hesi primary 2 Flashcards
Xerosis cutis
Xerosis cutis is the medical term for abnormally dry skin. Dry skin is common, especially in older adults, and it is usually a minor and temporary problem.
anomia
a form of aphasia in which the patient is unable to recall the names of everyday objects.
Pioglitazone (Actos) is contraindicated in patients with ?
Pioglitazone (Actos) is contraindicated in patients with class III or IV heart disease and congestive heart failure because it causes water retention.
sulfa allergies
Patients with sulfa allergies may be sensitive to thiazides, loop diuretics, and some protease inhibitors (e.g., darunavair, fosamprenavir), which are used in the treatment of HIV. Potassium-sparing diuretics are a safe alternative for patients with severe sulfa allergy
Reye’s syndrome,
Reye’s syndrome, which is a rare condition that can develop in children and young adults recuperating from febrile viral infections who ingest aspirin or salicylate medications. The condition can progress very quickly. Stage 1 symptoms are severe vomiting, diarrhea, lethargy, stupor, and elevated ALT and AST. Stage 2 includes personality changes, irritability, aggression, and hyperactive (not hypoactive) reflexes. Stages 3 to 5 present with confusion, delirium, cerebral edema, coma, seizures, and death.
Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid (ASA)
Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid (ASA) inhibit the vasodilatory effects of prostaglandins, which predisposes the kidney to ischemia. NSAIDs can cause acute kidney injury by decreasing renal blood flow. Nonselective NSAIDs can adversely affect the kidneys, gastrointestinal tract, liver, cardiovascular system, and lungs (bronchospasm).
thiazide diuretic side effects
Side effects of thiazide diuretics such as hydrochlorothiazide are hyperglycemia, hyperuricemia, and hypertriglyceridemia and hypercholesteremia. Patients should also be monitored for hypokalemia, hyponatremia (not hypernatremia), and hypomagnesemia.
SSRIs
Fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil CR) are SSRIs.
If a patient has a positive nucleic acid amplification test (NAAT) for Chlamydia trachomatis, both the patient and their sexual partner should be treated with what?
While azithromycin 1 g PO in a single dose or doxycycline 100 mg PO BID × 7 days are recommended regimens, azithromycin is the preferred treatment due to the compliance advantage of a single dose.
dig toxicity
The classic symptoms of digoxin toxicity are nausea, vomiting, confusion, and yellowish-green halos in the patient’s vision. Digoxin toxicity can cause hypokalemia and hypercalcemia.
Lithium toxicity symptoms
are seizures, slurred speech, increased urination, and increased thirst.
Phenytoin (Dilantin) toxicity symptoms
include nystagmus, ataxia, and confusion.
Carbamazepine (Tegretol) toxicity
will present as a skin rash and jaundice.
how do thiazide diuretics decrease calcium excretion?
by the kidneys and stimulate osteoblast production.
This positive side effect of thiazides results in a decrease in calcium bone loss and an increase in BMD.
The therapeutic level of phenytoin (Dilantin) is?
The therapeutic level of phenytoin (Dilantin) is 10 to 20 mcg/mL. Levels greater than this may cause adverse effects: 20 to 30 mcg/mL, nystagmus; 30 to 40 mcg/mL, ataxia; 40 to 50 mcg/mL, mental status changes; >50 mcg/mL, breakthrough seizures; and levels near 100 mcg/ mL may cause death.
Vitamin K in green leafy vegetables and Warfarin?
Green leafy vegetables have high levels of vitamin K, which can bind with the blood-clotting cascade and decrease the bleeding time. Vitamin K and warfarin sodium (Coumadin) have opposing effects. Vitamin K helps to decrease bleeding time; Coumadin helps to increase bleeding time. Leafy green vegetables high in vitamin K would normally decrease the bleeding time. In a patient who is taking Coumadin, the high vitamin K would interfere with the desired effect of the Coumadin (which would be to prolong or increase clotting time) and, in fact, would have the opposite effect, which would be to shorten or decrease the clotting time.
diuretics contraindicated in patients with sulfa allergies
Thiazides (hydrochlorothiazide and indapamide) and loop diuretics (furosemide and bumetanide) are contraindicated in patients with sulfa allergies. Potassium-sparing diuretics are a suitable alternative.
Terazosin (Hytrin)
Terazosin (Hytrin) is a quinazoline used to treat symptoms of BPH and hypertension.
Silodosin (Rapaflo) i
Silodosin (Rapaflo) is used to manage the signs and symptoms of BPH.
Finasteride (Proscar)
Finasteride (Proscar) is used to treat symptomatic BPH.
Phenoxybenzamine (Dibenzyline)
Phenoxybenzamine (Dibenzyline) is a nonselective alpha-adrenergic blocker used to improve urinary flow; however, because of nonselectivity, it has a high incidence of adverse effects.
Chronic use of NSAIDs is associated with increased risk of ? What systems are effected?
