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Terms in this set (716)
A new graduate nurse practitioner has a patient 4. The tuning fork lateralizes to the left ear
presents with a hearing complaint. The patient states
that they have had decreased hearing on the right
side for the last month that is continuing to get
worse. The NP completes both the Rinne and Weber
tests. If the patient has Ménière's disease, what
would be the expected finding on the Weber test?
1. AC is 2 times longer than BC
2. BC is 2 times longer than AC
3. The tuning fork lateralizes to the right ear
4. The tuning fork lateralizes to the left ear
What are common signs and symptoms of Meniere's Vertigo, tinnitus, ear pressure, nystagmus
Disease?
What is our biggest worry for a Meniere's Disease There is a possibility for a potential, permanent hearing loss.
patient?
What is rhinitis meidcamentosa? Drug-induced rebound nasal congestion, this can happen after use of nasal
decongestants like Afrin. These nasal decongestants should ideally not be
used for greater than 3-5 days because of this risk.
What is herpes keratitis? This is an infection of the cornea due to herpes simplex virus
How is herpes keratitis diagnosed? By examining the eye under a black lamp and visualized the cornea, in
herpes keratitis, fern like lines will be seen on the cornea
A child that has a history of mononucleosis is at Hodgkin's Lymphoma and Burkitt's Lymphoma, this is due to the exposure
increased risk for development for what cancer later of the Epstein-Barr virus
in life? And why?
What types of patients will be at a higher risk of Patient with chronic lung diseases: asthma, COPD, cystic fibrosis.
pneumonia?
Why are cough suppressants not helpful in Because we WANT them to get that gunk out, we do not want them to hold
pneumonia patients? it in their lungs, an expectorant would be a better option for these patients.
When should a follow up chest X-Ray be completed Around 8 week mark
after treatment of pneumonia?
What is COPD? Chronic Obstructive Pulmonary Disease. This is a chronic condition that is
made up of chronic bronchitis and emphysema. It is a progressive
inflammatory lung disease that makes it hard for the patients to breathe,
because the chronic bronchitis leads to mucous build up and the
emphysema portion destroys areas of the lungs.
What signs and symptoms are common in COPD Chronic cough
patients? Sputum production
Dyspnea- difficulty breathing
,What signs and symptoms are specific to B12 Neurological symptoms, paresthesia (numbness and tingling in hands and
deficiency anemia? feet), unsteady gait, memory issues
Beefy red tongue
What diet can result in B12 deficiency? Vegan- oral supplements can be used for treatment
What surgery can result in B12 deficiency? Gastric surgery- patient will lose intrinsic factor that is required to absorb
B12- these patients will require life long IM B12 injections
What patient population is lupus commonly seen? Women of childbearing age- ages 15-45, African Americans are going to be
at higher risk
What is the diagnostic criteria for Lupus? Must have 4/11 diagnostic criteria:
Malar rash
Discoid rash
Photosensitivity
Oral/nasal ulcers
Non-erosive arthritis
Cardio-pulmonary complaints
Renal complaints
Neurological concerns
Immunological disorders
+ ANA test
Hematologic disorders
What is Sjogren's Syndrome and what is the Dry eyes and dry mouth- treatment revolves around symptom
treatment? management- artificial tears, hard candies, etc.
Common in lupus patients
What is a major concern for lupus patients? How do Impact on the kidneys- Lupus nephritis
we monitor this? Be on the look out for glomerularnephritis as well as proteinuria
These patients will require routine UA for assessment of their kidneys and
protect them
What is the function of the thyroid? Viral hormone gland
Metabolism regulation- impacts every SINGLE cell within the body
Proper growth and development across the entire lifespan
What produces TSH? Pituitary gland
What is the function of TSH? Tells your thyroid when to produce and release those critical thyroid
hormones- T3 and T4.
What disorders include hypothyroidism? Iodine deficiency, Hashimoto's, or thyroiditis
A presence of thyroid peroxidase antibodies Hypothyroidism is caused by an autoimmune process of some sort
indicates that?
What are some signs and symptoms of Weight gain, constipation, dry skin, cold intolerance, fatigue, course hair,
hypothyroidism? facial puffiness, thick tongue, and maybe some cardiac side effects
What patient education must be included regarding Must be taken on an empty stomach before other medications
Synthroid administration?
What are signs and symptoms of a myxedema Low body temperature, edema, confusion, lethargy, tongue thickening,
coma? difficulty breathing
What medications can precipitate myxedema coma? Lithium or amiodarone
, Your patient who is on 75 mcg Synthroid PO daily Assess how the patient is taking their Synthroid
comes in for a 6 week follow up to check their TSH
level. When you get the results, their TSH is 0.1.
What should you do next as the NP?
What signs and symptoms are common in Anxiety, palpitations, cardiac abnormalities, tachycardia, diaphoresis,
hyperthyroidism? weight loss, and increased appetite, menstrual irregularities, amenorrhea,
tremors, lid lag, exophthalmos
What needs to be considered with PTU medication Need frequent lab work: CBC, and Thyroid panel
administration? Required to take PTU multiple times a day
What is the most common treatment for Grave's Radioactive iodine therapy
Disease?
Hyperthyroidism left untreated may lead to what Heart disease- patient's heart is in a constant high-output state, your heart
conditions? can't keep up with that all of the time, may lead to heart failure
Osteoporosis
Infertility
What is worst case scenario in hyperthyroid Thyroid storm- Temperature, HR, and BP- dangerously HIGH levels
patients? Puts body into compromised state, especially impacting your heart. Heart
starts to go into Letha dysrhythmias and even heart failure.
