NUR5079%20Exam%20Revision%20Notes Flashcards
(161 cards)
1
Q
What is hemopoiesis?
A
The process by which the body produces blood cells.
Also known as hematopoiesis.
2
Q
Where does hemopoiesis primarily occur?
A
In the bone marrow.
3
Q
What are the three main types of blood cells produced in hemopoiesis?
A
- Red blood cells (erythrocytes)
- White blood cells (leukocytes)
- Platelets (thrombocytes)
4
Q
What is the function of red blood cells?
A
Transport oxygen from the lungs to the rest of the body and return carbon dioxide to the lungs for exhalation.
5
Q
What role do white blood cells play?
A
Part of the immune system that helps fight infections.
6
Q
What are the common types of white blood cells?
A
- Neutrophils
- Basophils
- Eosinophils
- Monocytes
- Lymphocytes
7
Q
What is myeloid neoplasia?
A
A group of cancers that originate from myeloid cells in the bone marrow.
8
Q
What is Acute Myeloid Leukemia (AML)?
A
A rapidly progressing cancer that affects myeloid cells, leading to the accumulation of immature white blood cells.
9
Q
What characterizes Chronic Myeloid Leukemia (CML)?
A
A slower-progressing cancer characterized by the presence of the Philadelphia chromosome.
10
Q
What are Myelodysplastic Syndromes (MDS)?
A
Disorders caused by poorly formed or dysfunctional blood cells, often leading to anemia, infections, and bleeding.
11
Q
What are Myeloproliferative Neoplasms (MPN)?
A
Diseases where the bone marrow makes too many red blood cells, white blood cells, or platelets.
12
Q
What are common signs of blood malignancies?
A
- Anemia: Fatigue, weakness, shortness of breath
- Poor clotting: Easy bruising, frequent nosebleeds
- Infections: Frequent infections, fevers
- Swollen lymph nodes
- Bone pain
13
Q
What are the investigations for leukemia?
A
- Blood test
- Bone marrow biopsy
- Lymph node biopsy
- Scans
- Genetic tests
14
Q
What is active monitoring in leukemia treatment?
A
Not having a treatment until it is necessary.
15
Q
What is the purpose of targeted therapies?
A
To target the proteins that control the growth and division of cancer cells.
16
Q
What are the side effects of chemotherapy?
A
- Fatigue
- Anemia
- Infection
- Mucositis
- Hair loss or thinning
- Changes to bowel habits
- Nausea and vomiting
- Tumor lysis syndrome
- Infertility
17
Q
What is the difference between malignant and benign tumors?
A
Malignant tumors spread or invade nearby tissues, while benign tumors do not.
18
Q
What are characteristics of malignant tumors?
A
- Cancerous
- Grow rapidly
- Can invade nearby tissues
- Often have abnormal cells
- Higher chance of recurrence
19
Q
What are characteristics of benign tumors?
A
- Non-cancerous
- Grow slowly
- Do not invade nearby tissues
- Cells resemble normal cells
- Typically can be surgically removed
20
Q
What is neutropenic sepsis?
A
A potentially life-threatening complication of neutropenia, defined by a temperature over 38°C or signs of sepsis in a person with low neutrophil count.
21
Q
What are some causes of neutropenic sepsis?
A
- Cytotoxic chemotherapy
- Immunosuppressive drugs
- Stem cell transplantation
- Infections
- Bone marrow disorders
- Nutritional deficiencies
22
Q
What is the importance of patient education after discharge?
A
Educating on infection prevention, monitoring for symptoms, and adhering to medication plans.
23
Q
What are the four main chambers of the heart?
A
- Left atrium
- Right atrium
- Left ventricle
- Right ventricle
24
Q
What is the function of the atrioventricular (AV) valves?
A
Prevent backflow of blood into the atria.
25
What is the role of arteries in the circulatory system?
Carry oxygen-rich blood away from the heart.
26
What separates the left and right sides of the heart?
The septum.
27
What is pulmonary circulation?
The right side of the heart pumps oxygen-poor blood to the lungs.
28
What separates the left and right sides of the heart?
The septum
## Footnote
A wall of muscle called the septum separates the left and right sides of the heart.
29
What are the two main circuits through which the heart pumps blood?
* Pulmonary Circulation
* Systemic Circulation
## Footnote
The heart pumps blood through two main circuits: Pulmonary circulation pumps oxygen-poor blood to the lungs, while systemic circulation pumps oxygen-rich blood to the rest of the body.
30
What is the function of the pulmonary circulation?
Pumps oxygen-poor blood to the lungs
## Footnote
In the lungs, blood picks up oxygen and releases carbon dioxide.
