Exam (elaborations)
AGACNP BARKLEY
- Course
- Institution
- Book
AGACNP BARKLEY ACTUAL LATEST EXAM REVIEW| 130 QUESTIONS & CORRECT DETAILED ANSWERS| AGRADE (BRAND NEW!
[Show more]
Connected book
Book Title:
Author(s):
- Edition:
- ISBN:
- Edition:
More summaries for
-
AGACNP BARKLEY
-
NCLEX RN Versions 1 -12 (Latest) With 850 Questions And Answers Guaranteed 100% Grade A.
-
NRNP 6566 Key Concepts Week 1 to 5 spring
Seller
Follow
maxmaxwellmm254
Content preview
AGACNP BARKLEY 2023-2024 ACTUAL LATESTEXAM REVIEW| 130 QUESTIONS & CORRECT
DETAILED ANSWERS| AGRADE (BRAND NEW!
What causes fever? - ANSWER *ABCDEFGHIMN*
*Auto-immune* - SLE, GCA
*Blood* - Heme/Onc - Leukemia/Lymphoma
*Cancer*
*Drugs* - Amphotericin B, Beta-lactam abx, procainamide
*Endo* - hyperthyroidism, pheochromocytoma
*Familial mediterranean fever*
*GI* - intra-abdominal abscess, IBD
*Heart*- MI, endocarditis
*Infection* - bacterial, viral, fungal, parasites, etc.
*Misc* - Hematoma
*Neuro* - tumor, ICH, MS - interfere w/ thermoregulatory process
What is malignant hyperthermia? - ANSWER *high fever d/t succinylcholine*
usu given in OR to relax laryngeal muscle
contraindicated to succs? hyperkalemia
*Tx: dantrolene - reversal for succs*
What is the treatment for fever? - ANSWER 1. antimicrobials only when a microbe is
present
2. antipyretics
3. tx underlying condition
What are the causes of non-infectious post-op fever? - ANSWER 1. post-op atelectasis
2. increased basic metabolic rate
3. dehydration
4. drug reactions: Amphotericin B, trimethoprim-sulfamethazole, beta-lactam (abx),
procainamide, isoniazid, alpha-methyldopa, quinidine, etc.
What would prompt you to think that a post-op fever is infectious? - ANSWER 1. usu
accompanied by subjective complaints & a WBC elevation with *left shift* (i.e.,
bandemia)
2. WBC >30k is usu not d/t infection
3. *surgical incisions*
4. *point of entry for any catheter, culture it*
5. UTI
6. lungs
7. sinusitis
,8. abscess (e.g., intra-abd)
normal WBC - 5-10k
sinusitis - 12k
cellulitis - 17k
septic shock - 20-22k
leukemia - 30k
what is the initial tx for post-op fever in the absence of information of infection? -
ANSWER Hydration + measures to expand lungs
what is the treatment for infectious post-op fever? - ANSWER -IVF + APAP
-tx underlying source
-gram stain, C&S, all invasive lines or catheters, as indicated
**before cultures, do not give APAP or IVF. Do not suppress anti-inflammatory response
bec you want to culture at maximum inflammation response, then broad spectrum abx,
IVF, & APAP, then narrow once culture comes back.
