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Placement Questions

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Skill: Observations

  1. 1.     List the reasons that physiological observations (pulse, temperature, blood pressure, breathing, oxygen saturation and blood glucose) are measured on patients/clients within a hospital/community setting.
  2. 2.       What should you do if you find that a patient’s observations are different to the ones recorded previously?
    1. 3.        Breathing Observations

3.1.

What is the importance of monitoring a patient’s/client’s breathing?

What is pulse oximetry?

When do you measure peak flow?

3.2

What do the terms BREATHLESS and DYSPNOEA mean?

How can you measure ‘’DIFFICULTY IN BREATHING’’?

  1. 4.        What are the immediate actions for someone who is having difficulty with breathing? 
  2. 5.        Temperature

5.1 How does the environment affect body temperature? Why is this important in a child or an older person?

5.2 Make a list of signs and symptoms that you may observe if a patient/client has i) a high temperature ii) a low temperature?

How might an ‘abnormal’ temperature present itself in a child or an older person?

Patient

Signs & symptoms of high temperature

Signs & symptoms of low temperature

Child

Skin hot to ouch, sweating. Dehydration, restlessness, drowsiness, febrile convulsions, increased thirsty, increased pulse and respiratory rate, loss of appetite

Shivering (initially), drop in body temperature below 360 C. pale, cold and waxy skin, altered consciousness,

tachycardia followed by bradycardia, low urine output, dehydration, ataxia, shallow breathing, coma

Older person

Increased heart and respiration rates, restlessness, drowsiness, loss of appetite, feeling cold, sweating, shivering, increased thirst, increased pulse rate, weakness and malaise.

Shivering initially, hypotension, confusion, cold and pale skin, feeling of cold and chilly, bradycardia, weak pulse, muscle stiffness and incardination, decreased urine output, coma.

5.3 What actions would you take in the above situations? Hint: think about comfort measures and possible medications that might be prescribed.

  1. IN CASE OF FEVER/HYPERTHERMIA

         - Expose the patient or lighten the clothing to facilitate heat loss;

        - Do tepid sponge bathing to promote heat loss from the body;

        - Administer antipyretics e.g. paracetamol  to relief fever  and pain;

        - Give the patient plenty of fluids to counter dehydration and meet the increased metabolic demand;

        - Move one from the hot environment;

        -  Discourage activities that raise the metabolic rate and promote rest.

    INCASE OF HYPOTHERMIA

            - Cover the patient with blankets;

          - Administer warm oral or intravenous fluids;

          - Provide warm environment;

          - Apply warming pads

    6.      PULSE

3 things to monitor for

3 areas where pulse is most easily palpated

1. Heart Rate

2. Rhythm

3. Strength

1. Radial Area

2. Carotid Area

3. Temporal Area

 7. What is anxiety? How would you know if a patient was anxious? What would be your actions if you assessed a person to be anxious?

Anxiety

−        A state of dread or fear of impending, perceived or imagined threat (stressor).

Signs and symptoms

−        Restlessness, palpitations, headache, shortness of breath, GIT disturbances, sweating, fatigue, tachycardia, trembling, papillary dilation.

Management

−        The anxious person should be made to relax/rest by providing a calm environment free of stressors.

−        Make the patient perform deep-breathing exercises to improve gas exchange.

−        Help an individual to participate in the pleasurable activities e.g. listening to music, watching a movie or football to divert his/her attention from the stimulus causing anxiety.

−        Psychotherapy improves tolerance of the patient to stimulus causing anxiety.

−        Eliminate/control any identified underlying cause.

−        Advice the patient to avoid taking substances that might worsen anxiety by stimulating the central nervous system e.g. caffeine.

−        Involve people who are close to him/her to provide psychological support.

−        Anxiolytics e.g. diazepam are administered to calm the patient and allay anxiety.


Ways in which I could develop my knowledge and skills include: (give 3 examples) 8. Student self-assessment (skill: observation)

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