Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

AGACNP > acute care common problems > Flashcards

acute care common problems Flashcards

(64 cards)

Start Studying
1
Q

What are the 3 steps of pain management: WHO Ladder of Pain Management

A

Step 1: acetaminophen, NSAIDS, adjuvants- non traditional ex. amitriptyline (non-narcotics)
Step 2: add oral narcotics
Step 3: add IV narcotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what kind of dressing should be applied to pressure wound with high amounts of slough or drainage?

A

hydrocolloid dressing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are causes of post-op fever?

A

atelectasis- reduce with incentive spirometer
increased basal metabolic rate
dehydration
drug reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is a tension headache?

A

most common type of headache
s/s: tight, band sensation around head, generalized, no focal neurological symptoms, lasts several hours
Management: OTC pain meds, relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe migraine headaches: w/wo aura

A

class migraine- with aura, common migraine- without aura
lasts 2-72 hours
onset- adolescence, early adulthood, familial relation, females > males
triggers: emotional or physical stress, lack or excess sleep, missed meals, specific foods, alcohol, menstruation, OCP, nitrate containing foods, changes in weather
s/s: unilateral throbbing, building up gradually, possible neurological disturbances, visual disturbances; field defects, luminous visual hallucinations, aphasia, numbness, tingling, clumsiness or weakness, nausea, vomiting, photophobia, phonophobia.
if new migraine- rule out other causes of the symptoms; no new migraines in 50+ people
diagnostic w/u for other causes: CBC, BMP, venereal disease research laboratory test (syphilis), ESR, CT head
Pharm management: amitriptyline, divalproex, propranolol, imipramine, clonidine, verapamil, topiramate, gabapentin, methysergide, magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe cluster headaches

A

very painful, middle aged men common
cause/ incidence: alcohol, not familial. occurs at night, awaken from sleep, last less than 2 hours, severe unilateral periorbital pain daily for several weeks, ipsilateral nasal congestion, rhinorrhea and eye redness.
management: oral drugs don’t help. 100% supplemental oxygen can help, sumatriptan SQ, ergotamine tartrate aerosol inhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what electrolyte abnormalities are associated with refeeding syndrome?

A 
hypophosphatemia
hypokalemia
hypomagnesemia
hypocalcemia
thiamine deficiency

–> all low in these electrolytes: calcium, magnesium, potassium, phosphorus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

should cat bite/dog bite wounds of hands/ lower extremities be open or closed?

A

leave the bite wounds open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what should antibiotic coverage look like for human and animal bites?

A

prophylaxis: staphylococci and anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

on gram stain, what do gram positive and gram negative bacteria look like?

A

gram positive- pink/ purple: retain the stain

gram negative- (do not retain the stain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which antibiotics have MRSA coverage?

A

ceftaroline (5th gen), clindamycin, daptomycin, linezolid, tedizolid, TMP/SMX (bactrim), vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is anti-rejection triple therapy ?`

A
  1. corticosteroid: methylprednisolone, prednisone
  2. antimetabolite: Imuran, cellcept, myfortic, cytoxan- azathioprine, mycophenolate mofetil, mycophenolate sodium, cyclophosphamide
  3. calcineurin inhibitor (Tacrolimus, cyclosporine) or mammalian target of rapamycin inhibitor (mTOR): sirolimus, temsirolimus, everolimus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the treatment for herpes zoster (singles)?

A

acyclovir, famciclovir, valacyclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

if shingles impacts the eye, what should you do?

A

urgent referral to ophthalmologist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

who should get shingrix?

