominal thrusts, call for help continue 5/5 until help arrives or CRP is needed
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What does Pa02 mean? and whats normal ?
Partial pressure (level) of oxygen in the arterial blood - 11-13 kPa is normal (Resus council, 2016)
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What does PaC02 mean? and what is normal?
Partial pressure (level) of carbon dioxide in the arterial blood - 4.7-6 kPa is normal (Resus council, 2016)
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What are the three accessory muscles used for respiration?
Trapezius, scalenus, sternomastoid.
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List three signs and symptoms of someone with life threatening asthma?
*33 92 CHEST* PEF <33 (predicted or at best) <92% sats, Cyanosis, Hypotension, Exhaustion, Silent chest, Tachycardia
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List three signs and symptoms of someone with Acute severe asthma?
PEF 33-50% (predicted or at best) HR>110, Resps >25, unable to speak in full sentences
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List three signs and symptoms of someone with near fatal asthma?
Raised PaCo2
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What factors can increase the chance of near fatal asthma?
Previous near fatal asthma, previous admissions or repeat A+E attendances for asthma related episodes, >3 or more asthma medications, brittle asthma.
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What is vasodilation?
RELAXATION of the smooth muscle in the vessel walls causing them to DIALATE, lowering blood pressure
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What is vasoconstriction?
CONSTRICTION of the smooth muscle in the vessel walls causing them to CONSTRICT, reduced blood flow and increases vascular resistance
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what are the reversible causes of cardiac arrest? (4h's and 4t's)
Hypothermia, Hypoxia, Hyper/hypoKalemia, Hypovolemia - Tension pneumothorax, Cardiac tamponade, thrombosis, toxins
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What are the five rights of fluid management?
Replacement, Redistribution, Routine maintenance, Resuscitation, Reassessment
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What does SIRS mean?
Systematic inflammatory response syndrome
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List the signs and symptoms of sepsis?
S – Shivering, fever or feeling very cold E – Extreme pain or discomfort P – Pale or discoloured skin S – Sleepy, difficult to wake up or confused I – “I feel like I might die” S – Shortness of breath
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What is the sespsis six?
*BUFALO* or TAKE 3 and GIVE 3* - Blood cultures, urine output, fluids, antibiotics, lactate, oxygen
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What is hypovolemia?
Abnormal low fluid volume in the body
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What are symtoms of hypovolemia?
Low blood pressure, fast heat rate, low urine output, cyanosis, shallow breathing.
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What is heat?
History, examination, assessment, treatment- used to identify neurogenic sepsis
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List 4 signs and symptoms of dehydration?
increased thirst, dark urine, smelly urine, fatigue, headaches, dizziness
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What is fluid overload?
Fluid overload or volume overload (hypervolemia), is a medical condition where there is too much fluid in the body
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List three type of patients that neurological injury occur?
Stroke, trauma, spine head and neck injuries
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List signs and symptoms of raised inter cranial pressure? (ICP)
altered levels of consciousness, crushing triad, headache, nausea and vomiting.
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What can cushing triad be defined as?
hypertension, Bradycardia and Bradyapnea
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What are 4 common causes of decrease in consciousness?
Drugs, alcohol, hypoxia, stroke, epilepsy, Hypoglycaemia
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What is compartment syndrome?
Compression on the nerves, blood vessels and muscles that leads to tissue necrosis
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What is meant by the term hypercapnia?
An elevated PaCO2
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List three things that can trigger anaphylaxis?
Food, medications, Bee stings
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Tool used to indicate sepsis, >22 resps, <90 systolic, altered level of conscious (GCS <15)
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What routes can be used to administer drugs to a casualty during cardiac arrest?
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Factors that can precipitate delirium?
*PINCH ME* Pain, Infection, Nutrition, Constipation, Hydration, Medication, Environment.
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What is the squid test?
Single Question In Delirium (SQID): ask some one who knows the patient if they think the patient has been more confused in the past three days?
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What are the three types of delirium?
Hyperactive, hypoactive, mixed
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What breathing pattern is seen in diabetic ketoacidosis?