31
What is the function of the systemic circulation?
Pumps oxygen-rich blood to the rest of the body
## Footnote
This delivers oxygen and nutrients to tissues and organs.
32
How does the heart maintain blood pressure?
Generates force between the right atrium and right ventricle
## Footnote
The heart generates the force needed to maintain blood pressure and ensure continuous blood flow.
33
What role do the heart's valves play?
Ensure blood flows in the correct direction and prevent backflow
## Footnote
The heart's valves are crucial for regulating blood flow.
34
What initiates the heartbeat in the heart's electrical conduction system?
Sinoatrial (SA) node
## Footnote
The SA node is also known as the natural pacemaker of the heart.
35
What condition can maternal health issues during pregnancy increase the risk of?
Congenital heart defects
## Footnote
Conditions like diabetes, phenylketonuria, and viral infections during pregnancy can increase this risk.
36
What are some genetic and inherited conditions that can lead to cardiac abnormalities?
* Family History
* Genetic Mutations
## Footnote
A family history of congenital heart defects or specific genetic mutations can increase the likelihood of these conditions.
37
What is the prevalence of congenital heart defects in infants with Down syndrome?
Approximately 50%
## Footnote
About half of infants with Down syndrome are born with congenital heart defects.
38
What are some common heart defects in children with Down syndrome?
* Atrioventricular septal defect (AVSD)
* Ventricular septal defect (VSD)
* Persistent ductus arteriosus
* Tetralogy of Fallot
## Footnote
These defects are commonly associated with Down syndrome.
39
What is the recommended early screening for infants with Down syndrome?
Echocardiogram and evaluation by a pediatric cardiologist
## Footnote
This should occur within the first few months of life.
40
What procedure can close some ventricular septal defects (VSDs)?
Transcatheter closure
## Footnote
This method involves inserting a thin, flexible sheath via the femoral artery/vein and is less invasive than open heart surgery.
41
What are the baseline observations for a child with VSD?
* Oxygen Saturations
* Temperature
* Blood Pressure
* Heart Rate
## Footnote
These observations help ensure there are no signs of infection or hypertension.
42
What is a ventricular septal defect (VSD)?
A hole in the septum between the ventricles
## Footnote
Blood can flow from the left ventricle to the right ventricle and vice versa.
43
What are the symptoms of larger VSDs?
* Rapid breathing
* Difficulty feeding
* Poor weight gain
* Heart murmur
## Footnote
Symptoms can vary based on the size of the hole.
44
What is an Atrial Septal Defect (ASD)?
A hole in the septum between the upper chambers of the heart
## Footnote
Typically, blood moves from the oxygenated left atrium to the less oxygenated right atrium.
45
What are some symptoms of larger ASDs?
* Fatigue
* Shortness of breath
* Frequent respiratory infections
* Heart murmur
## Footnote
Many children with ASD are asymptomatic in early childhood.
46
What dietary considerations should be made for children with VSD and ASD?
High-calorie diet
## Footnote
Provide nutrient-dense meals to meet their increased energy needs.
47
What is Milrinone used for?
Improves cardiac output and reduces pulmonary vascular resistance
## Footnote
Milrinone is often used after cardiac surgery and in heart failure.
48
What is the mechanism of action for Milrinone?
Inhibits the degradation of cyclic adenosine monophosphate
## Footnote
This action increases heart contractility and decreases pulmonary vascular resistance.
49
What is Milrinone used for?
Medication administered to patients with acute heart failure, pulmonary hypertension, and chronic heart failure.
## Footnote
Indicated for cardiac support.
50
What is the mechanism of action of Milrinone?
Inhibits the degradation of cyclic adenosine monophosphate, increasing heart contractability and decreasing pulmonary vascular resistance.
## Footnote
It improves cardiac contractility (inotropy) and cardiac relaxation (lusitropy) and induces vasodilation.
51
What are the side effects of Milrinone?
* Arrhythmia (increased risk in patients with pre-existing arrhythmias) * Headache * Hypotension * Dizziness * Tremor * Chest pain * Renal failure
## Footnote
Continuous ECG monitoring is necessary due to the risk of arrhythmias.
52
What safety considerations should a nurse take while administering Milrinone?
Continuous ECG monitoring, hourly BP recording, use of an arterial line if in ITU, hourly site checks for extravasation, and regular monitoring of blood results for thrombocytopenia.
## Footnote
Milrinone can cause hypotension and thrombocytopenia.
53
What is sepsis?
A life-threatening condition that arises when the body’s response to an infection injures its own tissues.
## Footnote
It is shaped by pathogen and host factors.
