AANP Adult gerontology primary care
nurse practiotioner study guide
Pheochromocytoma - ANS-small vascular tumor of the adrenal medulla, causing irregular
secretion of epinephrine and norepinephrine, main to assaults of raised blood stress,
palpitations, and headache. Tx with Alpha blockers
Rovsing's Sign - ANS-Palpation in LLQ ilicits ache in RLQ shows appendicitis
NYHA classes of Heart Failure - ANS-I No drawback of physical pastime. Ordinary physical
activity does no longer reason undue fatigue, palpitation, dyspnea (shortness of breath).
II Slight hassle of physical interest. Comfortable at rest. Ordinary physical interest results in
fatigue, palpitation, dyspnea (shortness of breath).
III Marked quandary of physical hobby. Comfortable at relaxation. Less than everyday interest
reasons fatigue, palpitation, or dyspnea.
IV Unable to hold on any physical pastime with out pain. Symptoms of coronary heart failure at
rest. If any physical interest is undertaken, pain increases.
Step-sensible Approach to Asthma Diagnosis & Treatment - ANS-Step 1- Mild Intermitten
FEV1/PEF > 80% expected. Symptoms <2 days/week. Albuterol as needed.
Step 2- Mild presistent Asthma (FEV1/PEF > eighty% predicted. Symptoms > 2 days/week.
Albuterol as needed. Low dose ICS ex Flovent. Alt cromolyn, montelukast, nedocromil,
theophylline.
Step three- Mod presistent (FEV1 or PEF 60-eighty% anticipated. Daily Symptoms. SABA plus
low dose ICS or med dose ICS or low dose with leukotriene inhibitor (singulair, theophylline,
zileuton).
Step four- Severe presistent allergies (FEV1/PEF <60% anticipated. Symptoms most of day.
High dose ICS plus long performing B2 agonist plus oral steroid every day (prednisone).
Peak Expiratory Flow Rate (HAG):
Green Yellow Red Zone: - ANS-PEF based on Height Age Gender. Blow hard using spirometer
maximum fee recorded.
80-one hundred% expected volume Green Zone hold or lessen meds
50-80% predicted quantity Yellow Zone growth upkeep remedy. Or Having exacerbation.
Below 50% expected quantity Red Zone call 911 supply epinephrine inj.
, PPD - ANS-Neg- No corporation bump forms on the take a look at web page, or a bump
paperwork that is smaller than 5 mm (zero.2 in.).
A organization bump this is five mm (zero.2 in.) in length suggests a TB infection in folks that
are in a excessive-hazard institution. HIV, immunocompromise, exposed.
A company bump that is 10 mm (0.Four in.) in length suggests a TB infection in folks that are in
a mild-threat organization. Healthcare workers, immigrants, homeless.
A firm bump that is 15 mm (0.6 in.) in length shows a TB infection in folks who are in a
low-hazard organization no threat for tb.
Digoxin (Cardiac Glycosides) - ANS-Therapuetic zero.5-2.0
Overdose toxcitity GI disillusioned, arrhythmias, confusion visible changes (yellow/green tinge
vision- scotomas). Tx with digibind. Order dig degree, electrolytes, creatinine ekg.
Thiazide Diuretics - ANS-Pt with both htn and osteoporosis have an additional gain from
thiazides. Thiazide diuretics lower calcium excretion via the kidneys and stimulate osteoclasts
formation. Patients with critical sulfa allergic reactions have to keep away from thiazide diuretics.
Potassium sparing diuretics can be used as alternative.
Chlorthalidone (hygroton), hydrochlororthiazide (esidrix, microzide), indapamide (lozol),
metolazone (zaroxolyn); indicated for reduced fluid volume, inexpensive, powerful, useful in
intense high blood pressure, powerful orally, complements other antihypertensives; detrimental
reactions: hypokalemia symptoms, hyperuricemia, glucose tolerance, hypercholesterolemia,
sexual dysfunction; take a look at for postural hypotension, warning with renal failure gout and
purchaser taking lithium; hypokalemia will increase risk for digitalis toxicity, administer
postassium dietary supplements.
Avoid with Gout, Best fist line for aged w/ systolic htn.
