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AG-ACNP: Questions And Detailed Answers (Rated A+)
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AG-ACNP: Questions And Detailed Answers (Rated A+)
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AG-ACNP: Questions And Detailed Answers (Rated A+)Acute Pain Right Ans - Duration is usually less than 6 months, Caused by
tissue damage
Chronic Pain Right Ans - Continual or episodic pain of longer than 6
months
Cutaneous Right Ans - Localize on the skin or surface of the body
Visceral Right Ans - Poorly localized such as with internal organs
Somatic Right Ans - Originates in muscle, bones, nerves, blood vessels, and
supporting tissue. Soft tissue
Neuropathic Right Ans - Frequently caused by a tumor, involves the nerve
pathway
Subjective Findings of pain Right Ans - Most reliable indicator of the
existence and intensity of acute pain
WHO's pain management ladder Step 1 Right Ans - ASA, APAP, NSAIDs, and
+- adjuvants
WHO's pain management ladder Step 2 Right Ans - APAP or ASA, Codeine,
Hydrocodone, oxycodone, dihidrocodeine, tramadol, +- adjuvants
WHO's pain management ladder Step 3 Right Ans - Morphine,
Hydromorphone, methadone, levorphanol, fentanyl, oxycodone, +- Non opioid
analgesics, +-adjuvants
Fever definition Right Ans - Increased body temp above normal (37C)
Causes of fever Right Ans - Autoimmune, CNS, Malignant neoplastic
disease, hematologic disease, CV disease, GI disease, Endocrine disease,
Neuroleptic malignant syndrome (anti-psychotics)
Causes of non-infectious post-op fever Right Ans - #1: Post-op atelectasis,
increased metabolic rate, dehydration, and drug reactions
,Drugs that can cause fever Right Ans - Amphotericin B, trimethoprim
sulfamethaxazole, beta-lactam antibiotics, procainamide, isoniazid, alpha-
methyldopa, quinidine
Infectious indicators of post-op fever? What are the WBC indicators? Right
Ans - Usually accompanied by subjective complaints and a WBC elevation with
left shift. Increased 5-10000 is normal for elderly and immunocompromised.
>20,000 septic shock. >40,000 leukemia
Causes of infections post-op fever Right Ans - Surgical incisions, IV sites,
UTI, Lungs, abcess **sinusitis: NG tubes associated with increased incidence
Increase in esosiophils are a sign of: Right Ans - Allergic reaction
Treatment of post op fever non infectious causes Right Ans - First response
is hydration and expand lung inflation
Treatment of infections post-op fever Right Ans - Fluids, tylenol, treat
underlying source, C&S, and gram stain
Headache (components of evaluation) Right Ans - Chronology (most
important)
OLD CARTS
Presence of triggers and menstral cycle
What is the most common type of headache Right Ans - Tension headache
S/S of tension headache Right Ans - Vise-like or tight in quality,
generalized, most intense about the neck or back of head, no associated focal
neurological symptoms, usually lasts for several hours
Management of Tension H/A Right Ans - Over the counter analgesics and
relaxation
Migraine H/A signs and symptoms and different types Right Ans - Classic-
Migraine with aura
Common-Migraine w/o aura
,Related to dilation and excessive pulsation of branches of the external carotid
artery. Lasts 2-72 hours following the trigeminal nerve pathway.
Onset time and occurance and Triggers of Migraine H/A Right Ans - onset
is in adolescence or early adult years
family hx
females more often affected than males
Nitrate containing foods
Changes in weather
S/S of Migraine H/A Right Ans - Unilateral, lateralized throbbing h/a that
occurs episodically
dull or throbbing, builds gradually and lasts for several hours, focal neurologic
disturbances, visual disturbances, aphasia, numbness, tingling, n/v,
photophobia and phonophobia
Lab/Diagnostics for Migraine Right Ans - ESR, CBC, BMP, VDRL, CT of head
Treatment of Migraine Right Ans - Dark room and rest
ASA
Imitrex 6mg SQ at onset, may repeat in one hour (total of 3 times a day)
Imitrex 25mg PO at onset of H/A
Cluster Headache who gets them the most? Right Ans - Very painful, mostly
affecting middle-aged men
Causes s/s of Cluster H/A Right Ans - No family hx, ETOH, occurs at night,
lasts less than 2 hours, severe unilateral periorbital pain occurring daily for
several weeks, Ipsilateral nasal congestion, rhinorrhea and eye redness may
occur
Treatment of Cluster H/A Right Ans - inhalation of 100% O2, Imitrex 6mg
SQ
Normal Albumin level Right Ans - 3.5-5
Hgb/Hct Ratio Right Ans - 1:3
, Complications of enteral feeding Right Ans - Aspiration, diarrhea, emesis,
GI bleed, mechanical obstruction, hypernatremia, and
dehydration,refeedingsyndrome,Low-Phos,Low-k,Low-Mag,Low-
Ca,Thiaminedeficiency
Complications of parenteral nutrition Right Ans - Pneumothorax,
hemothorax, arterial laceration, air emboli, catheter thrombosis, catheter
sepsis, hyperglycemia, HHNK
What is the most common electrolyte abnormality Right Ans -
Hyponatremia
Urine sodium normal value Right Ans - 10-20
Sodium Osmolality normal value Right Ans - 2xs Na
275-285
Urine sodium >20 suggestive of what? Right Ans - Suggests renal salt
wasting (problem with kidneys)
Urine sodium <10 suggestive of what? Right Ans - Suggests renal retention
of sodium to compensate for extrarenal fluid loss (problem other than
kidneys)
Isotonic hyponatremia what is it's other name? Lab value and causes and
treatment Right Ans - Pseudohyponatremia; serium osmo 284-295: lab
artifact
Occurs with hyperlipidemia or hyperproteinemia, body water is normal and
pts are asymptomatic
Treatment: Cut down fat (no fluid restriction)
Hypotonic Hyponatremia normal lab value and definition Right Ans - Osmo
<280. State of body water excess diluting all body fluids: clinical signs arise
from water excess.
Hypovolemic w/urine Na+ <10 causes? Right Ans - Dehydration, diarrhea,
vomiting
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