Exam (elaborations)
AANP Adult Gerontology Primary Care Nurse Practitioner – Complete Study Guide
AANP Adult Gerontology Primary Care Nurse Practitioner – Complete Study Guide
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AANP Adult Gerontology Primary Care NursePractitioner – Complete Study Guide
Pheochromocytoma ✔️Ans - small vascular tumor of the adrenal medulla,
causing irregular secretion of epinephrine and norepinephrine, leading to
attacks of raised blood pressure, palpitations, and headache. Tx with Alpha
blockers
Rovsing's Sign ✔️Ans - Palpation in LLQ ilicits pain in RLQ indicates
appendicitis
NYHA classes of Heart Failure ✔️Ans - I No limitation of physical activity.
Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea
(shortness of breath).
II Slight limitation of physical activity. Comfortable at rest. Ordinary physical
activity results in fatigue, palpitation, dyspnea (shortness of breath).
III Marked limitation of physical activity. Comfortable at rest. Less than
ordinary activity causes fatigue, palpitation, or dyspnea.
IV Unable to carry on any physical activity without discomfort. Symptoms of
heart failure at rest. If any physical activity is undertaken, discomfort
increases.
Step-wise Approach to Asthma Diagnosis & Treatment ✔️Ans - Step 1-
Mild Intermitten FEV1/PEF > 80% predicted. Symptoms <2 days/week.
Albuterol as needed.
Step 2- Mild presistent Asthma (FEV1/PEF > 80% predicted. Symptoms > 2
days/week. Albuterol as needed. Low dose ICS ex Flovent. Alt cromolyn,
montelukast, nedocromil, theophylline.
Step 3- Mod presistent (FEV1 or PEF 60-80% predicted. Daily Symptoms.
SABA plus low dose ICS or med dose ICS or low dose with leukotriene
inhibitor (singulair, theophylline, zileuton).
Step 4- Severe presistent asthma (FEV1/PEF <60% predicted. Symptoms most
of day. High dose ICS plus long acting B2 agonist plus oral steroid daily
(prednisone).
Peak Expiratory Flow Rate (HAG):
, Green Yellow Red Zone: ✔️Ans - PEF based on Height Age Gender. Blow
hard using spirometer highest value recorded.
80-100% expected volume Green Zone maintain or reduce meds
50-80% expected volume Yellow Zone increase maintenance therapy. Or
Having exacerbation.
Below 50% expected volume Red Zone call 911 give epinephrine inj.
PPD ✔️Ans - Neg- No firm bump forms at the test site, or a bump forms
that is smaller than 5 mm (0.2 in.).
A firm bump that is 5 mm (0.2 in.) in size suggests a TB infection in people
who are in a high-risk group. HIV, immunocompromise, exposed.
A firm bump that is 10 mm (0.4 in.) in size suggests a TB infection in people
who are in a moderate-risk group. healthcare workers, immigrants, homeless.
A firm bump that is 15 mm (0.6 in.) in size suggests a TB infection in people
who are in a low-risk group no risk for tb.
Digoxin (Cardiac Glycosides) ✔️Ans - Therapuetic 0.5-2.0
Overdose toxcitity GI upset, arrhythmias, confusion visual changes
(yellow/green tinge vision- scotomas). Tx with digibind. order dig level,
electrolytes, creatinine ekg.
Thiazide Diuretics ✔️Ans - Pt with both htn and osteoporosis have an extra
benefit from thiazides. thiazide diuretics decrease calcium excretion by the
kidneys and stimulate osteoclasts formation. Patients with serious sulfa
allergies should avoid thiazide diuretics. Potassium sparing diuretics can be
used as alternative.
Chlorthalidone (hygroton), hydrochlororthiazide (esidrix, microzide),
indapamide (lozol), metolazone (zaroxolyn); indicated for decreased fluid
volume, inexpensive, effective, useful in severe hypertension, effective orally,
enhances other antihypertensives; adverse reactions: hypokalemia symptoms,
hyperuricemia, glucose tolerance, hypercholesterolemia, sexual dysfunction;
observe for postural hypotension, caution with renal failure gout and client
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