54
What are common causes of sepsis?
* Bacterial infections * Viral infections * Protozoal infections * Fungal infections
## Footnote
Common infection sites include lungs, urinary system, gastrointestinal system, bloodstream, catheter sites, and wounds.
55
What clinical signs and symptoms are associated with sepsis in the cardiovascular system?
* Low blood pressure (hypotension) * Rapid heart rate (tachycardia) * Reduced blood flow to organs
## Footnote
Can lead to septic shock.
56
What impact does sepsis have on the respiratory system?
May progress to acute respiratory distress syndrome (ARDS), requiring mechanical ventilation.
## Footnote
Signs include rapid breathing (tachypnea) and low oxygen levels (hypoxemia).
57
What are the signs and symptoms of renal system involvement in sepsis?
* Decreased urine output (oliguria) * Elevated levels of waste products in the blood (azotaemia)
## Footnote
Can lead to acute kidney injury (AKI).
58
What are the signs of gastrointestinal system involvement in sepsis?
* Nausea * Vomiting * Diarrhoea * Abdominal pain
## Footnote
Reduced blood flow can cause ischemia and gut lining damage.
59
What are the neurological signs associated with sepsis?
* Confusion * Disorientation * Agitation * Decreased level of consciousness
## Footnote
Severe cases can lead to septic encephalopathy.
60
What is neutropenic sepsis?
A whole-body reaction to an infection occurring when there is a low level of neutrophils.
## Footnote
Commonly associated with febrile neutropenia and anti-cancer treatments.
61
How does hypoxia relate to sepsis?
Sepsis can impair oxygen delivery to tissues due to poor blood flow and microvascular dysfunction.
## Footnote
Hypoxia occurs when tissues do not receive enough oxygen.
62
What is lactic acidosis in the context of sepsis?
A condition characterized by low blood pH due to the accumulation of lactic acid, indicating poor tissue perfusion.
## Footnote
High lactate levels are a marker of severe sepsis.
63
What happens during the dysregulated immune response in sepsis?
The immune response becomes excessive and prolonged, leading to inflammation that can damage the body's own tissues and organs.
## Footnote
This includes activation and migration of white blood cells.
64
What are the vascular behaviors in response to sepsis?
* Vasodilation * Increased permeability
## Footnote
These lead to fluid leakage, causing edema and hypotension.
65
What is the impact of coagulation abnormalities in sepsis?
Can cause disseminated intravascular coagulation (DIC), leading to excessive clotting and bleeding, impairing blood flow and contributing to organ damage.
## Footnote
DIC can complicate the clinical picture of sepsis.
66
What is perfusion?
The process of delivering oxygenated blood to tissues.
67
What causes hypotension in the context of systemic vasodilation?
Fluid leakage due to systemic vasodilation.
68
What happens to metabolism during reduced oxygen delivery to tissues?
There is a shift from aerobic to anaerobic metabolism.
69
What is the waste product of anaerobic metabolism?
Lactate.
70
Why does lactate accumulate in the blood during hypoxia?
It cannot be shifted by the liver, which is also impacted by hypoxia.
71
What is the association between high lactate levels and sepsis?
High levels of lactate are associated with higher mortality.
72
What is the Sepsis Six?
A list of six actions to be taken within the first hour of presentation to double the chance of survival.
73
List the actions included in the Sepsis Six for paediatrics.
* High flow oxygen
* Obtain intravenous/intraosseous access and take bloods
* Give intravenous/intraosseous antibiotics
* Consider fluid resuscitation
* Involve senior clinical early
* Consider inotropic support
74
List the actions included in the Sepsis Six for adults.
* Give high-flow oxygen
* Take blood cultures
* Give IV antibiotic
* Measure lactate
* Measure urine output
* Escalate the condition to a senior clinician
75
What are common side effects following sepsis?
* Lethargy
* Poor mobility
* Insomnia
* Hair loss
* Excessive sweating
* Changes in vision
* Poor appetite
* Breathlessness
* Reduced kidney function
* Changes in sensation of limbs
* Anxiety
* Depression
* Flashbacks
* Nightmares
* Post Traumatic Stress Disorder
* Short term memory loss
* Poor concentration
* Mood swings
76
Define Learning Disability.
Difficulty with everyday activities affecting someone for their whole life.
77
What are the causes of learning disabilities?
* Genetic factors
* Pre-natal infections
* Brain injury or damage at birth
* Brain infections or damage after birth
78
What are common co-morbidities of a learning disability?
* Cerebral Palsy
* Autism
* Epilepsy
* Physical disabilities
* Mental Health issues
* Sensory impairments
* Dysphagia
* Cardiovascular problems
* Respiratory issues
79
What is cognitive impairment?
