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NSG6002 REVIEW FOR FNP ALREADY GRADED A+
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NSG6002 REVIEW FOR FNPALREADY GRADED A
NSG6002 REVIEW FOR FNP ALREADY GRADED A
NSG6002 REVIEW FOR FNP
ALREADY GRADED A+
, NSG6002 REVIEW FOR FNP
ALREADY GRADED A+
ENT
Acute Bronchitis
• Dry cough for 3 weeks, mucus (clear or cloudy), fatigue, SOB, low grade, or no
fever, do not treat with ABX, use SABA, and cough medicine.
Chronic Bronchitis
• Symptoms - Chronic bronchitis is a type of COPD that is characterized by
inflammation of the bronchi, causing excess mucus; characteristics of chronic
bronchitis include diagnosis after age 35, obesity, copious amounts of purulent
sputum, elevated HCT level, increased diameter of lungs, hyper-resonance,
decreased FEV1. Normal
Findings of Lungs: Lower lobes vesicular breath sounds (soft and low). Upper lobes:
bronchial breath sounds louder.
• Treat with SABA (albuterol).
Bacterial Sinusitis
• Symptoms - pain in face and leaning over, pain in teeth, maxillary forehead, and
fluid in ears.
• Treatment – Amoxicillin or Augmentin BID for 5-7 days. If allergic use Levaquin.
Allergic Rhinitis
• Inflammatory changes of nasal mucosa due to allergy, may have seasonal or daily
symptoms.
• Symptoms – chronic nasal congestion with clear mucus discharge or postnasal
drip, nasal itch, frequent sneezing, coughing worsens when supine, blue-tinged or
pale boggy nasal turbinate’s.
• Treatment – nasal steroid sprays, decongestants, antihistamine, Cromolyn (mast
stabilizer).
Allergic Conjunctivitis
NSG6002 REVIEW FOR FNP
ALREADY GRADED A+
, NSG6002 REVIEW FOR FNP
ALREADY GRADED A+
• Caused by an acute type I hypersensitivity to allergen.
• Symptoms - itchy eyes, watery or stringy discharge, chemosis (swelling of the
conjunctiva), eyelid edema, rhinitis, and an “allergic shiner,” typically occurs
bilaterally.
• Treatment - oral antihistamine.
Bacterial Conjunctivitis
• Starts unilaterally with profuse tearing and a lot of exudate.
• Treatment – ABX drops.
Otitis Media
• Symptoms - organism - Streptococcus Pneumoniae, bulging TM, ear pain, fever.
Hypo-mobile eardrum usually accompanied by pain, or perforated eardrum,
often full, bulging, and opaque. Otitis media with effusion is fluid on the ear.
Treat it like an allergy with a decongestant.
• Treatment – Amoxicillin is gold standard for all ages if recent Amoxicillin use
Bactrim DS.
• Levofloxacin (Levaquin) or moxifloxacin (Avelox) can be used – only if patient is
18 years or older – increases risk for tendonitis/Achilles tendon rupture.
Otitis Externa – “Swimmer’s Ear”
• Symptom - bacterial infection of the external ear canal, more common during
warm, humid weather (summer), organisms – Pseudomonas aeruginosa, external
ear pain, swelling, green purulent discharge usually following recent swimming.
If malignant otitis externa, an urgent referral must be made to a
otolaryngologist.
• Treatment – Cortisporin otic drops QID x 7 days, keep water out of the ear during
treatment.
Mononucleosis
• If mono and Strep both present, do not give Amoxicillin or PCN due to viral rash.
NSG6002 REVIEW FOR FNP
ALREADY GRADED A+
, NSG6002 REVIEW FOR FNP
ALREADY GRADED A+
• Symptoms - extreme fatigue, maculopapular rash, fever, sore throat, body aches,
posterior swollen lymph nodes in the neck and armpits, swollen liver or spleen, no
contact sports.
• Caused by Epstein-Barr virus. Lasting around 4-6 weeks.
• Test – Monospot test (heterophile).
Strep/Bacterial Pharyngitis
• Centor Criteria = fever, tonsillar exudate, anterior cervical lymphadenopathy,
and absence of cough. May also have headache, abrupt sore throat, and rash
(scarlet fever/sandpaper rash).
• Pathogen - A beta hemolytic streptococci, specifically S. pyogenes.
• Testing – rapid strep test.
• Treatment - PCN V is first line. If allergy to PCN, give macrolide (Z-Pac).
NSG6002 REVIEW FOR FNP
ALREADY GRADED A+
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