Medical PT assessment Flashcards

(65 cards)

1
Q

What does SCENE stand for?

A

S - Safety
C - Cause
E - Environment
N - Number of patients
E - Extra resources required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 outcomes of medical patient assessment?

A
  • Acute care (ED, PPCI, MTC)
  • Community or primary care (hospital wards, DN, OOGP)
  • Discharge with worsening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is covered in your primary surve?

A

C - Cat haem
A - airway
B - Breathing
C - Circulation
D - Disability
E - Evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What should be completed after an intervention?

A

Full reassessment starting from A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is required for every vulnerable pt (inc children), unless in a life threatening emergency ?

A

An appropriate chaperone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should you be observant of when making a general impression of a PT?

A
  • Colour
  • Position and tone
  • Behaviour
  • Any abnormal noises
  • Any significant blood loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does ACVPU stand for?

A

A - alert
C - Confused
V - Voice
P - pain
U - Unresponsive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you assess if someone is Alert?

A

Orientated and conversing on arrival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How would you assess if someone is Confused

A

New onset confusion, disorientated to time and place.
use family to refer to PT normal.
Pt is otherwise alert.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How would you assess if someone is alert to voice?

A

Verbal command to the PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How would you assess if someone is alert to pain?

A

Alert only to a tactile stimulus, E.g giving them shake or tap.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When assessing airway what are you looking for?

A
  • Obstructions
  • Loose teeth
  • Foreign bodies
  • Vomit
  • Infection
  • Blood
  • Swelling
  • Trauma
  • Dry muccus membranes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When assessing air what are you listening for?

A
  • Noisy airflow (Snoring, gurgling ect)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When assessing airway what are you smelling for?

A
  • Any abnormal smells (Sweet = DKA, Alcohol ect)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are you feeling for in airway assessment?

A

AIrflow through oral cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the first step when managing an airway?

A

Manoeuvres (E.g Head tilt chin lift, postural drainage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Following an airway procedure what needs to be completed to demonstrate skill?

A

Airway log

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When assessing breathing, what are you initially assessing for?

A

Rate, Quality and depth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When assessing breathing in primary survey, what are you looking for?

A
  • Pallor (Cyanosis)
  • Adequacy of chest movement
  • Symmetry
  • Inspect anterior and posterior elements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When assessing breathing in the primary survey, what are you feeling for?

A
  • Stability of the chest wall
  • Depth
  • Equal rise an fall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the normal SPO2 range for a PT with COPD?

A

88% - 92%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the expected SPO2 range for a normal PT without previous respiratory history?

A

94% - 98%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When should assisted ventilation be considered?

A

< 10
>30
If the PT SPO2 is <90% on 15 l/min O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When assessing circulation, what are you main considerations other than external bleeding?

