PCC CT1

Question 1

State the purposes of bandaging.

Answer 1

• To restrict movement
• To reduce pain and swelling
• To provide support or immobilise a joint
• To hold the dressing in place

Question 2

Explain 5 principles of bandaging.

Answer 2

• Hold the roll in the dominant hand while the barrel is facing up, while the loose end is held by non-dominant hand.
• Start from distal to proximal
• The bandage should be applied evenly and firmly, ensuring it is not too tight
• Secure the start and end of bandaging with 2-3 rounds overlapping each other to secure the bandage.
• Roll the bandage in a figure of 8 and ensure that the bandage is at least 2/3 covered.
  -Stand on the patient’s injured arm side

Question 3

Explain the 4 stages of bone healing.

Answer 3

• Haematoma formation: Torn blood vessels present, a mass of clotted blood forms at the fracture site.
• Fibrocartilaginous formation: Granulation tissue forms a few days after fracture.
• Bony callus formation: Soft callus is converted to a bony callus of spongy bone.
• Bone remodelling: Bone continues to form and become compact, returning to its original shape.

Question 4

State 2 purposes of plaster cast.

Answer 4

• To immobilize and support fractures or fracture-dislocations
• To prevent movement in the diseased bones and joints to reduce pain and swelling

Question 5

Identify the 3 types of patients who require neurovascular assessment.

Answer 5

• Limb surgery patient
• Patient on a cast
• Patients who have fractures

Question 6

Explain the 3 components assessed in neurovascular assessment.

Answer 6

• Peripheral pulse
• Temperature of the area near the injured site
• Capillary refill

Question 7

Explain 5 signs and symptoms of compartment syndrome.

Answer 7

• Pulselessness
• Pallor
• Paraesthesia
• Paralysis
• Pain

Question 8

List 2 types of patients that requires the use of doppler.

Answer 8

• Patient’s with suspected peripheral arterial disease
• Obese patients

Question 9

Explain the term ‘Total Knee Replacement’.

Answer 9

A surgical procedure in which a damaged or worn-out knee joint is replaced with an artificial implant to relieve pain, improve joint function, and mobility.

Question 10

State 3 indications of total knee replacement.

Answer 10

-Osteoarthritis
-Rheumatoid Arthritis
-Knee deformities

Question 11

Outline 5 nursing considerations when assisting a patient post-TKR with mobility.

Answer 11

• Assist in administering analgesic before doing exercise
• Assist patient to do active range of movement exercises to unaffected joints
• Assist patient to put on CPM machine
• Teach patient to use monkey pole in bed to assist in mobility
• Provide positive reinforcement to patient for efforts

Question 12

Identify the 3 types of head injury.

Answer 12

• Concussion
• Laceration
• Skull fracture

Question 13

State the 3 causes of head injury.

Answer 13

• Falls
• Motor vehicle accidents/Penetrating trauma
• Assaults or physical violence

Question 14

Identify 3 signs and symptoms of head injury.

Answer 14

• Headache
• Giddiness
• Photophobia

Question 15

State the 3 complications of head injury.

Answer 15

• Dementia
• Respiratory failure
• Meningitis

Question 16

Identify the 3 types of epilepsy.

Answer 16

• Focal or partial seizures
• Generalized seizures
• Status Epilepticus

Question 17

State 3 risk factors of epilepsy.

Answer 17

• Alcohol consumption
• Flashing lights
• Lack of sleep

Question 18

State 3 causes of epilepsy.

Answer 18

• Stroke
• Drugs
• Electrolyte imbalances

Question 19

List 3 signs and symptoms of epilepsy.

Answer 19

• Loss of consciousness
• Changes in pupillary reactions
• Foaming or frothing from mouth

Question 20

State 3 complications of epilepsy.

Answer 20

• Aspiration
• Injuries
• Functional deficits

Question 21

Outline 5 nursing interventions when caring for a patient with epilepsy. Explain with rationales.

Answer 21

• Monitor the respiratory rate, depth, rhythm and effort of ventilation.
• Maintain in lying position, flat surface; turn head to side during seizure activity.
• Loosen clothing from neck or chest and abdominal areas
• Insert an oropharyngeal airway only if jaw is relaxed
• Perform oropharyngeal suctioning as required

Question 22

Outline 5 health teaching for patient with epilepsy. Explain with rationales.

Answer 22

• Educate the compliance with medication
  R: Compliance with medication can prevent the recurrence of seizures
  -Teach the patient signs and symptoms of adverse drug effects.
  R: To reduce anxiety and manage the condition better.
  -Educate the regular follow-up for the doctor’s appointment.
  R: To continue treatment plans and prevent complications.
  -Educate on the safety precautions when doing activities of daily living.
  R: To reduce possible dangers that can cause a seizure to occur.
  -Educate the importance of medical identification.
  R: Carrying of medical alert card can help to let the public be alert of seizure occurrences.

Question 23

State 3 purposes of lumbar puncture.

Answer 23

• To Measure the pressure of the cerebrospinal fluid
• To evaluate for signs of blockage of CSF flow
• To obtain CSF for examination for the presence of blood or microorganisms.

Question 24

Outline 3 nursing interventions for a patient post-lumbar puncture procedure.

Answer 24

• Assist the patient to lie in a supine position for 4 to 6 hours. To minimize post-spinal headache.
• Observe for signs and symptoms of changes in intracranial pressure. (eg. Pain, headache, numbness, and weakness of the lower limb)
• Observe for any leakage of CSF or bleeding from the puncture site.

Question 25

Define ‘meningitis’

Answer 25

Inflammation of the meninges

Question 26

Define ‘encephalitis’

Answer 26

Inflammation of the brain tissue (parenchyma)

Question 27

Explain 3 signs and symptoms of meningitis

Answer 27

Severe headache Vomiting Photophobia

Question 28

Explain 3 signs of symptoms of encephalitis

Answer 28

Confusion Pyrexia Malaise

Question 29

Explain 5 complications for ‘meningitis’

Answer 29

-Speech problems -Problems with memory and concentration -Hearing loss -Vision loss -Cerebral palsy

Question 30

Explain 5 complications for ‘encephalitis’.

Answer 30

-Epilepsy -Hearing impairment -Impaired sensation -Aphasia -Memory problems

Question 31

Outline 5 nursing intervention for patient with meningitis. Explain with rationales.

Answer 31

a. Assess for headache and neck pain R: When the meninges of the brain become infected, it can lead to inflammation that triggers a severe headache. b. Perform pain assessment as prescribed R: To determine the severity, location, duration, and type of pain. Sudden changes or severe pain may indicate a rise in the intracranial pressure and should be reported to the doctor immediately. c. Assist in the administration of analgesia as prescribed R: To reduce the severity of pain and allow the patient to rest. d. Reassure patient and provide a quiet, darkened environment R: To ally anxiety and to reduce the discomfort of photophobia. e. Maintain a quiet environment for the patient and encourage him to rest. R: Environmental changes such as increased noise and glaring light cause sensory overload that promotes cerebral irritation leading to convulsions.

Question 32

Explain 3 signs and symptoms of multiple sclerosis.

Answer 32

-Dizziness and vertigo -Sensitivity to heat and/or cold -Bladder and bowel changes

Question 33

State 3 complications of multiple sclerosis.

Answer 33

-Visual deficits -Contractures -Behavioural changes

Question 34

Explain 3 risk factors of Parkinson’s disease.

Answer 34

-Age -Genetics -Environmental exposure

Question 35

State 5 signs and symptoms of Parkinson’s disease.

Answer 35

-Rigidity -Resting tremor -Akinesia -Postural instability -Bradykinesia