Coumadin (Warfarin) - ANS-an anticoagulant administered to save you blood clots from forming
or developing large
Prophylaxis and/or treatment of venous thrombosis, pulmonary embolus, a fib, valve alternative,
recurrent MI, stroke; also motionless pt
Afiib goal INR 2-3
If INR 5-nine w/o bleeding keep 2-three days low dose vit k
avoid leafy veg, broccoli, brussels, canola oil, mayo.
nurse practiotioner study guide
Pheochromocytoma - ANS-small vascular tumor of the adrenal medulla, causing irregular
secretion of epinephrine and norepinephrine, main to assaults of raised blood stress,
palpitations, and headache. Tx with Alpha blockers
Rovsing's Sign - ANS-Palpation in LLQ ilicits ache in RLQ shows appendicitis
NYHA classes of Heart Failure - ANS-I No drawback of physical pastime. Ordinary physical
activity does no longer reason undue fatigue, palpitation, dyspnea (shortness of breath).
II Slight hassle of physical interest. Comfortable at rest. Ordinary physical interest results in
fatigue, palpitation, dyspnea (shortness of breath).
III Marked quandary of physical hobby. Comfortable at relaxation. Less than everyday interest
reasons fatigue, palpitation, or dyspnea.
IV Unable to hold on any physical pastime with out pain. Symptoms of coronary heart failure at
rest. If any physical interest is undertaken, pain increases.
Step-sensible Approach to Asthma Diagnosis & Treatment - ANS-Step 1- Mild Intermitten
FEV1/PEF > 80% expected. Symptoms <2 days/week. Albuterol as needed.
Step 2- Mild presistent Asthma (FEV1/PEF > eighty% predicted. Symptoms > 2 days/week.
Albuterol as needed. Low dose ICS ex Flovent. Alt cromolyn, montelukast, nedocromil,
theophylline.
Step three- Mod presistent (FEV1 or PEF 60-eighty% anticipated. Daily Symptoms. SABA plus
low dose ICS or med dose ICS or low dose with leukotriene inhibitor (singulair, theophylline,
zileuton).
Step four- Severe presistent allergies (FEV1/PEF <60% anticipated. Symptoms most of day.
High dose ICS plus long performing B2 agonist plus oral steroid every day (prednisone).
Peak Expiratory Flow Rate (HAG):
Green Yellow Red Zone: - ANS-PEF based on Height Age Gender. Blow hard using spirometer
maximum fee recorded.
80-one hundred% expected volume Green Zone hold or lessen meds
50-80% predicted quantity Yellow Zone growth upkeep remedy. Or Having exacerbation.
Below 50% expected quantity Red Zone call 911 supply epinephrine inj.
, PPD - ANS-Neg- No corporation bump forms on the take a look at web page, or a bump
paperwork that is smaller than 5 mm (zero.2 in.).
A organization bump this is five mm (zero.2 in.) in length suggests a TB infection in folks that
are in a excessive-hazard institution. HIV, immunocompromise, exposed.
A company bump that is 10 mm (0.Four in.) in length suggests a TB infection in folks that are in
a mild-threat organization. Healthcare workers, immigrants, homeless.
A firm bump that is 15 mm (0.6 in.) in length shows a TB infection in folks who are in a
low-hazard organization no threat for tb.
Digoxin (Cardiac Glycosides) - ANS-Therapuetic zero.5-2.0
Overdose toxcitity GI disillusioned, arrhythmias, confusion visible changes (yellow/green tinge
vision- scotomas). Tx with digibind. Order dig degree, electrolytes, creatinine ekg.
Thiazide Diuretics - ANS-Pt with both htn and osteoporosis have an additional gain from
thiazides. Thiazide diuretics lower calcium excretion via the kidneys and stimulate osteoclasts
formation. Patients with critical sulfa allergic reactions have to keep away from thiazide diuretics.
Potassium sparing diuretics can be used as alternative.
Chlorthalidone (hygroton), hydrochlororthiazide (esidrix, microzide), indapamide (lozol),
metolazone (zaroxolyn); indicated for reduced fluid volume, inexpensive, powerful, useful in
intense high blood pressure, powerful orally, complements other antihypertensives; detrimental
reactions: hypokalemia symptoms, hyperuricemia, glucose tolerance, hypercholesterolemia,
sexual dysfunction; take a look at for postural hypotension, warning with renal failure gout and
purchaser taking lithium; hypokalemia will increase risk for digitalis toxicity, administer
postassium dietary supplements.
Avoid with Gout, Best fist line for aged w/ systolic htn.
Coumadin (Warfarin) - ANS-an anticoagulant administered to save you blood clots from forming
or developing large
Prophylaxis and/or treatment of venous thrombosis, pulmonary embolus, a fib, valve alternative,
recurrent MI, stroke; also motionless pt
Afiib goal INR 2-3
If INR 5-nine w/o bleeding keep 2-three days low dose vit k
avoid leafy veg, broccoli, brussels, canola oil, mayo.