what are the components of headache evaluation? - ANSWER 1. chronology - most
impt hx item
2. location, duration, quality
3. associated activity - i.e. exertion, sleep, tension, relaxation
4. timing of menstrual cycle
5. presence of assoc symptoms
6. presence of "triggers"
What is the lab/diagnostic test and treatment for tension headache? - ANSWER - no
lab/diagnostic test specific for tension h/a
- tx is OTC analgesics & relaxation
What is the pathophysiology behind migraine headaches? - ANSWER - migraine
headaches are related to dilation & excessive pulsation of branches of the external
carotid artery
- typically lasts 2-72 hours following the trigeminal nerve pathway
What are the physical exam findings you may find in a migraine headache? - ANSWER
-many times appear normal, +/- neuro deficits, or appear ill
-neuro deficits - visual disturbances, aphasia, numbness/tingling, N/V,
photophobia/phonophobia
*careful neuro exam for focal deficits or findings supportive of tumor
What labs/diagnostic tests do you order in pts w/ new migraine h/a? - ANSWER CBC,
BMP
VDRL - r/o syphilis
ESR - elevated in GCA
head CT - r/o tumor & bleed, esp in young pt w/ ha
,other studies as indicated by H&P
What is the management for a migraine headache? - ANSWER 1. Avoidance of trigger
factors (very impt)
2. relaxation/stress mgt
3. PPX daily if attacks occure >2-3x/month
-amitryptyline(Elavil)
-divalproex(Depakote)
-propanolol(Inderal)
-Imipramine(Tofranil)
-clonodine(Catapres)
-verapamil(Calan)
-topiramate(Topamax)
-gabapentin(Neurontin)
-methysergide(Sansert)
-magnesium
***not an inclusive list**
What is the management for an acute attack of migraine headache? - ANSWER 1. rest
in dark, quiet room
2. simple analgesic (ASA) taken right away may provide some relief
3. Sumatriptan(Imitrex) 6mg SQ at onset, may repeat in 1hr (total of 3x/day)
4. Sumatriptan 25mg PO at onset of headache
Cluster headaches affect mostly __________? - ANSWER middle-aged men, very
painful syndromes
What are the causes/incidence of cluster headaches? - ANSWER - *middle-aged men*
- often no FMHx of headache or migraine
- may be *precipitated by alcohol ingestion*
- characterized by *severe, unilateral, periorbital pain* occurring daily for several weeks
- usu *occurs at night, awakening the pt from sleep*
- usu *lasts <2 hours*
- usu pain free for weeks or months b/w attacks
- *ipsilateral nasal congestion, rhinorrhea, & eye redness may occur*
What are the physical exam findings in cluster headache? - ANSWER - usually normal
exam, may see *eye redness, rhinorrhea, ipsilateral nasal congestion*
What is the management for cluster headache? - ANSWER - *100% of O2*
- *sumatriptan (Imitrex) 6mg SQ*
- *ergotamine* tartrate aerosol inh (Ergostat)
- tx of indiv attacks w/ oral drugs are usu unsatisfactory
What does albumin level of <3.5 indicate? - ANSWER Protein malnutrition
, Albumin normal - 3.5 to 5
How low does the albumin level when you can expect to see edema? - ANSWER
albumin level of <2.7g/dL
A hgb of <12g/dL for women & <13.5g/dL for men can indicate lack of iron or protein
resulting in _____________? - ANSWER inadequate oxygen perfusion
What is the H/H ratio & threshold to transfuse? - ANSWER H/H 1:3 ratio
Hgb of 8, HCT of 24 - transfuse, don't discharge without giving 2 units of PRBC
What is the earliest indication of malnutrition? - ANSWER Pre-albumin
Why do women have lower H/H than men? - ANSWER Testosterone promotes
erythropoiesis which is why women have lower Hgb
If a patient has an ashened skin color, what could this indicate? - ANSWER Folic acid
deficiency
Describe the nutritional support decision tree? - ANSWER **Can you use the GI tract?
*NO* => need total parenteral nutrition (TPN)
=> need support for >2 weeks?
- Yes => use central vein (esp dextrose >10%)
- No => use peripheral vein (<10% dextrose)
*YES* => need supplements for >6 weeks?
- Yes => use enterostomal tube (Peg, J-tube)
- No => use nasoenteric tube
=> is the patient at risk for aspiration?
-Yes => use duodenal tube (DHT) or nasoduodenal tube (NDT)
-No => use nasogastric tube
What the are complications of ENTERAL nutritional support? - ANSWER *Enteral =
Solution*
Aspiration
Diarrhea (dumping or refeeding syndrome)
Dehydration
Emesis
GIB
Hypernatremia
Mechanical obstruction of the tube
What the are complications of PARENTERAL nutritional support? - ANSWER
*Parenteral = Mode of Delivery*
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller maxmaxwellmm254. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $17.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
72841 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now