Skills: Indications, Contraindications, Precautions & Complications Flashcards
Romberg Test: Indications
Screening measurement for body’s sense of positioning or balance
- part of thorough neurological exam
Romberg Test: contraind* & precautions x 3
Contraindications: NIL
Precautions:
- risk of falling if test deemed Positive
- make sure Ex stands close to Pt to assist w stability
- employ assistant if Pt is large (height/weight)
Dix-Hallpike Manoeuvre: Ind* x 5
For Pt’s w;
- vertigo
- unsteadiness
- light headedness
- disequilibrium
- imbalance
Dix-Hallpike Manoeuvre: contraind* x 3 (+ many) & precautions x 3
Contraindications:
- ANY neck pathology; cervical instability, # odontoid peg, recent cervical spine #, Atlantic-axial subluxation, cervical disc prolapse, vertebra-basilar insufficiency, recent neck trauma that restricts torsional movement, cervical myelopathy, recent neck surg*, rheumatoid arthritis affecting the neck
- Carotid bruits
- Prior cerebrovascular Dx; carotid sinus syncope, cardiac bypass
Precautions:
- severe neck pain
- severe back pain
- severe orthopnoea may restrict duration of the test!
Flourescein Stain:Indications x 5
Indications:
- eval* suspected eye abrasions
- eval* suspected Non-Penetrating foreign bodies of the eye
- infections of the eye
- pepper spray exposure
- welding arc flame exposure
Flourescein stain: contraind* x 2 & precautions x 2
Contraindications:
- always check for prev reactions
- Penetrating foreign body to the eye - Do NOT - also avoid anaesthetics
Precautions:
- Flourescein stain permanently stains soft contact lenses; removal is mandatory & instruct no to replace for several hours
- Beware of using topical anaesthetics before staining; can result in superficial punctuate keratitis (potentially confusing Dx)
Otoscope: indications x 4, & precautions x 1
Indications:
- earache
- ear infection
- hearing loss
- ringing in the ears
Precautions:
- children need to be supported to avoid causing trauma during exam
Retrieval of FB: indications x 1 & contraind* x 4
Indications:
- prompt removal of FB when; well visualised, in the external auditory canal, & an uncomplicated first attempt is indicated
Contraindications:
- presence of tympanic membrane perforation
- FB in contact w tympanic membrane
- incomplete visualisation of the auditory canal
- if Button batteries or hearing aid batteries involved!
UA: indications x 8 & precautions x 2
Indications: to evaluate;
- renal failure
- UTIs
- renal or urethral calculi
- genitourinary malignancy
- acid base disorders
- volume status
- rhabdomyolysis
- response to alkalinisation Thx
Precautions:
- ensure a clear instruction is given in order to prevent contamination
- best to gain sample from first voiding of the day
Catheter replacement: indications x 2
Indications:
- dislodged catheter
- blocked catheter
Catheter replacement: contraind* x 4, precautions x 3, & comp* x 10
Contraindications:
- 1* catheterisation/first presentation of acute urinary retention in Males
- traumatic removal w evidence of bleeding (males)
- unexpected haematuria
- time lapse since SPC displacement >20-30mins
Precautions:
- benign prostatic hypertrophy
- urethral strictures
- medications affecting clotting
Complications:
- urethral trauma
- haematuria
- stricture formation
- bladder spasm
- urethral perforation- false passage
- catheter encrustation
- infection
- Males; meatal erosion
- SPC - small bowel obstruction
- SPC - bowel perforation
Stool specimen: ind* x 2 & precaution
Indications:
- very basic test to assess GIT issues
- identify bacteria, parasite, blood
Precaution:
- maintain hand hygiene; risk of contamination!
Guaiac Faecal Occult Blood test: Ind* x 2 & precautions x 2
Indications:
- very basic test to assess GIT issues
- identify blood in stools
Precautions:
- diet containing red meat, any blood containing foods, cantaloupe, uncooked broccoli, radish or horseradish within 3 days of sampling may affect result
- medications; vitamin C or NSAIDs may also affect result
OG/NG Tube Placement: indications x 5
Indications:
- decompress the stomach & upper bowel
- empty the stomach of accumulated gas & fluid; lavage of toxic fluid
- gain access to stomach contents for analysis
- gain access to upper GIT for meds admin
- provide enteral feeding
OG/NG Tube Replacement: contraind* x 1 & comp* x 3(+6)
Contraindication:
- NG route - nasal #s; suspected base of skull #
Complications:
- potential for aspiration
- NG - nasopharyngeal trauma & ulceration
- Long term feeding GIT comps; nausea, vomiting, diarrhoea, constipation, dehydration & electrolyte imbalances
