NR 577 Primary Care Management of Adolesce (NR577)
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Final Exam : NR 577 (NR577) |Latest 2023/ 2024 | Primary Care Management of Adolescents and Adults Final Exam Review| Guide with Verified A nswers Q: Signs and symptoms of concussio n Answer: headache drowsiness dizziness sensitivity to light memory difficulties difficulty concentrating feeling slowed down Q: When is a CT scan warranted for concussions Answer: CT scan to evaluate for hemorrhage is recommended for patients who are over 60, patients who are on anticoagulants, or patients with: vomiting persistent short -term memory loss drug/alcohol intoxication post-injury seizure persistent headache Q: What should you observe patients for who have a concussion Answer: loss of consciousness increasing headache repeated vomiting slurred speech confusion unusual behaviors seizures limb weakness or numbness The presence of any worsening symptoms requires emergency care. Q: Immediately after injury (for concussions) Answer: Conduct serial assessments since signs and symptoms may not appear for minutes to hours after the injury or may evolve over time. Apply guidelines for assessment and management that support the use of a multi - disciplinary approach including qualified sports medicine specialists. Use the Balance Error Scoring System (BESS) assessment tool at the sideline to objectively assess balance after a concussion. Q: How do you grade a TBI Answer: Glasgow coma scale (GCS) Q: Mild injury on GCS Answer: Mild injury: GCS 13 -15 Q: Moderate injury on GCS Answer: Moderate injury: GCS 9 -12 Q: Severe injury on GCS Answer: Severe injury: 3 -9 Q: Chronic Traumatic Encephalopathy (CTE) Answer: a degenerative brain disease caused by repeated head trauma. CTE is seen in athletes, such as boxers and football players, and veterans Q: s/s of Chronic traumatic encephalopathy Answer: depression confusion irritability impulsivity aggression memory problems attention problems poor decision -making Q: Impetigo Answer: begins as a small, erythematous macule (commonly the face) that evolves into a vesicle beneath the stratum corneum. The thin -roofed collection of fluid ruptures easily, leaving denuded, oozing areas. A honey -colored crust forms as the fluid dries and coll ects. Intense erythema at the base of the pustule. New lesions appear in the same location, and they coalesce. When the honey -colored crusts are removed, the skin appears raw and glistening. Individual lesions usually do not exceed 2 cm in size. Impetigo i s seen most frequently in children, but it also occurs in adults, especially those with poor hygiene. Q: Tx of imeptigo Answer: The crusts of impetigo should be debrided to expose the skin surface where bacteria are present. The use of a washcloth for this purpose is rec - ommended. Furuncles and carbuncles are treated with hot compresses to enhance drainage. Fluctuant lesions with abscess formation usually require incision and drainage. Sometimes, packing of the wound is necessary. With exudative lesions, drying compresses are required to remove detritus and desiccate the lesion. Saline solution, tap water, or Burow solution (alumi num acetate) may be applied for 10 to 20 minutes three to four times a day. Q: Scabies Answer: Transmission is through close personal contact, either sexual or non - sexual. Patients usually present with intense pruritus, which is often more severe during the night. Eighty -five percent of infested persons have burrows on the fingers, interdigital areas, and wrists; these appear as linear marks a few millimeters in length. Q: Dx of scabies Answer: A skin scraping is performed by placing a drop of mineral oil on a suspicious lesion, shaving off the roof of the burrow with a scalpel, scraping the base to remove the contents, and placing the material on a microscope slide with cover slip. Q: tx of scabies Answer: Permethrin 5% cream, which is synthetically derived from the chrysanthemum flower, is the FDA -approved and first -line treatment for scabies for patients aged 2 months and older. Q: Head lice Answer: The diagnosis is made by direct examination of the involved areas. Few adult lice are found at the bases of the hairs, but many nits are typically seen. Both are usually visible to the naked eye, but a hand lens and bright light may help. Nits appear as g ray or white specks attached to the hair shafts. Q: Lice tx Answer: Permethrin 1% cream rinse shampoo is the first -line treatment for pedicu - losis and can be obtained over the counter. Only permethrin has activity against eggs because it retains residual activity for 2 weeks and remains on the hair for 14 days after trea tment, thereby killing hatched eggs. Some physicians still recommend that a second permethrin treatment be given 1 week after the first, for maximum cure rate.
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