AGACNP
____ and ____ chart is the most commonly used in tertiary burn centers (among others) b/c
it takes into consideration TBSA according to age w/ specific calculations (%s) for each body
part burned - ANS-Lund & Browder chart
_____ are acute vesicular eruption due to infection with varicella-zoster virus, which may be
life-threatening in immunocompromised adults. - ANS-Herpes zoster (shingles)
_____ is a major cellular ion and important mediator of neuromuscular and cardiac function.
- ANS-Calcium
______ degree burn involves epidermis only and looks dry, red, with no blisters. - ANS-First
degree burn
_____-______ or _____ degree burn extends beyond epidermis and looks moist with blisters
- ANS-partial-thickness or second degree burn
_____-______ or _____ degree burn extends from epidermis to dermis to underlying
tissues, fat, muscle and/or bone. It looks dry, leathery, black, pearly, and waxy -
ANS-full-thickness or third degree burn
A hgb of <12g/dL for women & <13.5g/dL for men can indicate lack of iron or protein
resulting in _____________? - ANS-inadequate oxygen perfusion
A1C Lab Value - ANS-Normal 5.5-7.0
ABCDEs of melanoma - ANS-Asymmetry
Border irregularity
Color variation
Diameter >6mm
Elevation
Enlargement
2 or more "yes" then 97% sensitive for diagnosis
ABX Group A Strep Cellulitis - ANS-Cefazolin, Vacomycin, Clindamycin, Zyvox, Daptomycin
Acetaminophen intoxication signs and symptoms - ANS-EX: Acetaminophen, Anacin-3,
Panadol
Usually asymptomatic in early phase
Around 24-48 hours, nausea and vomiting
RUQ pain
,Signs of hepatotoxicity: Jaundice, elevated LFT's, prolonged PT, altered mental status,
delirium
Acetaminophen Toxicity - ANS-S/S: Hepatotoxicity, jaundice, elevated LFTs, prolonged PT,
altered mental status, delirium, RUQ pain
Tx: Acetylcysteine (Mucomyst)
Acidemia: ______ ionized calcium // Alkalosis: _________ ionized calcium - ANS-Acidemia:
increases ionized calcium // Alkalosis: decreases ionized calcium
ACT Lab Value - ANS-Normal 70-120 seconds
actinic Keratosis - ANS-Occur in sun exposed areas of the body. Premalignant = squamous
cell carcinoma.
Rough, raised, flesh colored or hyper pigmented in appearance
Tx: Liquid nitrogen removal
Actinic Keratosis (AK) - ANS-Small patches occurring on sun-exposed parts of body
Premalignant
Asymptomic, small patches, may be tender
Rough, flesh colored, pink, or hyperpigmented
Acute Coronary Syndrome - ANS-Peaked T Waves, ST elevation, Q Wave Development
Cardiac enzymes are elevated within 4-6 hours and can remain elevated for 3 days- 3 weeks
Troponin I and CKMB are most cardiac sensitive
Acute Coronary Syndrome Management - ANS-ASA 325
Nitro q5 min x 3
O2
12 Lead
Morphine
Lasix for pulmonary edema
ACE inhibitors and beta blockers
Heparin or Lovenox 1 mg/kg q 12h
Acute Heart Failure - ANS-Left= Lung
Abrupt onset, usually following acute MI or valve rupture
S/S: Dyspnea at rest, coarse crackles, S3, pulmonary edema on CXR
Acute Lymphocytic Leukemia (ALL) - ANS-More difficult to cure in adults compared to
children
Hallmark Sign: Pancytopenia with circulating blasts
Acute Myelogenous Leukemia (AML) - ANS-Most ACUTE leukemia in adults
Remission rate 50-85%
Long term survival around 40%
,Acute otitis media, sinusitis most likely pathogen - ANS-H. Influenza, S. pneumoniae,
Moraxella catarrhalis
Acute Pancreatitis - ANS-S/S: Abrupt onset, severe epigastric pain, pain improving when
leaning forward, N/V, anxiety
Physical Exam: Upper abdomen tender to palpation, Grey Turner's Sign, Cullen's Sign
Labs: LDH elevated, AST elevated, serum amylase 50-180, serum lipase 14-280, elevated
blood sugar, elevated C reactive protein= necrosis
Tx: NPO, IVF, NGT, Pain management
Addison's Disease - ANS-Deficient cortisol, androgen, and aldosterone
S/S: Hyperpigmentation, diffuse tanning & freckles, hypotension, scant axillary and pubic
hair
Labs: BG low, Na Low, K High, Plasma cortisol < 5 mcg/dL @0800
*Cosyntropin test used to r/o addisons. If cortisol levels do not rise with administration, the
patient is positive for addisons
Tx: Glucocorticoid and mineralcorticoid
Ex) Hydrocortisone and fludrocortisone (Florinef)
Adult rule of 9's - ANS-Each arm= 9%
Each leg= 18%
Thorax= 18% front & 18% back
Head= 9%
Perineum/genitals= 1%
Approx 1% of total body surface area (TBSA) may be depicted by the size of the patients
palm
Adult Rule of Nines - ANS-Each Arm 9%
Each Leg 18%
Anterior Torso 18%
Posterior Torso 18&
Head 9%
Genitals 1%
AIDS - ANS-immunodeficiency disorders in which HIV uses T4 (CD4) cells as receptor and
reservoir for HIV
AIDS criteria - ANS-CD4<200 and/or presence of an opportunistic infection
Albumin Lab Value - ANS-Normal 3.5-5
Alkaline Phosphatase Lab Value - ANS-Normal 30-120
Allergic conjunctivitis treatment - ANS-Stringy; increased tearing discharge
oral antihistamines
, ALT Lab Value - ANS-Normal <35-40
American Burn Association Referral criteria - ANS--parital or full thickness burn greater than
10% TBSA
-burns that involve the face, hands, feet, genitalia, perineum, and major joints.
-full-thickness burns in any age group
-electrical burns, including lightening injury
-chemical burns
-inhalation burns
-burn injury with a preexisting medical disorder that could complicate management, prolong
recovery, or affect mortality
-burns accompanied by trauma in which the burn injury poses the greatest risk for morbidity
and mortality
-burned children in hospitals without qualified personnels or equipment for the care of
children
-burn injury for those who will require social, emotional, or rehabilitative intervention,
Amylase Lab Value - ANS-Normal 25-125
An antibiotic necessity for human bites remains controversial. Yet, for human and animal
bites, employ a ___ to ___ day course for PO prophylactic antibiotics with coverage for both
staphylococci and anaerobes. Give an example of antibiotic for human bites. - ANS-3-7 days
of Augmentin - amox/clav
Anaphylactic Shock S/S & Management - ANS-CO/CI Low
CVP Low
PCWP Low
SVR Low
SVO2 Low
Tx: Benadryl, supportive therapy
* If shock: IVF, H2 Blockers
* Epi only for respiratory distress or stridor
Anemia of Chronic Disease - ANS-The most common in-hosptial anemia.
- Normocytic
- Normochromic
- H/H Low, MCV Normal, MCHC Normal, TIBC Low, Ferritin High
Angina Characteristics - ANS-Chest discomfort lasting several minutes. Usually precipitated
by physical activity and subsides with rest. Nitro shortens or prevents attacks.
- Levine's Sign- clenched fist
- ECG may be normal or show ST depression
- Stress Test
- Coronary Angiography
- Lipid Panel
Angina Management - ANS-Decrease Risk Factors
____ and ____ chart is the most commonly used in tertiary burn centers (among others) b/c
it takes into consideration TBSA according to age w/ specific calculations (%s) for each body
part burned - ANS-Lund & Browder chart
_____ are acute vesicular eruption due to infection with varicella-zoster virus, which may be
life-threatening in immunocompromised adults. - ANS-Herpes zoster (shingles)
_____ is a major cellular ion and important mediator of neuromuscular and cardiac function.
- ANS-Calcium
______ degree burn involves epidermis only and looks dry, red, with no blisters. - ANS-First
degree burn
_____-______ or _____ degree burn extends beyond epidermis and looks moist with blisters
- ANS-partial-thickness or second degree burn
_____-______ or _____ degree burn extends from epidermis to dermis to underlying
tissues, fat, muscle and/or bone. It looks dry, leathery, black, pearly, and waxy -
ANS-full-thickness or third degree burn
A hgb of <12g/dL for women & <13.5g/dL for men can indicate lack of iron or protein
resulting in _____________? - ANS-inadequate oxygen perfusion
A1C Lab Value - ANS-Normal 5.5-7.0
ABCDEs of melanoma - ANS-Asymmetry
Border irregularity
Color variation
Diameter >6mm
Elevation
Enlargement
2 or more "yes" then 97% sensitive for diagnosis
ABX Group A Strep Cellulitis - ANS-Cefazolin, Vacomycin, Clindamycin, Zyvox, Daptomycin
Acetaminophen intoxication signs and symptoms - ANS-EX: Acetaminophen, Anacin-3,
Panadol
Usually asymptomatic in early phase
Around 24-48 hours, nausea and vomiting
RUQ pain
,Signs of hepatotoxicity: Jaundice, elevated LFT's, prolonged PT, altered mental status,
delirium
Acetaminophen Toxicity - ANS-S/S: Hepatotoxicity, jaundice, elevated LFTs, prolonged PT,
altered mental status, delirium, RUQ pain
Tx: Acetylcysteine (Mucomyst)
Acidemia: ______ ionized calcium // Alkalosis: _________ ionized calcium - ANS-Acidemia:
increases ionized calcium // Alkalosis: decreases ionized calcium
ACT Lab Value - ANS-Normal 70-120 seconds
actinic Keratosis - ANS-Occur in sun exposed areas of the body. Premalignant = squamous
cell carcinoma.
Rough, raised, flesh colored or hyper pigmented in appearance
Tx: Liquid nitrogen removal
Actinic Keratosis (AK) - ANS-Small patches occurring on sun-exposed parts of body
Premalignant
Asymptomic, small patches, may be tender
Rough, flesh colored, pink, or hyperpigmented
Acute Coronary Syndrome - ANS-Peaked T Waves, ST elevation, Q Wave Development
Cardiac enzymes are elevated within 4-6 hours and can remain elevated for 3 days- 3 weeks
Troponin I and CKMB are most cardiac sensitive
Acute Coronary Syndrome Management - ANS-ASA 325
Nitro q5 min x 3
O2
12 Lead
Morphine
Lasix for pulmonary edema
ACE inhibitors and beta blockers
Heparin or Lovenox 1 mg/kg q 12h
Acute Heart Failure - ANS-Left= Lung
Abrupt onset, usually following acute MI or valve rupture
S/S: Dyspnea at rest, coarse crackles, S3, pulmonary edema on CXR
Acute Lymphocytic Leukemia (ALL) - ANS-More difficult to cure in adults compared to
children
Hallmark Sign: Pancytopenia with circulating blasts
Acute Myelogenous Leukemia (AML) - ANS-Most ACUTE leukemia in adults
Remission rate 50-85%
Long term survival around 40%
,Acute otitis media, sinusitis most likely pathogen - ANS-H. Influenza, S. pneumoniae,
Moraxella catarrhalis
Acute Pancreatitis - ANS-S/S: Abrupt onset, severe epigastric pain, pain improving when
leaning forward, N/V, anxiety
Physical Exam: Upper abdomen tender to palpation, Grey Turner's Sign, Cullen's Sign
Labs: LDH elevated, AST elevated, serum amylase 50-180, serum lipase 14-280, elevated
blood sugar, elevated C reactive protein= necrosis
Tx: NPO, IVF, NGT, Pain management
Addison's Disease - ANS-Deficient cortisol, androgen, and aldosterone
S/S: Hyperpigmentation, diffuse tanning & freckles, hypotension, scant axillary and pubic
hair
Labs: BG low, Na Low, K High, Plasma cortisol < 5 mcg/dL @0800
*Cosyntropin test used to r/o addisons. If cortisol levels do not rise with administration, the
patient is positive for addisons
Tx: Glucocorticoid and mineralcorticoid
Ex) Hydrocortisone and fludrocortisone (Florinef)
Adult rule of 9's - ANS-Each arm= 9%
Each leg= 18%
Thorax= 18% front & 18% back
Head= 9%
Perineum/genitals= 1%
Approx 1% of total body surface area (TBSA) may be depicted by the size of the patients
palm
Adult Rule of Nines - ANS-Each Arm 9%
Each Leg 18%
Anterior Torso 18%
Posterior Torso 18&
Head 9%
Genitals 1%
AIDS - ANS-immunodeficiency disorders in which HIV uses T4 (CD4) cells as receptor and
reservoir for HIV
AIDS criteria - ANS-CD4<200 and/or presence of an opportunistic infection
Albumin Lab Value - ANS-Normal 3.5-5
Alkaline Phosphatase Lab Value - ANS-Normal 30-120
Allergic conjunctivitis treatment - ANS-Stringy; increased tearing discharge
oral antihistamines
, ALT Lab Value - ANS-Normal <35-40
American Burn Association Referral criteria - ANS--parital or full thickness burn greater than
10% TBSA
-burns that involve the face, hands, feet, genitalia, perineum, and major joints.
-full-thickness burns in any age group
-electrical burns, including lightening injury
-chemical burns
-inhalation burns
-burn injury with a preexisting medical disorder that could complicate management, prolong
recovery, or affect mortality
-burns accompanied by trauma in which the burn injury poses the greatest risk for morbidity
and mortality
-burned children in hospitals without qualified personnels or equipment for the care of
children
-burn injury for those who will require social, emotional, or rehabilitative intervention,
Amylase Lab Value - ANS-Normal 25-125
An antibiotic necessity for human bites remains controversial. Yet, for human and animal
bites, employ a ___ to ___ day course for PO prophylactic antibiotics with coverage for both
staphylococci and anaerobes. Give an example of antibiotic for human bites. - ANS-3-7 days
of Augmentin - amox/clav
Anaphylactic Shock S/S & Management - ANS-CO/CI Low
CVP Low
PCWP Low
SVR Low
SVO2 Low
Tx: Benadryl, supportive therapy
* If shock: IVF, H2 Blockers
* Epi only for respiratory distress or stridor
Anemia of Chronic Disease - ANS-The most common in-hosptial anemia.
- Normocytic
- Normochromic
- H/H Low, MCV Normal, MCHC Normal, TIBC Low, Ferritin High
Angina Characteristics - ANS-Chest discomfort lasting several minutes. Usually precipitated
by physical activity and subsides with rest. Nitro shortens or prevents attacks.
- Levine's Sign- clenched fist
- ECG may be normal or show ST depression
- Stress Test
- Coronary Angiography
- Lipid Panel
Angina Management - ANS-Decrease Risk Factors
