Physical Assessments, Red Flag Risks, Holistic Considerations Flashcards
What are some of the physical assessment that should be carried out for a patient with GORD?
Onset/Duration
Pain on swallowing - due to ulcer or stricture
Assess BMI - due to increased internal pressure that obesity creates.
Dental erosion - coming up far enough to damage the back teeth.
Cough or wheeze - aspiration
Medication review.
What are some of the risks (red flag) associated with GORD?
Coughing up blood might indicate a rupture of an ulcer.
Infection might lead to sepsis.
Reduced swalled could lead to choking, aspiration or malnutrition.
Anaemia could indicate internal bleeding.
What are some of the holistic factors that should be considered with GORD?
Diet and fluid intake - potential triggers
Smoking - irritation/damage of mucosa
Hiatus hernia - increased internal pressure.
History of GORD
Anxiety - commonly associated condition.
Alcohol intake
What are some of the physical assessments that should be carried out with ACS?
Baseline observations (NEWS2)
12-Lead ECG
Pain assessment (SOCRATES)
Bloods - Troponin
What are some holistic factors to be considered with ACS?
Diet
Smoking status
Past Medical History (PMH)
Patient Risk Factors
Family history
What are some of the red flag risks associated with ACS?
Elevated Troponin - Cardiac ischaemia, Myocardial Infarction
ST Elevation - Cardiac muscle has died enough to disrupt conduction.
Low BP/High HR/Low Urine output/altered mental state - Cardiogenic Shock can lead to cardiac arrest.
What are some of the physical assessments that should be carried out with PONV?
Onset, duration, frequency, quantity, other symptoms
Medication review
Abdominal examination
What are some risk factors to be considered with PONV?
Absence of bowel sounds/ flatus - could indicate an Ileus
Signs of blood in vomit - could indicate perforation
Confusion - Dehydration and electrolyte imbalance.
Anaemia - blood less from internal bleeding.
What are some of the red flag risks associated with PONV?
Absence of bowel sounds/ flatus - could indicate an Ileus
Signs of blood in vomit - could indicate perforation
Confusion - Dehydration and electrolyte imbalance.
Anaemia - blood less from internal bleeding.
What are some of the red flag risks associated with Diarrhoea?
Blood, Masses, Weight loss, Dehydration - Cancer.
Antibiotics / Allergies.
Cancer treatments, recent surgery.
Fever, vomiting, exposure to infection. Stool Sample, blood tests for inflmmatory markers.
Loss of control of bowel movements.
What are some holistic factors to be considered with Diarrhoea?
New medications/vitamins/supplements.
Laxative use.
Alcohol or substance abuse.
Exposure to food items.
Travel abroad.
Anxiety
Fad diets
Diet and fluid intake
Family History.
What are some of the physical assessments that should be carried out with Diarrhoea?
Physical exam of abdomen and PR exam.
Onset, duration, frequency, severity, colour, smell, urgency.
Bristol Stool chart.
