case 2 Flashcards
(22 cards)
what are our stages of change
precontemplation
contemplation
plan
action
management
relapse
describe pre-contemplation and some questions that can be asked in this stage
the person isnt even considering change at this stage, in denial that the behaviour is even bad for them in the first place.
we want to raise awareness around the change
whats stopping you from considering change?
under what circumstance do you see yourself changing?
describe the contemplative stage and some questions asked to the patient in this stage
they are aware of what needs to change and why, they are open to change but may not know where to start. its about helping them identify what to do
whats stopping you from changing?
why are you considering change now?
what may be some large barriers that are opposing the change?
describe the preparation stage and what can be said to the patient during this time
this is where we are outlining how the patient can inact the change and the possible timeline and steps toward the change.
who can help you change?
who will you tell about the plan to help you with it?
what is avindicated PI?
it is a sort of anatomical seive which we use when a patient presents with symptoms. we use this as a sieve to determine what sort of system is responsible for the presentation.
its in order of acute severity
letters of AVINDICATED PI please
anoxia, vascular, inflammatory, neoplastic, degenerative, intoxication, congenital, allergic/autoimmune, trauma, endocrine, pyschiatric and iatrogenic
what is an antiemetic drug
a type of medication that allieviates nausea and vomiting
2 examples of anti-emetics and their action please
Ondansetron is a specific 5HT3-receptor antagonist. It reduces the vomiting reflex by blocking serotonin at 5HT3 receptors both peripherally in the gastro-intestinal tract and centrally in the chemoreceptor trigger zone.
Granisteron works the same as above. Its also a serotonin receptor blocker
why does alcohol cause nausea
it causes irritation to the stomach lining, causing increased acid production in the stomach, which can then result in nausea.
what class drug is Diclofenac
NSAID, so it reduces inflammatory pain
what are the four major boundaries to change
no immeadiate consequence of the bad behaviour, the difficulty of the change, the enjoyment of the poor behaviour
the denial that the behaviour is bad for them
what is an internal locus of control
this is the internal belief that ones own actions play a key role in shaping their own life outcomes. having an internal locus of control means we believe we have the power to influence our own health through our actions, thoughts beliefs, choices and efforts
what is an external locus of control
when we believe that the condition or what is happening in our lives is not within our control. rather these events are controlled by external events, genetics, chance or the actions of the health care provider.
what are the 4 anti-emetic drugs from the cases post test
cyclizine, prochlorperazine, ondansetron, metoclopramide
mechanism of action of cyclizine
histamine H1 receptor antagonist. blocks histamine binding
mechanism of action for procholrperazine
This is an anti-psychotic drug also anti-emetic by blocking the dopamine D2 receptor in CTZ which limits activity in the vomiting centre of the brain.
mechanism of action in metoclopramide
Metoclopramide, a dopamine receptor antagonist, is an antiemetic. It stimulates gastrointestinal peristalsis (accelerating gastric emptying and intestinal transit time), lowers oesophageal sphincter pressure, and antagonises dopamine receptors in the chemoreceptor trigger zone.
mechanism of nausea in morphine
morphine binds to mu opiod receptors in the CNS at the CTZ, chemoreceptor trigger zone, this increases vestibular sensitivity and reduces gut motility thereby causing feelings of nausea.
mechanism of nausea in person whos seen something horrific
witnessing a horrific event will trigger the release of adrenaline as the SNS has been activated - they are in fight or flight mode. thus the blood perfusion to the gut is changed and we see alterations in gastric motility
mechanism of nausea in pregant person
Hormonal changes during pregnancy can effect the GI tract by influencing gastric motility, stomach emptying and smooth muscle relaxation.
mechanism of nausea in cardiogenic shock patient
in cardiogenic shock we are seeing decreased cardiac output due to heart muscle defects. The sympathetic nervous system is triggered by this decrease in cardiac output. This results in reduced blood flow to the GI tract, increased aldosterone secretion leading to electrolyte imbalance and increase intracranial pressure which stimulates the patients vomiting centre.
mechanism of nausea in cytotoxic therapy patient
cytotoxic cause direct irriation to the gut lining as they target the dividing cells, these drugs also cause release of serotonin which activates 5HT-3 receptors in the gut which slow gastric emptying
