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NSB236 Week 1 - Recognising the deteriorating patient Questions and Correct Answers the Latest Update $13.49   Add to cart

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NSB236 Week 1 - Recognising the deteriorating patient Questions and Correct Answers the Latest Update

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  • NSB236

Why is recognising the deteriorating patient important? Failure to rescue/recognise clinical deterioration is associated with increased patient mortality - Clinical staff frequently lack the clinical skills to identify and interpret signs and symptoms of clinical deterioration - Poor co...

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  • November 7, 2024
  • 21
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NSB236
  • NSB236
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NSB236 Week 1 - Recognising the
deteriorating patient Questions and
Correct Answers the Latest Update
Why is recognising the deteriorating patient important?


✓ Failure to rescue/recognise clinical deterioration is associated with increased patient
mortality
✓ - Clinical staff frequently lack the clinical skills to identify and interpret signs and
symptoms of clinical deterioration
✓ - Poor communication
✓ - Introduction of modified early warning scores (MEWS) track and trigger - MET and
RRS



What are the most common causes for a MET call?


✓ Hypoxia
✓ Hypotension
✓ ALOC
✓ Tachycardia
✓ Tachypnoea



What are the most Commun underlying causes medical emergency calls are

attributed to?


✓ Sepsis
✓ Cardiogenic shock
✓ Pulmonary shock
✓ Arrrythmia


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What is important for recognising deterioration?


✓ Ability to critically evaluate assessment findings in the context of the patients primary
condition and co-morbid condition

✓ Understanding of vital signs is paramount
✓ - Normal ranges for vital signs have not been validated
✓ - Consider what is normal in context



What are signs suggestive of sepsis?


✓ Temperature >38.3 or <36
✓ Respiratory rate >20
✓ Heart rate >90
✓ ALOC or confusion
✓ Hyperglycaemia >7.7
✓ Oliguria (Less than 0.5ml/kg/hr)



What should be assessed with blood pressure?


✓ - BP or MAP is effected by cardiac output and systemic vascular resistance
✓ - Clinical hypotension considered to be 20% decreased in the patients normal blood
pressure or 30mmHg reduction in systolic blood pressure
✓ - Systolic blood pressure less than 100 are difficult to accurately measure both
manually and via electronic devices
✓ - MAP is the perfusion pressure within the arteries during one cardiac cycle -
provides a better indicator of perfusion to organs
✓ — MAP = SBP + (2xDBP)/3



What are the properties of haemodynamic perfusion?


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✓ Four cardiovascular properties are necessary to maintain adequate tissue perfusion
for cellular metabolism
✓ - Sufficient CO
✓ - Uncompromised vascular tone
✓ - Sufficient blood volume and blood pressure
✓ - Tissues are able to utilise oxygen



What is pulse pressure?


✓ The difference between SBP and DBP
✓ - PP = SBP-DBP.
✓ - Conceptually proportional to SV
✓ - Low pulse pressure - insufficient preload, heart failure, shock
✓ - Wide pulse pressure - atherosclerosis, hyperthyroidism, raised ICP

✓ Positive Portsmouth sign
✓ - Heart rate should not go above systolic BP (shock state)



What are the haemodynamic aspects of heart rate?


✓ Increased great rate - reduction in time to allow for ventricular filling

✓ Increased heart rate increased myocardial oxygen demand

✓ Heart rates that exceed blood pressure

✓ Increased heart rate - compensatory process initiated by the sympathetic nervous
system in order to preserve cardiac output (CO - stroke volume x HR)



What compensation is seen in respiration?


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