Exam (elaborations)
ACNP I Midterm Exam – Questions & Answers (Solved)
- Course
- Institution
ACNP I Midterm Exam – Questions & Answers (Solved)
[Show more]
Content preview
ACNP I Midterm Exam – Questions & Answers (Solved)Immediately Life-Threatening Causes of Altered Mental Status (AMS) Right
Ans - •Arrhythmias
•CO2 narcosis
•Hypoxia
•Loss of airway
•Shock (brain hypoperfusion)
•Cardiogenic
•Distributive (septic, anaphylactic, neurogenic)
•Hypovolemic
•Obstructive
•Stroke
•Ischemic
•Hemorrhagic
Neurologic Causes for AMS Right Ans - •Stroke/TIA
•Structural brain disease
•Tumors: primary or metastatic
•Encephalitis, meningitis, other neurological infections
•Postictal
•Seizures (including partial and subclinical)
•Wernicke's encephalopathy
•Korsakoff syndrome
Metabolic Causes for AMS Right Ans - •Hyper/hypoglycemia
•Hyper/hyponatremia
•Hypercalcemia
•Hyper/hypothyroid
•Encephalopathy
•Hepatic failure, renal failure, drug-induced
•Medications
•Drug or ETOH intoxication or withdrawal
Delirium is a diagnosis of ...... Right Ans - exclusion (always rule out
pathologic causes first)
Immediate Work-Up for AMS Right Ans - •ABG
•Blood glucose
,•CBC with difference
•BMP, Mg
•Lactic acid
•Liver function tests
•Thyroid function tests
•Drug/ETOH screen
•EKG
Other Tests to Consider for AMS Right Ans - •Ammonia (NH3)
•VDRL/RPR
•R/o syphilis
•Vitamin B12
•Folate
•Tests for specific toxic ingestions, if indicated
•Acetaminophen
•Salicylic acid
•And many others
•CT head
•MRI head
•EEG
•Lumbar puncture
Signs and Symptoms Right Ans - •Syndrome that occurs after stopping
heavy and prolonged ETOH use
•Can occur within 12-48 hours after stopping ETOH in any person who is
physically dependent on ETOH
•Agitation
•Anxiety
•Tremors
•Nausea and vomiting
•Weakness
•Diaphoresis
•Hallucinations
•Confusion
•Delirium
•Tachycardia
•HTN
•Fever
•Tonic-clonic seizures
, CIWA-AD (Clinical Institute Withdrawal Assessment for Alcohol) Right Ans
- •Quantifies severity of withdrawal
•Guides patient care
•Benzodiazepines are the mainstay of treatment
•Remember: if giving haloperidol (Haldol), monitor the patient's QT interval;
Haldol can prolong the QT and lead to Torsades
Clinical Opioid Withdrawal Scale (COWS) Right Ans - •Used to help
clinicians determine the stage or severity of opiate withdrawal and assess the
level of physical dependence on opioids
•Caution: opioid withdrawal can have flu-like symptoms; don't give the
patient more than the lowest score in a category, unless they are exhibiting
some signs of withdrawal
https://
•Score:
•5-12 = mild
•13-24 = moderate
•25-36 = moderately severe
•>36 = severe withdrawal
•Methadone
•Buprenorphine
•Much of the treatment is symptomatic:
•Alpha and beta-blockers: decrease somatic symptoms
•Nausea/vomiting: Odansetron (Zofran)
•Diarrhea: loperamide (Immodium)
•Abdominal cramping: Dicyclomine (Bentyl)
•Myalgias, athralgias: Acetaminophen, Ibuprofen
Delirium: Contributing Factors Right Ans - •Systemic illness
•Fever, infection, metabolic imbalances
•Check for hypoxia, hypercarbia
•Acute renal failure
•Electrolyte imbalances
•Dehydration
•Cardiopulmonary bypass
•Medications
•Drug or alcohol withdrawal
•Sleep deprivation
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 LeCrae. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $19.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
82215 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now