A
  • Epistaxsis
  • Haemostasis
  • Haematemasis
  • Malaena
  • Internal bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
When assessing a pulse, what are you looking for?
- Strength - Regularity - Rate
26
If a radial pulse isn't present, where is the next place to check for a pulse?
Carotid
27
If a pulse is present in the radial what is the PTs estimated systolic blood pressure?
80-90 systolic
28
If a pulse is present in the Carotid what is the PTs estimated systolic blood pressure?
50+ mmHG
29
If a pulse is present in the femeral what is the PTs estimated systolic blood pressure?
70+ mmHG
30
When assessing skin, what are you looking for?
- Rashes - Motteling - Cyanosis - Cold peripheries - Skin turger
31
What are the early signs of Hypovalaemic shock?
- Poor Pallor - Cold peripheries - Abnormal behaviour - Tachypneoia - Tachycardia
32
When are you looking for as part of you disability assessment?
- ACVPU, - PEARL - Purposeful limb movements - Sensory function - Blood glucose (If appropriate) - FAST test (If appropriate)
33
Under what circumstances must a Blood Glucose be taken?
- Diabetic Patients - Impaired LOC - Alcohol consumption - Seizures - Syncope and falls - Paediatrics
34
When should a FAST test be completed?
- Any sensory or motor deficit - Any new onset confusion
35
What is covered under the environment section of the primary survey?
- BP - Temperature
36
What is the NEWS 2 threshold for a pre-alert?
- NEWS2 higher than 5 - NEWS2 score of 3 in any parameter
37
In a diabetic PT, what is the minimum value for a PT to be Hypertensive?
130/80
38
In a Non-Diabetic Pt, what is the threshold value for Hypertension?
140/90
39
In what circumstances must an ECG be conducted?
- Syncope - CP - Post rosc - Abnormal pulse (irregular, Tachy, Brady) - New onset confusion where possible
40
When forming differential diagnosis, what needs to be considered?
- Any clinically concerning findings? - Anything else it could be ? - Diagnosis of exclusion? - Any pertinent negatives? - Any further information required?
41
What needs to be included when taking a patient history?
- Presenting complaint - History of presenting complaint - Past medical history - Prescribed medications - Allergies - Family history - Social history
42
What information are looking for when obtaining a history of presenting complaint?
- Symptom summary - Symptom duration - Event history - Impact on patient - Previous occurrences - Assessment of pain
43
What does SOCRATES stand for?
- Site - Onset - Character - Radiation - Associations - Timing - Exacerbating and relieving factors - Severity
44
When assessing a patients medical history, what needs to be obtained?
- Current illness or disease - Previous illness or disease - Previous trauma -Surgical history - Obstetric/ GYN history
45
When obtaining details about a patients medication, what information do you require?
- Prescribed medications - Over the counter medications - Compliance - Recent medication changes - Recreational andd illegal drug use - herbal remedies
46
What key pieces of information should be obtained for the social history?
- Who they live with - Employment status - Mobility aids - Main carer - Care package/ Provider - Schools (If attending) - Social worker inc details
47
When formulating a working impression, what needs to be considered?
- Differential diagnosis - Current findings - What can be ruled out - What is needed to support or reject the working impression.
48
What needs to be assessed as part of a head assessment?
Inspection of face for: Bruising, wounds, Abnormal swelling and rashes. Check: Pupil size, GCS Inspect oral cavity for: Dehyrdration, Bleeding, deformities, Inspect the nose for: Woulds, Swelling, infection or CSF leak.
49
What needs to be assessed as part of a neck examination?
Inspect for: Surgical scars, accessory muscle uuse, lacerations, bruising and deformity, Tracheal deviation and jugular vein distention.
50
What are the red flags during a neck assessment?
Tracheal deviation - ?Pneumothorax Jugular vein distention - ?HF, Increased WOB.
51
State the difference between Decorticate and Decerabate presentation.
Decorticate - Flexion facing inwards (Duck) Decerabatte - Extension outwards (Penguin)
52
During a chest examination, what needs to be reassessed from the primary survey?
- Rate - Quality - Depth - SPO2 - Skin colour - Temperature
53
What do crackles indicate?
Infection
54
What does a silent chest indicate?
No air entry!
55
What does Strider indicate?
Obstructed airway
56
When palpating the chest what are you looking for?
Deformities, Crepitus, Flail segments, Surgical emphysema
57
How many quadrants are included in an abdo assessment, what are they called?
4 - All together Left upper/lower, Right upper/lower
58
What are the red flags during an abdo assessment?
- Bruising - guarding -Swelling, - Wounds - Pulsating masses - Distention
59
What might a pulsating mass indicate?
AAA
60
When would you stop palpation?
- Pulsating mass - PT isn't able to tolerate due to pain
61
When inspecting the lower limbs what are you looking for?
- Rashes - Localised inflammation - Bruising - Swelling - Odema - Jaundice
62
When assessing a lower limb concern, what observation must be taken?
Distal Pulse
63
What is the MSC entail?
Motor - Test for movement in limbs Sensation - applying light touch to evaluate sensation Circulation - Temp and distal pulses
64
What components should make up your safety netting consideration?
- If diagnosis correct what will happen - if diagnosis incorrect what will hapen - What should the PT do if their condition worsens
65
As part of the worsening advice what should be outlined?
- Recovery timeline - When any safety nets are likely to take effect (GP appt ect) - Expected signs and symptoms - Expected outcome