A

all adults > 50 years, regardless of previous shingles vaccine; two dose regimen, 2nd dose given 2-6 months after initial dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

describe squamous cell carcinoma

A

comes from actinic keratoses
firm irregular papule or nodule
develops over a few months- 3-7% metastasis
prolonged sun exposed in fair skin people
tx: biopsy, surgical excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

seborrheic keratoses

A

benign, not painful. beige brown or black plaques
“stuck on”, 3-20mm in diameter
tx. liquid nitrogen, or no tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

basal cell carcinoma

A 
most common skin cancer
slow growing 1-2cm after years
waxy pearly appearance, shiny or red
central depression or rolled edge, 
telangiectatic vessels
tx: shave biopsy, surgical excision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how to detect skin cancer: abcdee

A

asymmetry, border irregularity, color variation, diameter > 6cm, elevation, enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

malignant melanoma

A

highest mortality rate of all skin cancers
median age of diagnosis = 40
may metastasize to any organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when are gastric lavage or activated charcoal indicated?

A

within 1st hour of ingestion

often used with Sorbitol as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

acetaminophen intoxication

A

delayed symptoms- 24-48 hours- hepatotoxicity: jaundice, LFTs elevated, PT prolonged, AMS, RUQ pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Tx of tylenol overdose

A

N-acetylcysteine (mucomyst)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Salicylate Intoxication (ASA)

