OSCE PART B Flashcards
(81 cards)
What is the normal SG and pH of urine?
Specific gravity: 1.016 -1.022
pH: 4.5 -8.0
Identify 4 indications for the insertion of a urinary catheter?
Surgery
Long term bladder management
Urinary retention
Measurement of output in the acutely ill
What are 3 complications associated with catheterisation?
UTI’s
Urethral trauma and bleeding
Sphincter erosion
List 6 signs/symptoms of UTI’s
Burning sensation, pain or heaviness during voiding Aching or cramping in lower abdomen Cloudy, dark brown or milky urine Leukocytes present in urinalysis Nausea and vomiting Tiredness Delirium or confusion in certain populations High temperature
List 4 risk factors for urinary incontinence
Pathology (eg. spinal cord injury, disease) Age - over 65 Gender Mobility levels Trauma Pregnancy Co-morbidities
How many bladder measurements should you do for a bladder scan?
3 within 10% of eachother to ensure accuracy
You have a patient who is being discharged with a catheter. What discharge planning would you perform to ensure a safe discharge?
Follow up appointment with the patient
Make sure the patient has the appropriate equipment for maintenance
Manke sure they are educated on cleaning and maintenance
Commmunity service providers
Care plan
What are 5 symptoms of hypoglycaemia?
Tachycardia or increased HR to their normal Sweating and chills Hunger Shakiness/weakness Lightheadedness/diziness Irritability
What are two reasons for wiping the patients’ hand with a warm cloth?
Promotes vasodilation
Cleans away surface bacteria
May help soften skin
Why do you rotate the sites when taking a BGL?
To avoid continued trauma to one area of the hand or finger and give time for it to heal. Also to reduce chance of infection, introducing possible pathogens into an open wound. Portal of entry.
What are two strategies they can use to encourage blood flow to the area prior to taking a BGL?
Resting the hand below the heart so more blood flow enters the limb
Milking the hand
Warm cloth or compress for vasodilation
What part of the finger should they take the blood from? Why?
The side of the finger as it’s in usage less. Pain less likely to interfere with their daily activities. Less nerve ending in the side compared to the top and the pad so will be less painful on the whole.
State 4 indications for intravenous infusion therapy.
Restore/maintain fluid and electrolyte balance
Nutrition
Administration of medications
What are 5 potential sources of infection for someone with an intravenous canula (IVC)?
Contaminate infusate Intraluminal spread Extraluminal spread Skin flora Contaminated entry port Haematogenous spread Catheter tip contaminated on insertion
Identify 3 risk management strategies a nurse implements to reduce the risk of infection for a patient with an IVC?
Change immediately when patient comes into ER, or every 72 hours.
PIVC
5 moments of hand hygiene
Flushing when appropriate
Your buddy nurse asks you to explain how you will’ look, listen and feel’ when caring for a patient with an IVC.
LOOK: Observe the PIVC site for discharge, swelling and redness. Observe the dressing, is it intact, clean and dry?
LISTEN: LIsten to the patient, are they in pain, does it hurt on movement or palpation?
FEEL: Feel for heat, hardening of the vein
What is mechanical phlebitis?
Caused by mechanical (movement) irritation of the vein. Usually by rubbing or insertion on a flex point that causes the inner cannula to scrape the inside of the vessel. Inappropriate cannula size.
What is chemical phlebitis?
Caused by medications, injectable recreational drugs. Often from improper dilution of drugs or overuse of one point. pH
What is infectious phlebitis?
The indroduction of bacteria into the vein, or at the IV site.
Your patient has charted passive range of movements. Explain the difference between active and passive range of movements.
Passive is external force
Active movement: patient does themselves
Explain how the respiratory system is impacted in a patient with reduced mobility.
Reduced o2 due to Collapse of alveoli, increase risk for pneumonia. Due to pooling secretions
Positional
Explain how the musculoskeletal system is impacted in a patient with reduced mobility.
Muscle atrophy
Bone loss
range of movement decreases
Explain the 2 aspects that a nurse is assessing when completing a neurovascular assessment.
Sensory and motor function - Neuro
Peripheral circulation - vascular
List 4 indications for taking a set of neurovascular observations (NVO’s)on a patient.
Spinal injury
Stroke
Surgery on the area to test for nerve function
Burns patients