Leik Review 2 Flashcards
When starting an elderly patient on a new prescription of levothyroxine (Synthroid), the nurse practitioner should keep in mind that the rationale for beginning with a lower dose in such patients relates to the drug’s:
Cardiac effects - palpitations, tachycardia, anxiety, irritability, elevated BP, flushing, and insomnia
What is the total burn surface area percent of the left arm and hand?
9%
What is the total burn surface area percent of the anterior thorax?
18%
What is a partial thickness burn? Superficial? Full-thickness?
partial
superficial
full:
A 13-year-old girl has a throat culture that is positive for strep throat. She reports that her younger brother was recently diagnosed with strep throat and treated. The patient has a severe allergy to penicillin and reports that erythromycin makes her very nauseated. What antibiotic is the best choice?
Macrolide - Azithromycin, patient will have a 10% cross-reactivity to cephalosporins (first generation). Nausea is a common reaction to Erythromycin. Azithromycin has fewer drug interactions
What treatments do NOT require parental consent?
STDs
pregnancy testing
contraception counseling and treatment
An ophthalmoscope assesses for:
cataracts
Damage to the cochlea, vestibule, and/or auditory nerve pathways causes what type of hearing loss?
sensorineural
Condylomata lata is associated with?
spyhillis - painless chancre, maculopapular rash of palms and soles, lymphadenopathy, and condylomata lata
Condylomata acuminata is associated with?
human papillomavirus - genital warts
Causes of pulsus paradoxus is associated with?
status asthmaticus, tamponade, pericarditis, and cardiac effusion
systolic pressure drops with inspiration because of increased pressure/positive pressure
A patient newly diagnosed with diabetes reports severe hives and swollen lips after taking Bactrim for a bladder infection 2 months ago. What is true about taking medications in the sulfonylurea class for this patient?
They can take ANY of the pills in the sulfonylurea class - no cross reactivity between antimicrobials and nonantimicrobials (furosemide, thiazide, sulfonylurea hypoglycemics, protease inhibitors, carbonic anhydrase inhibitors)
lab values of normal ferritin level, high serum iron, elevated TIBC, normal red blood cell color, and abnormal electrophoresis. What should be suspected?
thalassemia
can be normocytic/normochromic or microcytic/hypochromic (minor vs major)
lab values of low ferritin levels, decrease serum iron, elevated TIBC, decreased MCH concentration, and normal hemoglobin electrophroesis. What should be suspected?
IDA
Sickle cell anemia includes what?
abnormal hemoglobin electrophoresis findings
diagnostic testing does not include ferritin, iron, TIBC, or MCH concentration of this anemia.
A 28-year-old male is evaluated by the nurse practitioner for frequent episodes of psychotic delusions and paranoia. He has taken risperidone (Risperdal) in the past but states that the drug was not effective. Which medication will the nurse practitioner prescribe?
Clozapine (Versacloz) - decreases psychotic symptoms and episodes in patients with resistance to first line antipsychotics
Sudden onset of unilateral scrotal pain, nausea, vomiting, and abdominal pain. What do you suspect? What sign should be assessed?
testicular torsion
cremasteric reflex (negative = bad)
A sexually active man with fever, chills, nausea, and unilateral pain. What should be suspected?
acute epididymitis
A recent mumps infection (parotitis) is associated with what?
acute orchitis with testicular edema
The anti-hepatitis C virus (HCV) test of a 60-year-old female patient is positive. What test is appropriate for follow-up?
HCV RNA - anti-HCV detects the presence of antibodies to hepatitis C virus = exposure. RNA is qualitative and can distinguish current and past infection
An infant will regain its weight by ______.
Double weight by ______.
Triple weight by _______.
regain by 2 weeks
double by 6 months
triple by 12 months
A 55-year-old male presents with a swollen, painful right testicle and burning on urination. Examination reveals edematous scrotum with tenderness and a positive Prehn’s sign. The patient states he is heterosexual and has been in a monogamous relationship for the past 5 years. He denies practicing anal intercourse. The nucleic acid amplification test (NAAT) is negative. What medication will the nurse practitioner prescribe?
NAAT negative = no chlamydia or gonorrhea
older male = acute epididymitis (E. Coli) is probable with negative STD test results
Levofloxacin/Levaquin is the best treatment
Signs and symptoms of viral keratoconjunctivitis
redness unilateral spreads bilateral
watery and crusted in the morning
cobblestone appearance of lower eyelid
ipsilateral preauricular adenopathy
What are the treatment options for viral keratoconjunctivitis?
Topical ophthalmic vasoconstrictor for redness
Excuse from school - this is transmitted easily (pools, hands, contagious for 10-12 days after onset)
Cold compresses
Artificial tears for itching
No towel sharing, avoid touching eyes