Skill sheets 34-39

Question 2

What are the indications for PO ondansetron?

Answer 2

• Clinically significant nausea
• Clinically significant vomiting

Ondansetron is used to prevent nausea and vomiting in various clinical situations.

Question 3

What are the contraindications for PO ondansetron?

Answer 3

• Known severe allergy to ondansetron
• Age less than one year
• Unable to swallow

These contraindications must be considered before administering ondansetron.

Question 4

What are the cautions for PO ondansetron?

Answer 4

• Known prolonged QT syndrome

Caution is advised in patients with this condition when considering ondansetron.

Question 5

What is the oral rehydration formula?

Answer 5

A balanced electrolyte solution containing sodium, potassium, and glucose

It helps to provide both electrolytes and water to the intravascular space.

Question 6

What is the mechanism by which the oral rehydration formula works?

Answer 6

Transport proteins pump glucose and sodium into capillaries, creating an osmotic gradient that pulls water into the capillaries

This process helps to rehydrate the body effectively.

Question 7

Indications for using oral rehydration.

Answer 7

Mild to moderate Gastroenteritis (predominantly in children)

It is particularly useful for rehydrating children suffering from gastroenteritis.

Question 8

What is a contraindication for administering oral rehydration formula?

Answer 8

Severe dehydration

In cases of severe dehydration, other medical interventions may be necessary.

Question 9

List the cautions to consider before administering oral rehydration formula.

Answer 9

• Suspected abdominal pathology requiring surgery

Caution is advised in cases where there may be underlying surgical issues.

Question 10

What are the steps for administering oral rehydration formula?

Answer 10

• Add one sachet to 200 ml of water
• Stir until combined
• Sip the recommended dose as tolerated

Ensure the patient or caregiver understands the instructions.

Question 11

True or false: Oral rehydration formula is safe to administer during pregnancy and while breastfeeding.

Answer 11

TRUE

It is considered safe for both pregnant and breastfeeding individuals.

Question 12

If a patient is vomiting, what should be done regarding the administration of oral rehydration formula?

Answer 12

Administer small amounts and increase volume once vomiting settles

This approach helps manage hydration without exacerbating vomiting.

Question 13

Can you administer ondansatron to someone with a reduced LOC?

Answer 13

> Ondansetron should not be administered for
vomiting associated with an altered level of
consciousness because it is rarely effective.

Question 14

What is the purpose of ophthalmoscopy?

Answer 14

Examination of the back part of the eye (fundus)

Used predominantly to assess the retina.

Question 15

What is the magnification produced by ophthalmoscopy?

Answer 15

Approximately 15 times

The examination produces an upright image.

Question 16

List the indications for performing ophthalmoscopy.

Answer 16

• Inspection of retina
• Assessing for red light reflex

These are the primary reasons for conducting the examination.

Question 17

Are there any contraindications for ophthalmoscopy?

Answer 17

None

There are no specific contraindications for this procedure.

Question 18

What is a caution to consider during ophthalmoscopy?

Answer 18

Sensitivity to light

Patients may experience discomfort due to light exposure.

Question 19

What equipment is required for ophthalmoscopy? List them.

Answer 19

• Ophthalmoscope
• Chair

These items are necessary to conduct the examination effectively.

Question 20

What should be done to the room before starting the ophthalmoscopy?

Answer 20

Darken the room

This helps to enhance visibility of the retina.

Question 21

How far should the ophthalmoscope be held from the patient’s eye during examination?

Answer 21

20–15 cm

This distance is optimal for viewing the retina clearly.

Question 22

What is the red reflex in ophthalmoscopy?

Answer 22

A reflection of light from the retina

It is an important indicator of eye health.

Question 23

What are the four quadrants of the retina to assess?

Answer 23

• Superior temporal (ST)
• Superior nasal (SN)
• Inferior nasal (IN)
• Inferior temporal (IT)

Dividing the retina into quadrants aids in systematic assessment.

Question 24

What are potential complications of the ophthalmoscopy procedure?

Answer 24

• Photophobia
• Mild headache

These complications may arise from the examination process.

Question 25

Fill in the blank: If you have normal visual acuity, set the diopter dial to _______.

Answer 25

0 ## Footnote This setting allows for clear viewing without corrective lenses.

Question 26

What common retinal pathology is associated with **diabetic retinopathy**?

Answer 26

* Dot and blot haemorrhages * Cotton wool spots * Hard exudates ## Footnote These findings are indicative of retinal damage due to diabetes.

Question 27

What are **flame haemorrhages** associated with?

Answer 27

* Hypertensive retinopathy * Thrombocytopaenia * Retinal vein occlusion * Trauma ## Footnote These larger haemorrhages indicate serious underlying conditions.

Question 28

What is a **branch retinal vein occlusion**?

Answer 28

Blockage of one of the retinal veins. Typical signs include flame haemorrhages, dot and blot haemorrhages, cotton wool spots, hard exudates, retinal oedema, and dilated tortuous veins.

Question 29

What are the **analgesic** and **antipyretic** actions of paracetamol?

Answer 29

Paracetamol has analgesic and antipyretic actions but only weak anti-inflammatory properties ## Footnote Paracetamol inhibits the production of prostaglandins resulting in a reduction in pain and fever.

Question 30

List the **indications** for intravenous paracetamol.

Answer 30

* Breakthrough pain in adults during end of life care * Headache, where the cause is likely to be a primary headache syndrome * Pain associated with gout * Pain associated with renal colic * Step three analgesia in patients aged 13–65 years ## Footnote These indications highlight the specific situations where intravenous paracetamol is recommended.

Question 31

What is a **contraindication** for administering paracetamol?

Answer 31

Known severe allergy ## Footnote This is a critical factor to consider before administration.

Question 32

What are the **cautions** to consider before administering paracetamol?

Answer 32

* Patient has taken paracetamol within the last four hours * Known severe liver disease ## Footnote Paracetamol is contained in many products, and caution is advised if there is any doubt.

Question 33

What is the preparation of Paracetamol IV?

Answer 33

* One bag of paracetamol, containing 1g / 100ml ## Footnote Proper equipment is crucial for safe administration.

Question 34

How do you calculate the **IV flow rate** for paracetamol administration?

Answer 34

Divide the total volume (in ml) by the time (15 min), multiplied by the drop factor (in gtts/ml) ## Footnote This calculation gives the IV flow rate in gtts/min.

Question 35

True or false: Paracetamol is safe to administer during **pregnancy** and while **breastfeeding**.

Answer 35

TRUE ## Footnote This makes paracetamol a preferred choice for pain relief in these populations.