NR 511 Midterm SANNER Study Guide With Verified Solutions

NR 511 Midterm SANNER Study Guide With Verified Solutions Assesses the clients HPI OLDCARTS TRUE or FALSE... The history of present illness is a breakdown of the clients chief complaint TRUE What is needed to make a sound clinical decision Evidence based research clinical practice guidelines published evidence-based algorithms (few false positives) high percentage of healthy people will show a normal result high specificity high number of false positives low specificity if a diagnostic study has ____________, then a high number of healthy people will show a normal result high specificity proportion of true positives sensitivity ______________ will lead to positive findings for patients with a disease high sensitivity how clients cover out of pocket expenses when on medicare secondary insurance to cover 20% out of pocket expense inpatient hospital, skilled nursing care, hospice, home care Part A medicare outpatient, provider visits, surgery, labs, medical equipment, preventative exams Part B Medicare Wellness services, eye exams, hearing exams, hearing aides, glasses Part C Medicare Prescription drugs Part D Medicare NP's are reimbursed at _______of the physician fee 85% what is the purpose of medicare advantage plans lower co payments , add additional benefits Third party payers fall into 7 categories...( name 7) Medicare, Medicaid, indemnity, managed care, Workers comp, Veterans admin, auto liability Papular rash, satellite lesions = what kind of skin issue fungal those at risk for fungal skin infections immunocompromised young - diaper rash Diabetic antibiotic therapy Aids corticosteroid treatment chemo flat to slightly elevated brown papules and plaques, scale when rubbed, hypopigmentation, puritic, found on trunk and shoulders tinea vesicolor candidiasis in tip of penis balanitis annual lesions with scaly borders, ring shape scaly borders on exposed skin and trunk tinea corporis Athletes foot tinea pedis jock itch tinea cruis white or yellow nail discoloration, thickening of nail, separation from nail bed tinea unguium dry skin teaching use tepid water and mild soaps,older adults at risk spreading skin infection of epidermis and subcutaneous tissue,begins after a break in the skin cellulitis bacterial infection characterized by papules folliculitis' highly contagious bacterial skin infection, most common in young children impetigo Nonpharmacologic Treatment of impetigo use of solutions to debride lesions bacterial skin infections that produce burning and pruritis, regional lymphadenopathy bullous and non-bullous impetigo chronic history of cyst on same site for months to years, cheesy white discharge with strong odor epidermal inclusion cyst acute process , only takes several days to form furuncles if rash is around neck/face and difficulty breathing/hoarsness occurs... give EPI hives or wheals that occur on trunk and arms after exercise, anxiety, elevated body temps, hot baths cholinergic uticaria treatment for cholinergic uticaria antihistamines long term inflammation of the skin, characterized by extremely low threshhold for puritis, referred to as the itch that rashes/itch occurs before the rash. Scratching makes it worse atopic dermatitis What is the cardinal sign of atopic dermatitis severe pruritus what is the primary locations for atopic dermatitis in children antecubital fossa popliteal fossa Common treatment of immunocompromised patients with Herpes simplex Famvir or valtrex/valacyclovir unilateral vesicular rash along a dermatome, begins as erythema, changes to papular lesions then vesicles herpes zoster/shingles First line treatment for acne benzoyl peroxide good candidates for oral antibiotic treatment with acne at risk for pigmentation changes, scarring, nodulocystic acne ance teaching sunscreen needs to be used with all acne medicaiton Skin condition that causes blushing/flushing and visible blood vessles in the face rosacea mainstay treatment for Rosacea metronidazole, takes 6-8 weeks lesions are superficial epithelial growths that originate from the horny layer of epidermis, result of benign proliferation . May reveal dark keritin plugs or horny cysts Seborrhea keratosis at risk population for seborrhea keratosis older white female Considered epidermal