Changes in memory, concentration, and the ability to think clearly.
80
Provide three examples of cognitive impairment in clinical practice.
* Dementia
* UTI or infections
* Trauma to the head
81
Define Diagnostic Overshadowing.
Misattribution of physical health symptoms to a mental health diagnosis.
82
What challenges do patients with learning disabilities face when admitted to hospital with sepsis?
* Difficulty understanding medical information
* Communication barriers
* Concerns about equity in care
* Best interest decisions
* Respect for autonomy
* Resource allocation issues
* Family or carer involvement
* Assumption of capacity
* Quality of life considerations
* Post-hospital care
83
What is STOMP?
Stopping Over-Medication of People with a Learning Disability, Autism or Both.
84
What are the key goals of STOMP?
* Raising awareness
* Reviewing medication
* Promoting alternatives
* Empowering individuals
85
What is STAMP?
Supporting Treatment and Appropriate Medication in Paediatrics.
86
What are the primary objectives of STAMP?
* Ensuring safe prescribing
* Monitoring and review
* Education and training
* Involving families
87
What is the main difference between STOMP and STAMP?
STOMP focuses on individuals with learning disabilities, while STAMP focuses on the paediatric population.
88
What does LeDeR stand for?
Learning from the lives and deaths of people with a learning disability and autism.
89
What does LeDeR do?
Collect data from individuals with learning disabilities and autism.
90
What is the purpose of increasing awareness in paediatrics regarding antipsychotic medications?
To promote the correct use of antipsychotic medications
91
What does LeDeR stand for?
Learning from the lives and deaths of people with a learning disability and autism
92
What data does LeDeR collect?
Data from deaths of people with LD and autism across England that are avoidable
93
What is a key goal of the LeDeR report?
To improve the health and wellbeing of people with a learning disability
94
What is diagnostic overshadowing?
The misattribution of physical health symptoms to an existing mental health or learning disability diagnosis
95
Name three practice tips to avoid diagnostic overshadowing.
* Good communication with all involved
* Think holistically and of the bigger picture
* Make reasonable adjustments, such as longer appointments
96
What is somatisation?
Manifestation of psychological distress through physical symptoms
97
Define psychosis.
A severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality
98
What are common signs and symptoms of psychosis?
* Hallucinations
* Delusions
* Disorganized thinking
99
What might trigger the development of psychosis?
* Psychosocial stressors
* Substance misuse
* Trauma or abuse
100
What are the symptoms of schizophrenia?
* Hallucinations
* Delusions
* Disorganized thinking
101
What are the treatment options for the management of acute psychosis?
* Early intervention
* Acute episode management
* Long-term recovery support
102
How does the NICE guideline recommend managing physical health in individuals with psychosis?
* Regular monitoring of physical health issues
* Annual health checks
* Lifestyle advice on diet and exercise
103
What is the Glasgow Antipsychotic Side Effect Scale (GASS)?
A tool used to monitor and evaluate the side effects of antipsychotic medications
104
List the common types of antipsychotic medications used in treatment.
* Chlorpromazine
* Haloperidol
* Clozapine
* Aripiprazole
* Quetiapine
105
What are non-pharmacological interventions for psychosis?
* Crisis teams
* Home treatment teams
* Psychological interventions
106
What nursing care considerations should be taken for individuals on antipsychotic medication?
* Metabolic health
* Extrapyramidal symptoms
* Cardiovascular health
107
What is the purpose of an electrocardiogram (ECG)?
To record the electrical activity of the heart muscle
108
What can improper ECG lead placement cause?
Misdiagnosis and inappropriate treatment
109
What is a key component of patient preparation for a 12 lead ECG?
* Patient identification
* Communication and informed consent
* Relaxation of the patient
110
What is the importance of patient relaxation in ECG procedures?
Patient needs to be relaxed
111
What must be exposed during an ECG procedure?
Chest
112
What can improper ECG lead placement cause?
Significant issues, including misdiagnosis and inappropriate treatment
113
What can occur due to misdiagnosis of cardiac conditions?
Incorrect placement of leads can mimic or mask conditions like myocardial infarction, arrhythmias, or bundle branch blocks
114
What are potential consequences of false-positive or false-negative results in ECG?
Misplacement of V1 or V2 leads can result in false-positive findings for anterior ST-segment elevation myocardial infarction
115
How can altered ECG waveforms occur?
Lead reversal or misplacement can cause waveforms to appear inverted or abnormal
116
What can misinterpretation due to lead misplacement lead to?
