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a middle-age female patient presents to the clinic with a recurrence of
mild hidradenitis suppurativa after topical therapies failed. which first-
line treatment is recommended? - correct -100%correct verifaid answer--tetracycline
twelve weeks of oral tetracycline (sumycin) is the recommended first-
line treatment for hidradenitis suppurativa.
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hidradenitis suppurativa is a disorder of the terminal follicular
epithelium in apocrine gland-bearing skin. it is a chronic, disabling
disorder that progresses, often causing keloids, contractures, and
immobility. it is characterized by comedone-like follicular occlusion,
chronic and relapsing inflammation, mucopurulent discharge, and
progressive scarring.
arthropathy associated with hidradenitis may be present. typical
presentation includes nodules and sinus tracts (inflamed or
,noninflamed), abscesses, and scarring found in the axilla, genitofemoral
area, perineum, gluteal area, and inframammary area in women.
recommended treatments include antibiotics, steroids, retinoids,
dapsone, and anti-tumor necrosis factor agents. a dermatology
consultation should also be considered.
first-line treatment is a 12-week course of an oral tetracycline (sumycin)
such as doxycycline. for patients who do not respond to doxycycline, the
next recommended step is a combination of twice-daily clindamycin
(cleocin) and rifampicin (rifadin) for 10-12 weeks. if treatment fails,
acitretin (soriatane, for males and nonfertile females) or dapsone
(aczone) may be considered by a dermatologist. in patients with
moderate to severe hidradenitis suppurativa,
adalimumab (humira) may possibly be considered.
when providing culturally competent health care services to an american
indian elder, the nurse practitioner understands which is traditionally
true?
- correct -100%correct verifaid answer--the "medicine wheel" is used by many for the
purpose of health and healing
the "medicine wheel" is traditionally used and contains four directions;
north, south, east, and west.
traditionally each tribe has different meanings for each direction and
they may represent the season of the year or stage of life. it is aimed at
providing a holistic view of life.
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an understanding of different cultural preferences leads to cultural
competence in healthcare. some patients may value traditional culture
and preferences as it relates to healthcare. these individual preferences
should be included in the interview and treatment plan for patients.
traditionally, the american indian culture values a holistic approach to
health care integrating the person, lifestyle, environment, family, and
religion. patients adhering to these traditional cultural practices often
feel that illness is due to a lack of harmony with the physical body, mind,
spirit, and emotions. patients may seek care from western medicine for
specific ailments while also consulting with traditional healers for
spiritual guidance.
healthcare providers should seek to understand relevant cultural factors
and assess each individual's healthcare literacy in order to provide
culturally competent care.
the nurse practitioner sees an older adult patient in the clinic with the
primary report of hearing loss and a sensation of fullness in the right ear.
the nurse practitioner suspects conductive hearing loss. which could
contribute to this? - correct -100%correct verifaid answer--cerumen, commonly called
earwax, is a combination of secretions and sloughed epithelial cells that
protects the ears from infection, water, and insects. it is normally
expelled from the ear canal through natural jaw movement. when this
self-cleaning process fails, cerumen can become impacted. cerumen
, impaction occludes the ear canal and can press against the tympanic
membrane, resulting in conductive hearing loss.
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conductive hearing is the transition of sound from the external and
middle ear to the inner ear. conductive hearing loss is caused by
problems in the external and middle ear that interfere with the
transmission of sound and its conversion to mechanical vibration. causes
of conductive hearing loss include obstruction of the external auditory
canal by cerumen, foreign bodies, debris from otitis externa, and large
exocytosis and osteomas.
sensorineural hearing loss involves difficulty converting mechanical
vibrations to electrical potential in the cochlea or in auditory nerve
transmission to the brain. it is mostly caused by permanent damage in
the organ of corti. it can be caused by age-related hearing loss, noise
trauma, medications, autoimmune diseases, mechanical trauma,
meniere disease, infection, and neoplasm (acoustic neuroma).
approximately one-third of older adults between the
ages of 61 and 70 years have hearing loss. more than
90% of adults older than 85 years of age have hearing loss. the most
common type of hearing loss is agerelated and sensorineural. all adults
older than 60 years of age should be screened for hearing loss at periodic
health examinations.