tumors, not malignant or premalignant seborrhea keratosis pre cancerous lesions, can progress into squamous cell carcinoma actinic keratosis flesh colored, hard, sandpaper like rash, lesions found on sun-exposed, damaged skin , refer to dermatology acintinic keratosis Most aggressive skin cancer, thickness of lesion impacts prognosis. Risk factors include age, immunosupression, indoor tanning exposure malignant melanoma benign , rubbery , smooth and round mass lipoma intense itchy rash, can last several days or weeks scabies Scabies treatment Ivermectin lice education itching may continue up to a week after treatment painful red bumps under the skin due to infection of the hair follicles or oil glands furuncle if located in axilla, diff diagnosis for furuncle /carbuncle is... hidradenitis suppurativa caused by human papilloma virus, abrading skin can spread virus warts easiest types of warts to treat filiform, digitate causative organism of viral conjunctivits adenovirus hallmark symptoms of red, itchy eyes, clear to no drainage, preauricular lymph node swelling and tenderness indicate viral conjunctivitis red eye, crusted lid, normal visual acuity ,watery, itchy eyes, photophobia indicate bacterial conjunctivitis gradual, painless, progressive loss of vision cataracts tend to be bilateral in nature, may manifest as blurry/distorted vision, c/o glare with driving age related cataracts small lump,or swelling which develops in the eye lid as result of blockage in a gland chalazion/cyst inflammation around eyelid margins,caused by staphylococcal infection at lash base blepharitis treatment for blepharitis bacitracin 0.5 ointment treatment for resistant stapylococcal infections d/c bacitracin, start quinolone ointment/erythromycin when to refer to a chalazion to ophthalmologist persist for more than 4 weeks Tests for dry eye include: slit lamp,shermer test first level education for dry eyes client education overflow of tears onto the face epiphora treatment for epiphora should not include... corticosteroid or anesthetic eye gtts, may block healing and increase infection red,hot, tender swelling at edge of eyelid, most improve on their own hordeolum/stye sinus pain felt behind the eye include what sinuses ethmoid sinuses pressure over the cheek include what sinuses, maxillary sinuses symptoms that confirm diagnosis of sinusitis URI x 7 days plus 2 or more of the following colored nasal drainage poor response to decongestants facial/sinus pain/positional headache tender pinna/tragus erythematous ear canal swimming history otitis externa red bulging tympanic membrane otitis media standard treatment for otitis media amoxicillin 40-45 mg/kg/day divided in two doses x 10 days results in increased intraocular pressure, an emergency if left untreated, can cause blindness, occurs suddenly, dramatic onset of symptoms of blurry vision, red eyes, unilateral pain, pressure, headache, seeing halos, photophobia, loss of peripheral vision then central vision Acute Angle-Closure glaucoma strategy to relieve middle ear pressure due to barotrauma oral decongestants and nasal steroids type of hearing loss that occurs due to loud noises sensorineural bone conduction is greater than air conduction, produces high frequency hearing loss that is bilateral and symmetrical conductive hearing loss/presbycusis is cerumen impaction sensorineural or conductive hearing loss conductive tests used to determine if hearing loss in conductive or sensorineural Weber test & Rinne test if a client has persistent sore throat ,fever, throat pain ,difficulty swallowing, secretions, respiratory difficulty, stridor, but no pharyngeal erythema or cough... Epiglottis posterior cervical lymph node swelling ,persistent sore throat, fever , malaise, not responding to treatment test for mono using monospot test Treatmetn for group A strep pharyngitis penicillin V 500mg BID or 250mg 4 x daily x 10 days or benzathine penicillin 1.2 million units IM once infection is almost always unilateral ,located between the tonsil and superior pharyngeal constrictor muscle peritonsillar abscess Ig3 mediated, type 1 sensitivity. Turbinates pale rhinitis/hay fever watery rhinorrhea nasal congestion nasal speech, mouth breathing viral rhinitis atopic triad consists of: allergic rhinitis, asthma, eczema