A

tinnitis, dizziness, n/v, respiratory distress, LFTs

tx activated charcoal, sodium bicarb for severe acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Organophosphate (insecticide) poisoning
blurred vision, bradycardia, AMS wash skin, if ingested- activated charcoal atropine- drug of choice
26
antidepressant toxicity
s/s- AMS, urinary retension, hemodynamic instability, seizures-- need ICU admission activated charcoal sodium bicarb- dysrhythmias and maintain pH
27
serotonin syndrome management
Dantrolene sodium (dantrium), clonazepam - rigor, cooling blankets
28
opioid toxicity
narcan activated charcoal emetics contraindicated
29
pupillary effects: opioids vs cocaine
pinpoint: miosis: opioids dilated: mydriasis: cocaine
30
Benzodiazepine overdose
flumazenil IV activated charcoal respiratory/ BP support
31
beta blocker overdose
hypotension, SB, bronchospasm | tx: charcoal, glucagon***, atropine for SB, airway stabilization
32
Ethylene Glycol (antifreeze) overdose
Fomepizole (antizol) | Ethanol (if fomepizole not available)
33
Stages of ethylene glycol overdose
``` 1st stage (30 min-12 hours): loss of coordination, headache, slurred speech 2nd stage (12-24 hrs): irregular HR, shallow breathing, BP changes 3rd stage 24-72 hrs: kidney failure ```
34
Burns: Rule of 9s- what are the body percentages?
``` each arm- 9% each leg- 18% thorax- 18% front, 18% back head-9% perineum/ genitalia- 1% ```
35
what is Parkland's formula? for burns
4ml/kgx TBSA % burned = fluid resuscitation goal in 1st 24 hours. 1/2 of fluid goal in first 8 hours, 1/2 in the remaining 16 hours crystalloids** no colloids monitor for metabolic acidosis, - presents in early resucitaiton phase hyperkalemia in first 24-48 hours, then hypokalemia after that- - fluid shifts
36
Burn mangement pearls
maintain normal temperature sterile saline for treatment, wrap in sterile towels pain management IV narcotics, conscious sedation
37
definition of AIDs
HIV + and | CD4< 200 cells/uL and/ or presence of opportunistic infection
38
what is ELISA test?
enzyme-linked immunosorbent assay (ELISA) is an immunological assay commonly used to measure antibodies, antigens, proteins and glycoproteins in biological samples.
39
HIV testing
HIV 1/2 antigen/ antibody combination immunoassay; if positive, then do HIV 1/2 antibody differentiation immunoassay PCR: viral load- high numbers correlate to progression of HIV- should be zero or undetectable with AART
40
pneumocystis jirovecii
pneumonia that is an opportunistic infection in HIV | patients need prophylaxis for this with Bactrim
41
AART
active antiretroviral therapy: take as soon as HIV+ diagnosis occurs. danger of drug resistance- adherence is extremely important
42
PrEP
indicated for HIV negative people that are at risk: | have sex with HIV + person, IV drug uses that share needles
43
PEP
post-exposure prophylaxis: Truvada (emtricitabine/tenofovir disoproxil fumarate)- prevent HIV for all people at risk Descovy (emtricitabine/tenofovir alafenamide)- not studied in people with receptive vaginal sex Descovy- improved renal and bone safety- 90% decrease in plasma levels, more intracellular concentrations- smaller doses needed. Truvada- can cause significant renal and bone density effects due to high plasma concentration
44
osteoarthritis vs rheumatoid arthritis
OA: asymmetrical, older, better in morning, worse at the end of the day, Xray- narrowing of joint space, RA: symmetrical, younger onset, worse in morning, better as day progresses, warm joints, ESR elevaed, synovial aspirate- WBCs, joint swelling
45
Heberden's nodes
distal interphalangeal joints | finger tips
46
Bouchard's nodes
proximal interphalangeal joints mid finger knuckles osteoporosis
47
osteoarthritis medication management
ASA, acetaminophen, NSAIDS, celebrex (but likely avoid in cardiac patients)
48
Rheumatoid arthritis pharmacological management
high dose ASA, NSAIDs, disease modifying antirheumatic drugs; corticosteroids, methotrexate, antimalarials (hydro chloroquine), gold salt injections
49
define avulsion
bone fragment pulled off by attached ligaments and tendons
50
define subluxation
incomplete dislocation- often for vertebrae
51
how to objectively assess for compartment syndrome?
Stryker tonometer- intra-compartmental pressure > 30 mm Hg- needs fasciotomy
52
What is delta pressure?
for compartment syndrome delta pressure = diastolic blood pressure- intra-compartmental pressure if < 30 mmHg, fasciotomy needed
53
systemic lupus erythematous s/s
butterfly rash, fever, malaise, weight loss, splinter hemorrhages, alopecia, joint symptoms, vasculitis, nephritis, ocular manifestations, pericardial and pulmonary manifestations, abdominal pain **so many impacted areas; multisystem inflammatory autoimmune disorder
54
SLE diagnostics
ANA + in 95% of patients antiphospholipid antibodies anemia, leukopenia, thrombocytopenia; CBC
55
SLE pharmacological management
NSAIDs, hydroxychloroquine, glucocorticoids
56
Many medications can create lupus-like syndrome
cardiac meds, psych meds, antibiotics, cholesterol meds, seizure meds, OCPs, amiodarone, atenolol, buproprion, diltiazem, gemfibrozil, hydralazine, lithium, macrobid, OCPs, phenytoin, rifampin, tetracycline
57
Giant cell arteritis
temporal arteritis -inflammation of temporal artery, age 50+, can lead to permanent blindness s/s: fever of unknown origin, headache, scalp tender, visual complaints, temporal artery tender
58
giant cell arteritis diagnostics and treatment
ESR very high, normal WBC, temporal artery biopsy- gold standard Prednisone, referral needed
59
diabetic retinopathy eye exam findings
microaneurysms, ruptured is late finding- retinal hemorrhages- cotton-wool spots- deep layers of retina or superficial- flame- shaped hemorrhages
60
AV nicking on eye exam
sign of chronic hypertension
61
arcus senilis
cloudy appearance of cornea with gray/white arc or circle- due to deposition of lipid material - no visual impairment
62
bacterial conjunctivitis antibiotics:
drops: levofloxacin, ciprofloxacin, tobramycin, gentamycin
63
gonococcal conjunctivitis treatment
ophthalmic emergency- copious, purulent discharge ceftriaxone 250 mg IM and azithromycin same treatment for chlamydial conjunctivitis
64
open vs closed angle glaucoma
open: chronic, asymptomatic, elevated IOP, cupping of disc, constriction of visual fields, prostaglandin analogs: latanoprost, travoprost, alpha 2 adrenergic agonists- brimonidine beta-adrenergic blockers- timolol miotic agents- pilocarpine Closed: acute, extreme pain, blurred vision, halos, pupil dilated or fixed; carbonic anhydrase inhibitors- acetazolamide IV (diamox), osmotic diuretics- mannitol, surgery to relive humoral pressure

AGACNP (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions