Advanced Nursing 6001
Females are more prone to lower gastrointestinal disorders such as...
... irritable bowel syndrome, constipation and abdominal distention
Metabolic syndrome will cause...
....abdominal obesity, excessive fat around the waist, high blood pressure, high blood glucose, high cholesterol levels and low levels of HDL cholesterol, which is good cholesterol
Metabolic syndrome refers to...
...a cluster of conditions that occur together, which can increase the risk of heart disease, stroke, and type 2 diabetes if not corrected.
Hyperlipidemia can be caused by medications such as...
...beta blockers, prednisone, HIV protease inhibitors, amiodarone and diuretics
GERD is a chronic condition characterized by...
...the backflow of stomach acid into the esophagus. Common symptoms of GERD include heartburn, acid regurgitation, difficulty swallowing and chest pain.
When a person starts Chantix, they need to set a goal such as...
1 week to quit smoking
The CURB 65 test criteria
1. confusion (yes/no) 2. urea BUN >19 mg/dL (>7 mmol/L urea) 3. respiratory rate Respiratory Rate ≥30 4. blood pressure Systolic BP <90 mmHg or Diastolic BP ≤60 mmHg 5. age Age ≥65
TB skin test results in otherwise healthy patients are considered positive at what size induration
10mm of greater is positive in normal population.
Ranson's criteria is one of the first scoring systems used to assess prognosis in acute pancreatitis. It consists of _______ perimeters. ______ assessed on admission and ________ more during the next 48 hours (about 2 days).
11 perimeters, 5 assessed on admission, 6 more during the next 48 hours (about 2 days.
An average cigarette contains
15-20mg nicotine
Total cholesterol to HDL ratio
4.5 - 5.2 - CAD starts at 4.0 so you realy want it below that but the normal values are 4.5 - 5.2
A patient on theophylline needs to have levels checked and they need to remain between
5-15MCG/ml.
The American Cancer Society recommends that men have the discussion with their doctor about the potential risk and benefits of prostate cancer screening, starting at the age of
50 for most men. However, if a man is at higher risk, such as those with a family history of prostate cancer or African American men. The discussion should begin at the age of 40 or 45.
For patients taking oral theophylline treatment, monitor serum concentrations at what intervals (baring any other changes0
6-month intervals for rapidly developing children and at annual intervals for all other patients (if their symptoms are well controlled).
A chronic cough is a cough that lasts longer than
8 weeks
Triglycerides levels
<150 mg/dL
Total cholesterol levels
<200 mg/dL
Merkel's Diverticulum
A congenital intestinal abnormality, usually is self-limited, painless, may include bloody stool, or Melina or black-tarry stool. Rule of 2s: 2 feet from iliocecal valve. 2% of the population. 2 inches in length. 2 years old common age for presentation. 2 to 1 ratio of male to female affected.
How much water should a female drink per day to prevent constipation
A female needs to drink 91 ounces (about 2.58 kg) of water a day to prevent Constipation.
Two medications to take for asthma
A long-acting beta agonist and an inhaled corticosteroid should be taken with asthma.
How much water should a male drink per day to prevent constipation?
A male should drink. 125 ounces (about 3.7 L) of water a day
chronic bronchitis - PFT results
A pulmonary function test shows normal lung capacity, a decreased PaO2, and an increased PaCO2.
Known risk factor for bladder cancer. (A)
Age. The risk of developing bladder cancer increases with age, with the majority of cases occurring in individuals over the age of 55.
When does variant angina occur?
Almost always occurs when a person is at rest. It usually occurs between midnight and early morning.
GOLD stage III: severe COPD
At this stage patients have a FEV1 between 30 and 49% of the predicted value symptoms are more pronounced in daily activities can be significantly empire. (LAMA)
The most common form of a-fib is
CAD with heart failure
Evidence-based practice interventions for common GI disorders:
CT scan, ultrasound, colonoscopy, and endoscopy Blood tests such as, CBC, LFTs, Lipase, Amylase Test for H.pylori infections.
If there is a suspected cecal volvulus bowel obstruction.
Cecal volvulus presents as a large gas bubble within the midabdomen or left upper quadrant on abdominal x-ray film. For both cecal and sigmoidal volvulus, a barium enema is done to reveal the precise location of the obstruction. Colonoscopy and endoscopy are contraindicated in patients suspected of mechanical bowel obstruction because to visualize the intestine, air must be introduced into the colon and can increase the chance of perforation.
Potential alternatives for mild reactions to penicillin
Cephalosporins - Cephalexin* (first generation) Cefadroxil* (first generation)
Known risk factor for bladder cancer. (I)
Chronic bladder inflammation.
Known risk factor for bladder cancer (E)
Exposure to certain chemicals.
The treatment of choice for trichomonas
Flagyl
Combination LABA and Inhaled Corticosteriods
Fluticasone propionate and salmeterol xinafoate (Sold as Advair Diskus)* * Approved for children 4 and over. Advair contains two active components. In addition to the long-acting beta-agonists, salmeterol xinafoate, it also contains an inhaled corticosteroid, fluticasone propionate
Managing chronic pancreatitis involves a combination of medical treatments and lifestyle changes. Here are some recommendations.
Follow the prescribed medications, such as pain relievers, enzyme supplements, or insulin. Low-fat diet of less than grams of fat a day 50.
The system doctors use to describe how severe your COPD is
GOLD staging or grading system.
A condition that results in a colicky abdominal type
Gallstones
Known risk factor for bladder cancer. (G)
Gender. Men are more likely to develop bladder cancer than women.
The most common cause of bacterial pharyngitis
Group A strep and should be treated with PCN.
Known risk factor for bladder cancer. (F)
Having a family history with bladder cancer increases the risk of developing the cancer.
If you have Constipation, there are several strategies that you can try to manage it. These include:
Increase your fiber intake. Stay hydrated. drink plenty of water. Exercise regularly. Even a simple daily walk can make a difference. Establish regular bathroom routines.
TB skin test results may be positive with only a 5mm induration in what populations
Individuals with certain medical conditions such as HIV or other immunosuppressive conditions A person on steroids may have a decreased response to the skin test.
Pletal treats...
Intermittent problems with blood flow to the legs (claudication) by enabling people to walk longer distances with less pain. It causes platelet aggregation
What is the CURB 65 test
It is a scoring system used to assess the severity of pneumonia and determine if there is a need for hospitalization.
Good Cholesterol (HDL) levels
Levels above 40 mg/dL (1 mmol/L) in men and above 50 mg/dL (1.3 mmol/L) in women
Bad Cholestrol (LDL) levels
Levels below 130 mg/dL (3.4 mmol/L)
What is Lipitor (atorvastatin) used for
Lipitor is used for the prevention of heart or blood pressure problems. It is also prescribed for treatment of "bad" cholesterol and triglycerides levels in some people
Benefits of the Hawthorn Berry
Lowering blood pressure, heart problems, reducing cholesterol, digestive issues, anxiety and heart problems. It can help with orthostatic hypotension.
GOLD stage 1
Mild airflow limitation, with FEV1 greater than or equal to 80% 0f the predicted value (SABA or LABA)
chronic bronchitis - other symptoms
Other symptoms may include shortness of breath, wheezing chest tightness and increased production of mucus.
foods with copper
Oysters and other shellfish, whole grains, beans, nuts, potatoes, and organ meats (kidneys, liver) are good sources of copper. Dark leafy greens, dried fruits such as prunes, cocoa, black pepper, and yeast are also sources of copper in the diet.
Prostate cancer screening typically starts with a blood test called
PSA test - prostate specific antigen.
GOLD stage II moderate
Patients in this moderate stage. have a FEV1 between 50 and 79% of the predicted value. They may experience more noticeable symptoms in a higher risk of exacerbations. (LABA or LAMA)
GOLD stage IV: very severe COPD
Patients in this stage have an FEV1 below 30% of the predicted value, or an FEV1 less than 50% with chronic respiratory failure. They experience severe symptoms, reduced exercise capacity, and a high risk of exacerbations. (LAMA or LAMA + LABA or ICS + LABA)
Behavioral steps of smoking cessation:
Precontemplation; Preparation; Action; Maintenance
Examples of LABA for asthma
Salmeterol xinafoate (also sold as Serevent Formoterol fumarate (also sold as Foradil) AlbuterolSulfate
Patients with COPD when they first start coughing the cough is referred to as:
Smoker's cough
Factors the affect gastrointestinal health
Socioeconomic factors, psychological factors, race, gender
What type of medication is Lipitor
Statin - works by reducing the amount of cholesterol produced by the liver
Asthma Classification Mild Intermittent
Symptoms </= 2 days per week, nighttime awakenings </= 2 times per month, an inhaler is required </= 2 days per week, and the FEV1 is >80% of predicted. PEF < 20% - SABA PRN
Asthma Classification: Moderate Persistent
Symptoms are present daily, nighttime awakenings occur >1 time per week but not nightly, and an inhaler is required daily. FEV1 60-80%. PEF >30% - LABA with low dose ICS or medium dose ICS only
Asthma Classification: Mild persistent
Symptoms present >2 days per week but not daily, nighttime awakenings 3-4 times per month, and inhaler use >2 days per week but not daily and not more than once on any day. The FEV1 is >80% of predicted. PEF 20-30%. - Add low dose ICS
Asthma Classification: Severe Persistent
Symptoms present throughout the day, nighttime awakenings up to 7 times per week, inhaler use several times per day, and an FEV1 <60% of predicted. PEF > 30% - LABA with medium-high dose ICS, refer to Respi
Viral causes of CAP
The flu (influenza) virus is the major viral cause of CAP. Having the flu also makes you more likely to get bacterial pneumonia. This type is often worse than viral pneumonia.
Hypertension is commonly known as high blood pressure. It is a medical condition where....
The force of blood against the walls of the arteries is consistently too high.
Because of the narrow therapeutic window of theophylline and its many side effects, physicians should monitor the following in the patient:
The heart rate of the patient CNS effects (headache, insomnia, irritability) The respiratory rate Patient's arterial or capillary blood gases The patient's electrolyte concentrations, fluid balance, and acid-base balance require monitoring during prolonged IV therapy.
The CURB 65 test consist of how many criteria each assigned how many points.
The score consists of five criteria, each assigned one point. The higher the score, the greater the pneumonia severity and the higher the risk of complications or mortality. Chronic conditions also increase the risk of complications from pneumonia
Known risk factor for bladder cancer. (S)
These include Smoking. Cigarette smoking is the most significant risk factor for bladder cancer. Smokers are at least three times more likely to develop bladder cancer compared to non-smokers.
When does typical angina occur?
Typical Angina is often triggered by exertion or emotional stress
Caused by a mutation in the ATP 7B gene.
Wilson's Disease
A rare genetic disorder that leads to the accumulation of copper in various organs in the body, primarily the liver and brain.
Wilson's disease
What bacteria most commonly causes community-acquired pneumonia?
Worldwide, Streptococcus pneumoniae is a bacteria that is most often responsible for CAP in adults. Some other common bacteria that cause CAP are: Haemophilus influenzae Mycoplasma pneumoniae Chlamydia pneumoniae Legionella Gram-negative bacilli Staphylococcus aureus
If patient does not wish to quit smoking should you continue to ask them at every visit about their plan to quit?
Yes
Will the GOLD stage grade effect the treatment you get
Yes
Herbal supplements not be used with HTN
You must be careful using herbal supplements such as licorice with high blood pressure. Studies have also shown that it significantly raises blood pressure, lowers potassium levels, and raises sodium levels in the bloodstream when taken in larger amounts.
hyperlipidemia
Your blood has too many lipids, such as cholesterol and triglycerides.
Ranson's criteria for pancreatitis
[GA LAW + C HOBBS] @ admission: Glucose > 200; Age > 55; LDH > 350; AST > 250; WBC 16k. Then @ 48 hours: Ca < 8; Hct drop > 10%;PO2 < 60; BUN > 8; Base deficit > 4; Fluid sequester > 6L
Asthma - A late response can occur....
a few hours after the early response. This phase is related to airway edema and mucus production.
The primary symptom of chronic bronchitis is
a persistent cough that lasts for at least three months in two consecutive years.
Serum theophylline concentrations should be checked after what type of changes?
after the initiation of therapy, before increasing dose, and if any signs or symptoms of toxicity appear. Worsening of the current illness, an occurrence of a new illness, or any change in the patient's treatment protocol that may alter theophylline clearance should also prompt the physician to check serum concentrations of theophylline.
Potential causes of low testosterone
aging. certain medical conditions such as hypogonadism, obesity, chronic illness and certain medications
In acute cholelithiasis, the patient will have an elevated
alkaline phosphate
Types of PCNto treat bacterial pharyngitis
amoxicillin (brand names Alphamox, Amoxil, Cilamox, Ibiamox, Fisamox) - Preferred
Pepto Bismol's common side effects
blackening of the tongue and stool. Constipation, darkening of the stools. and rarely an allergic reaction
Asthma - The early response is primarily related to
bronchospasm and bronchoconstriction It peaks within 30 minutes and resolves within 3 hours.
Key characteristics of asthma are
chronic airway inflammation and bronchial hyperresponsiveness with intermittent, reversible airway obstruction.
Chronic obstructive pulmonary disease (COPD) may sound like a single condition, but it includes three kinds of lung disease:
chronic bronchitis; emphysema; chronic obstructive asthma.
In individuals with Wilson's disease, the liver is unable to properly release
copper
The major muscle of inspiration is the
diaphragm
The treatment for irritable bowel syndrome includes
diet, alkaloid, antispasmodic, B Lactulose and probiotics
The decision when to start prostate cancer screening is a personal one that should be made
in consultation with your healthcare provider.
Emphysema
is a form of COPD that is an abnormal, permanent enlargement of the acini accompanied by the destruction of the alveolar walls. The barrel-chest characteristic of emphysema is a result of hyperinflation.
If they are using nicotine gum, they need to chew the gum until...
it becomes soft and then place in the buccal mucosa.
chronic bronchitis is typically caused by
long term exposure to irritants such as cigarette smoke, air pollution and occupational hazards.
Cigarette smoking can increase the risk of a...
pneumothorax
Any female that is complaining with abnormal uterine bleeding and pain during intercourse. Should be evaluated for
polyps
Digitalis competes with what electrolyte at binding sites
potasium
Chronic bronchitis is a type of COPD It is typically caused by
smoking or occupational hazards (think coal miner)
Asthma attacks are characterized by two phases-
the early response and the late response.
Even when I patient with testicular cancer is cancer free with no signs of the disease for one year, he still needs to have a CAT scan every
three to four months
Testosterone is a hormone that plays a crucial role in...
various body sleep functions, including muscle growth. Bone density, mood regulations and sexual health.