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See-Saw respirations are seen in what type of patients?
complete obstruction of the airway (choking)
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Define delirium?
Delirium is the temporary onset of an acute state of confusion
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What is the formulae for working out cardiac output?
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List readings that can be taken from an ABG
PaCO2, PaO2, lactate, blood ph, electrolyte levels
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Which drug given in cardia arrest is given in both shockable and non-shockable rhythms?
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What causes Renin-Angiotensin System activation?
Hypotension, drop in blood pressure
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Name the three components for adequate perfusion
blood vessels, blood volume, heart
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How do you correctly size an OPA?
Corner of mouth (incisor) to ear lobe
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How do you correctly size an NPA?
tip of nose to ear lobe, check diameter also.
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What is the range of blood PH?
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What is the term for blood in the plural space causing increasing pressure on the lung?
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What are the 6 ’P’s of compartment syndrome?
Pressure, Pain, Pallor, Paralysis, Paresthesia, Pulselessness
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What is the definitive treatment for compartment syndrome?
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Give three ways to control catastrophic haemorrhage
Direct Pressure if possible, tourniquet, haemostatic agents and dressings
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Give 5 causes of unconsciousness
Alcohol/drugs, hypoxia, hypoglycaemia, Infection, Stroke, cardiac arrest, epilepsy
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List 5 things to look for on exposure
Rashes, Bruises, Swelling, Temperature, signs of trauma
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Who should be consulted before a ‘Do not attempt resuscitation’ (DNAR) order is put in place on a competent individual?
The individual and the medical team
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Why would you use a nasopharyngeal airway rather than an oropharyngeal airway?
Vomiting, if the patient was conscious
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Why would you use a oropharyngeal airway rather than an nasopharyngeal airway?
Active nose bleed
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What is meant by the term “the golden hour'?
The first hour after a deterioration, confirmed infection (sepsis) or traumatic injury, when emergency treatment is most likely to be successful
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When would supplementary oxygen be required for a patient?
Patient with T1 respiratory failure, oxygen saturation's consistently or pronged below 94%
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What does the Glasgow coma scale measure?
Level of consciousness, broken down in to 3 sections, motor response, eyes, verbal response, <15 abnormal
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Which structure provides the only direct link for the electrical impulse to travel from the atria to the ventricles?
AV node
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Which oxygen device would you select if an inspired oxygen percentage above 60% is required?
Non-rebreathe mask
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Why might a jaw thrust rather than a chin lift be used to manage a patients airway
Suspected C spine injury
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What are the symptoms of fluid overload?
Oedema, ascities, hypertension, tachicardia, tiredness and fatigue
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List two ways you can recognise a cardiac arrest?
unconscious and not breathing
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List four symptoms that would indicate a pneumothorax?
SOB, Chest pain, tachycardia, shallow and rapid breathing, deviated trachea in tension pneumothorax
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• What three specific signs and symptoms would you see in a patient who is having a severe anaphylactic reaction?
Sudden onset of illness, skin and/or mucosal changes, life threatening airway, breathing or circulation problems.
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• What does the acronym reSPECT stand for and what is the purpose of this plan?
Recommended Summary Plan for emergency care and treatment. - creates personalised recommendations for a person’s clinical care in a future emergency in which they are unable to make or express choices.
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• Which Resuscitation Council Algorithm contains the drug Chlorphenamine?
Anaphylaxis- anti-histamine
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Other cards in this set

Card 2


What are the 3 P's of Prehospital care?


Preserve life, Prevent deterioration, Promote recovery

Card 3


What are the 5 R’s of fluid therapy?


Preview of the front of card 3

Card 4


What are the 4 stages of shock?


Preview of the front of card 4

Card 5


Give three causes of hyponatraemia


Preview of the front of card 5
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