Unnecessary or delayed treatment
117
What symptoms should be considered when interpreting an ECG?
Chest pain, palpitations, upper abdominal pain, breathing problems, history of dizziness, collapse and/or history of falls
118
Why is patient history important when interpreting an ECG?
It provides contextual accuracy and helps avoid misdiagnosis
119
What can guide further investigation in ECG interpretation?
A detailed history and symptom assessment
120
What special considerations are needed for limb electrodes?
Amputations/tremors may require moving electrodes up to the limbs
121
How should precordial electrodes be placed in relation to breast tissue?
V4, V5, and V6 should be placed underneath the breast, while V3 can be positioned over the breast tissue
122
What are the first steps to ensure an accurate ECG recording in infants?
Consider symptom correlation and control environmental factors
123
Where should arm electrodes be placed on an infant?
Upper or lower arms, not on shoulders or clavicles
124
What effect can antipsychotic medications have on ECG findings?
QT interval prolongation, T-wave abnormalities, sinus tachycardia, and other arrhythmias
125
What medications are known to prolong the QT interval?
Haloperidol, Sertindole, Pimozide
126
What can T-wave abnormalities indicate when caused by antipsychotics?
Changes in T-wave morphology that can be mistaken for ischemic changes
127
What are common sources of artefacts on an ECG?
Patient movement, electrode issues, external interference, lead reversal
128
What is atrial fibrillation characterized by?
Rapid and disorganized electrical signals in the atria
129
What is the difference between atrial flutter and atrial fibrillation?
Atrial flutter has more organized electrical activity, resulting in a 'sawtooth' pattern
130
What are the signs of a haemolytic reaction to blood transfusion?
Destruction of red blood cells, leading to pain and dark urine
131
What are the principles of safe blood transfusion?
Patient identification, blood compatibility, monitoring, communication
132
What are common indications for blood transfusion?
* Shortage of red blood cells
* Severe bleeding
* Conditions affecting blood cell function
* Cancer treatments affecting red blood cells
133
What should be documented in a patient's notes regarding blood transfusions?
Discussions about reasons for transfusion, consent, risks, and alternatives
134
What are the steps to ensure a child experiences a safe blood transfusion?
* Patient identification
* Blood compatibility testing
* Blood storage and preparation
135
What should be monitored during a blood transfusion?
Vital signs and signs of transfusion reactions
136
What can cause sinus tachycardia as a side effect of antipsychotics?
Atypical antipsychotics such as Clozapine
137
True or False: Lead reversal can result in abnormal waveforms on an ECG.
True
138
What is the purpose of blood compatibility testing?
To ensure compatibility between the child's blood and a donor's blood.
139
At what temperature should blood units be stored?
1–6 °C.
140
What does the nurse do to confirm the blood bag is stored correctly?
Double-checks the expiration date.
141
What is used to administer blood transfusions to avoid contamination?
A sterile set.
142
How often are the child's vital signs monitored during transfusion?
Every 15 minutes.
143
What is TRALI?
Transfusion-related acute lung injury.
144
What should the nurse document after a blood transfusion?
Transfusion details in her medical record.
145
What information is provided to the child's parents after a transfusion?
Signs of a potential reaction.
146
What is venepuncture?
The act of drawing or removing blood from the circulatory system through a puncture to the vein.
147
Name one reason for venepuncture.
To assess conditions such as infections, anaemia, and metabolic disorders.
148
What is therapeutic phlebotomy used for?
To remove excess iron in conditions like hemochromatosis.
149
What is the purpose of a peripheral cannula?
To provide short-term access for intravenous therapy.
150
Fill in the blank: Blood donations are collected for _______.
[transfusions and medical use]
151
What is one use of urinary catheterisation?
To treat acute or chronic urinary retention.
152
What role does lidocaine play during catheterisation?
Serves as both a local anaesthetic and a lubricant.
153
Name one reason for using lidocaine during catheterisation.
To reduce discomfort during catheter insertion.
154
What is the order of draw for blood collection tubes starting from the first?
Blood Culture Tubes or Vials.
155
True or False: The hospital keeps a record of the entire transfusion process for traceability.
True.
156
What is the purpose of monitoring the child for an additional 30 minutes after a transfusion?
To ensure there are no delayed reactions.
157
What should be done before administering blood transfusions?
Confirm the doctor’s orders.
158
Fill in the blank: A blood type test and crossmatch are conducted by the _______.
[hospital laboratory]
159
What are some signs that parents should watch for after their child’s transfusion?
Swelling, bruising, or a change in energy level.
160
What is one reason for using a peripheral cannula?
To administer medications.
161
