ANCC AGACNP Barkley Review – Converted.
Acute Pain - ANSWER-Duration is usually less than 6 months, Caused
by tissue damage
Chronic Pain - ANSWER-Continual or episodic pain of longer than 6
months
Cutaneous - ANSWER-Localize on the skin or surface of the body
Visceral - ANSWER-Poorly localized such as with internal organs
Somatic - ANSWER-Originates in muscle, bones, nerves, blood vessels,
and supporting tissue. Soft tissue
Neuropathic pain - ANSWER-Frequently caused by a tumor, involves
the nerve pathway
Subjective Findings of pain - ANSWER-Most reliable indicator of the
existence and intensity of acute pain
WHO's pain management ladder Step 1 - ANSWER-ASA, APAP,
NSAIDs, and +- adjuvants
WHO's pain management ladder Step 2 - ANSWER-APAP or ASA,
Codeine, Hydrocodone, oxycodone, dihidrocodeine, tramadol, +-
adjuvants
,WHO's pain management ladder Step 3 - ANSWER-Morphine,
Hydromorphone, methadone, levorphanol, fentanyl, oxycodone, +- Non
opioid analgesics, +-adjuvants
Fever definition - ANSWER-Increased body temp above normal (37C)
Causes of fever - ANSWER-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 - ANSWER-#1: Post-op
atelectasis, increased metabolic rate, dehydration, and drug reactions
Drugs that can cause fever - ANSWER-Amphotericin B, trimethoprim
sulfamethaxazole, beta-lactam antibiotics, procainamide, isoniazid,
alpha-methyldopa, quinidine
Infectious indicators of post-op fever? What are the WBC indicators? -
ANSWER-Usually accompanied by subjective complaints and a WBC
elevation with left shift (bandemia). Increased 5-10000 is normal for
elderly and immunocompromised. >20,000 septic shock. >30,000
leukemia
Causes of infections post-op fever - ANSWER-Surgical incisions, IV
sites, UTI, Lungs, abcess **sinusitis: NG tubes associated with
increased incidence
Increase in esosinophils are a sign of: - ANSWER-Allergic reaction
Treatment of post op fever non infectious causes - ANSWER-First
response is hydration and expand lung inflation
Treatment of infections post-op fever - ANSWER-Fluids, tylenol, treat
underlying source, C&S, and gram stain
,Headache (components of evaluation) - ANSWER-Chronology (most
important)
OLD CARTS
Presence of triggers and menstral cycle
What is the most common type of headache - ANSWER-Tension
headache
S/S of tension headache - ANSWER-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 - ANSWER-Over the counter analgesics
and relaxation
Migraine H/A signs and symptoms and different types - ANSWER-
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 - ANSWER-
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 - ANSWER-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 - ANSWER--ESR
, -CBC
-BMP
-VDRL (to rule out syphilis)
-CT of head
Treatment of Migraine - ANSWER-- 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? - ANSWER-Very painful,
mostly affecting middle-aged men
Causes s/s of Cluster H/A - ANSWER--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 - ANSWER-inhalation of 100% O2, Imitrex
6mg SQ
Normal Albumin level - ANSWER-3.5-5
Hgb/Hct Ratio - ANSWER-1:3
Complications of enteral feeding - ANSWER-Aspiration, diarrhea,
emesis, GI bleed, mechanical obstruction, hypernatremia, and
dehydration,
Refeeding syndrome: Low-Phos,Low-k,Low-Mag,Low-
Ca,Thiaminedeficiency
Acute Pain - ANSWER-Duration is usually less than 6 months, Caused
by tissue damage
Chronic Pain - ANSWER-Continual or episodic pain of longer than 6
months
Cutaneous - ANSWER-Localize on the skin or surface of the body
Visceral - ANSWER-Poorly localized such as with internal organs
Somatic - ANSWER-Originates in muscle, bones, nerves, blood vessels,
and supporting tissue. Soft tissue
Neuropathic pain - ANSWER-Frequently caused by a tumor, involves
the nerve pathway
Subjective Findings of pain - ANSWER-Most reliable indicator of the
existence and intensity of acute pain
WHO's pain management ladder Step 1 - ANSWER-ASA, APAP,
NSAIDs, and +- adjuvants
WHO's pain management ladder Step 2 - ANSWER-APAP or ASA,
Codeine, Hydrocodone, oxycodone, dihidrocodeine, tramadol, +-
adjuvants
,WHO's pain management ladder Step 3 - ANSWER-Morphine,
Hydromorphone, methadone, levorphanol, fentanyl, oxycodone, +- Non
opioid analgesics, +-adjuvants
Fever definition - ANSWER-Increased body temp above normal (37C)
Causes of fever - ANSWER-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 - ANSWER-#1: Post-op
atelectasis, increased metabolic rate, dehydration, and drug reactions
Drugs that can cause fever - ANSWER-Amphotericin B, trimethoprim
sulfamethaxazole, beta-lactam antibiotics, procainamide, isoniazid,
alpha-methyldopa, quinidine
Infectious indicators of post-op fever? What are the WBC indicators? -
ANSWER-Usually accompanied by subjective complaints and a WBC
elevation with left shift (bandemia). Increased 5-10000 is normal for
elderly and immunocompromised. >20,000 septic shock. >30,000
leukemia
Causes of infections post-op fever - ANSWER-Surgical incisions, IV
sites, UTI, Lungs, abcess **sinusitis: NG tubes associated with
increased incidence
Increase in esosinophils are a sign of: - ANSWER-Allergic reaction
Treatment of post op fever non infectious causes - ANSWER-First
response is hydration and expand lung inflation
Treatment of infections post-op fever - ANSWER-Fluids, tylenol, treat
underlying source, C&S, and gram stain
,Headache (components of evaluation) - ANSWER-Chronology (most
important)
OLD CARTS
Presence of triggers and menstral cycle
What is the most common type of headache - ANSWER-Tension
headache
S/S of tension headache - ANSWER-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 - ANSWER-Over the counter analgesics
and relaxation
Migraine H/A signs and symptoms and different types - ANSWER-
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 - ANSWER-
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 - ANSWER-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 - ANSWER--ESR
, -CBC
-BMP
-VDRL (to rule out syphilis)
-CT of head
Treatment of Migraine - ANSWER-- 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? - ANSWER-Very painful,
mostly affecting middle-aged men
Causes s/s of Cluster H/A - ANSWER--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 - ANSWER-inhalation of 100% O2, Imitrex
6mg SQ
Normal Albumin level - ANSWER-3.5-5
Hgb/Hct Ratio - ANSWER-1:3
Complications of enteral feeding - ANSWER-Aspiration, diarrhea,
emesis, GI bleed, mechanical obstruction, hypernatremia, and
dehydration,
Refeeding syndrome: Low-Phos,Low-k,Low-Mag,Low-
Ca,Thiaminedeficiency
