Communication skills Flashcards
What is INR?
- Derived from prothrombin time
- 1.0 represents global average
- monitors patients on warfarin
What is PT?
- prothrombin time
- measures how long it takes blood to clot via extrinsic pathway ( play tennis outside so PT = extrinsic)
- 10-13 seconds
How do you open an INR consultation?
- establish reason for being on warfarin and target INR range
- Ask ICE, if they know what warfarin is
How do you explain warfarin to a patient?
- warfarin is an anticoagulant
- thins blood to prevent clots
- used to treat prev clots in legs/lungs
- prevent clots for high risk e.g. irregular heartbeat or heart valve
How do you explain INR to a patient?
- measure of how long blood takes to clot
- 1 in healthy people
- target range is 2-3 (2.5)
- monitor INR often and adjust warfarin
How should warfarin be taken?
- same time each day
- no skipped doses
What affects PT?
- liver disease
- vit K deficiency
- warfarin levels
- DIC
What should you ask about the patient’s daily life relating to warfarin?
- impact on work, social
- impact on mood
- impact on sleep
- weight change
What are abnormal INR symptoms?
- clots
- leg swelling
- SOB
What dietary advice can you give regarding INR?
- Lower consumption of foods high in Vit K - broccoli, kale, spinach. cranberry juice (interacts)
What other lifestyle advice should you give regarding INR?
- limit alcohol to 1-2 drinks per day, no bingeing
- take care brushing teeth or shaving
What is FEV1?
- forced expiratory volume in 1s
- vol exhaled in 1st second after deep inspiration and forced expiration
What is FVC?
- total volume of air that pt can forcibly exhale in 1 breath
What are normal FEV1, FVC and FEV1/FVC ranges?
- FEV1: >80% predicted
- FVC: >80% predicted
- FEV1/FVC ratio: >0.7
What are findings in obstructive lung disease?
- reduced FEV1 <80% predicted
- reduced FVC (to a lesser extent
- FEV1/FVC ratio reduced <0.7
What are findings in restrictive lung disease?
- reduced FEV1 <80% predicted
- reduced FVC <80% predicted
- FEV1/FVC ratio normal >0.7
What changes should you ask about at a peak flow station?
- new pets
- moving house
- changes in job
What should you ask about previous resp diagnoses at a peak flow station?
- cough
- SOB
- prev hospital admissions
- inhaler technique
- inhaler frequency
What symptoms should you enquire about at a diabetes station?
- polyuria and polydipsia
- neuropathy
- sleep disturbance
- vision
- weight change
What social factors should you enquire about at a diabetes station?
- alcohol and amount
- mood and stress
- impact on daily activities
What should you ask about the patient’s diabetes diagnosis?
- how long ago they were diagnosed
- how they are managing to control their diabetes