Chronic use of NSAIDs is associated with increased risk of ulcers, perforation, bleeding of the gastrointestinal tract, heart attacks, cardiovascular damage, strokes, acute interstitial nephritis and kidney injury, and liver damage. It can also affect the lungs of those with asthma or underlying aspirin sensitivity, causing bronchospasm. Chronic NSAID use does not adversely affect the endocrine system.
positive Finkelstein’s test
Finkelstein’s test is used to diagnose de Quervain’s tenosynovitis. De Quervain’s tenosynovitis occurs from repetitive movement or overuse of the wrist and thumb. The symptoms associated with de Quervain’s tenosynovitis result from inflammation of the tendons and sheaths located on the thumb side of the wrist, causing pain traveling up the arm and swelling over the thumb and wrist. The patient will be instructed to apply ice packs for a prescribed amount of time daily and take a nonsteroidal anti-inflammatory drug such as ibuprofen for discomfort.
Tetracyclines (category D) safe for children?
should not be prescribed for patients younger than 9 years old.
preferred first-line therapy for children with impetigo
Mupirocin is the preferred first-line therapy for children with impetigo.
Levothyroxine (Synthroid) interact with which numerous drugs and food?
anticoagulants, tricyclic antidepressants, antacids and calcium, iron, multivitamins, proton pump inhibitors, estrogens, statins, metformin. Certain foods interfere with absorption (calcium-fortified foods, dietary fiber, walnuts, soy). Patients should avoid taking them together and should space these foods and drugs several hours apart. Levothyroxine is a synthetic form of T4.
The current treatment for hypothyroidism ?
The current treatment for hypothyroidism is levothyroxine T4. Replacement therapy with levothyroxine T3 alone is not recommended. Much of the conversion of T3 comes from T4. T3 has a very short life span in the body, which would require a patient to take the medication several times a day and may result in imbalanced levels resulting in unpleasant symptoms. Too high of a level can result in injury to the heart and bones. Combined levothyroxine T3 and T4 can be prescribed, but this does not offer any advantage over prescribing T4 alone.
Diphenhydramine (Benadryl) side effects?
Diphenhydramine (Benadryl) is an antihistamine that causes sedation and is used as a hypnotic. Older patients have increased sensitivity to the drug’s effects. Diphenhydramine use places the patient at risk for confusion, urinary retention and incontinence, and sedation.
What should be monitored upon initiation of an ACE inhibitor or angiotensin-receptor blocker (ARB) in a patient with kidney disease?
Serum potassium should be monitored upon initiation of an ACE inhibitor or angiotensin-receptor blocker (ARB) in a patient with kidney disease. Potassium may rise initially and begin to taper off 2 to 3 months later, so continued monitoring of serum potassium is recommended.
What would you do for a patient who presents with symptoms associated with Pasteurella multocida , which is an anaerobic gram-negative coccobacillus found in the oropharynx of healthy cats, dogs, and other animals?
The diagnosis of the bacteria can be made with a gram-stain culture; however, a broad-spectrum antibiotic that targets Pasteurella, as well as other gram-positive and gram-negative bacteria, is preferred for prophylaxis. Amoxicillin–clavulanate is a recommended antibiotic for prophylactic treatment.
shingles treatment 3 months after outbreak
The outbreak that occurs with shingles lasts about 3 to 5 weeks. A patient prescribed gabapentin 3 months after an outbreak of shingles is being treated for postherpetic neuralgia. Therefore, the nurse practitioner will inquire about pain, which is generally confined to the area in which dermatomal involvement occurred. Symptoms associated with postherpetic neuralgia include a sensation of burning, throbbing, sharp pain, and aching at the site of the outbreak.
risks with The combination of a statin with niacin
symptoms of liver damage, including fatigue, anorexia, jaundice, and dark-colored urine. The statin should be discontinued, and a liver function profile is indicated. This patient is taking high-dose atorvastatin (60 mg) plus a high-dose B-complex vitamin (which contains niacin or vitamin B3). The combination of a statin with niacin raises the risk of drug-induced hepatitis and rhabdomyolysis.
The first-line antibiotic treatment for an infant with pertussis
The first-line antibiotic treatment for an infant with pertussis are macrolides (azithromycin, erythromycin, or clarithromycin).
Penicillins for children indications
Penicillins are indicated for strep throat and otitis media.
Cephalosporins for children indications
Cephalosporins are appropriate for gram-positive cocci bacteria.
Quinolones for children indications
Quinolones are effective against gram-negative and atypical bacteria.
The chronic effect of using finasteride to treat prostate cancer ?
The chronic effect of using finasteride to treat prostate cancer is the stabilization or gradual decline of the patient’s PSA. An acute effect of the finasteride on PSA is a reduction, rather than an increase, of approximately 50%. Any increase in PSA is a concern, even if the value is within a normal range.