What are the 8 most common drug classes for Biguanides (Metformin)
diabetes medications? DPP-4 inhibitors
GLP-1 Agonists
SGLT-2 inhibitors
Insulin
Sulfonylureas
TZDs
Alpha-glycosides inhibitors
Why are type 1 diabetics insulin dependent? They have an autoimmune destruction of their beta cells
What are some examples of rapid acting insulin? Humalog, Novalog, Apidra
What is the onset, peak, and duration of rapid acting Onset: 15 minutes
insulin? Peak: 1 hour
Duration: 2-4 hours
What are some examples of short acting insulin? Regular insulin (Humulin R, Novolin R)
What is the onset, peak and duration of short acting Onset: 30 min- 1 hour
insulin? Peak: 2-4 hours
Duration: 6-8 hours
What are some examples of intermediate insulin? NPH (Humulin N, Novolin N)
What is the onset, peak, and duration of intermediate Onset: 1-2 hours
insulin? Peak: 6-12 hours
Duration: 24 hours
What are some examples of long acting insulin? Lantus, Levemir
What is the onset, peak and duration of long acting Onset: 2 hours
insulin? Peak: NONE
Duration: 24 hours
What is truly our GO TO oral diabetes medication? Metformin (Biguanides)
S
A
R
A
H
M
I
C
H
E
L
L
E
LI
V
E
R
E
V
I
E
W
S
T
U
D
Y
G
U
I
D
E
,Students
also
studied
Terms in this set (716)
A new graduate nurse practitioner has a patient 4. The tuning fork lateralizes to the left ear
presents with a hearing complaint. The patient states
that they have had decreased hearing on the right
side for the last month that is continuing to get
worse. The NP completes both the Rinne and Weber
tests. If the patient has Ménière's disease, what
would be the expected finding on the Weber test?
1. AC is 2 times longer than BC
2. BC is 2 times longer than AC
3. The tuning fork lateralizes to the right ear
4. The tuning fork lateralizes to the left ear
What are common signs and symptoms of Meniere's Vertigo, tinnitus, ear pressure, nystagmus
Disease?
What is our biggest worry for a Meniere's Disease There is a possibility for a potential, permanent hearing loss.
patient?
What is rhinitis meidcamentosa? Drug-induced rebound nasal congestion, this can happen after use of nasal
decongestants like Afrin. These nasal decongestants should ideally not be
used for greater than 3-5 days because of this risk.
What is herpes keratitis? This is an infection of the cornea due to herpes simplex virus
How is herpes keratitis diagnosed? By examining the eye under a black lamp and visualized the cornea, in
herpes keratitis, fern like lines will be seen on the cornea
A child that has a history of mononucleosis is at Hodgkin's Lymphoma and Burkitt's Lymphoma, this is due to the exposure
increased risk for development for what cancer later of the Epstein-Barr virus
in life? And why?
What types of patients will be at a higher risk of Patient with chronic lung diseases: asthma, COPD, cystic fibrosis.
pneumonia?
Why are cough suppressants not helpful in Because we WANT them to get that gunk out, we do not want them to hold
pneumonia patients? it in their lungs, an expectorant would be a better option for these patients.
When should a follow up chest X-Ray be completed Around 8 week mark
after treatment of pneumonia?
What is COPD? Chronic Obstructive Pulmonary Disease. This is a chronic condition that is
made up of chronic bronchitis and emphysema. It is a progressive
inflammatory lung disease that makes it hard for the patients to breathe,
because the chronic bronchitis leads to mucous build up and the
emphysema portion destroys areas of the lungs.
What signs and symptoms are common in COPD Chronic cough
patients? Sputum production
Dyspnea- difficulty breathing
,What signs and symptoms are specific to B12 Neurological symptoms, paresthesia (numbness and tingling in hands and
deficiency anemia? feet), unsteady gait, memory issues
Beefy red tongue
What diet can result in B12 deficiency? Vegan- oral supplements can be used for treatment
What surgery can result in B12 deficiency? Gastric surgery- patient will lose intrinsic factor that is required to absorb
B12- these patients will require life long IM B12 injections
What patient population is lupus commonly seen? Women of childbearing age- ages 15-45, African Americans are going to be
at higher risk
What is the diagnostic criteria for Lupus? Must have 4/11 diagnostic criteria:
Malar rash
Discoid rash
Photosensitivity
Oral/nasal ulcers
Non-erosive arthritis
Cardio-pulmonary complaints
Renal complaints
Neurological concerns
Immunological disorders
+ ANA test
Hematologic disorders
What is Sjogren's Syndrome and what is the Dry eyes and dry mouth- treatment revolves around symptom
treatment? management- artificial tears, hard candies, etc.
Common in lupus patients
What is a major concern for lupus patients? How do Impact on the kidneys- Lupus nephritis
we monitor this? Be on the look out for glomerularnephritis as well as proteinuria
These patients will require routine UA for assessment of their kidneys and
protect them
What is the function of the thyroid? Viral hormone gland
Metabolism regulation- impacts every SINGLE cell within the body
Proper growth and development across the entire lifespan
What produces TSH? Pituitary gland
What is the function of TSH? Tells your thyroid when to produce and release those critical thyroid
hormones- T3 and T4.
What disorders include hypothyroidism? Iodine deficiency, Hashimoto's, or thyroiditis
A presence of thyroid peroxidase antibodies Hypothyroidism is caused by an autoimmune process of some sort
indicates that?
What are some signs and symptoms of Weight gain, constipation, dry skin, cold intolerance, fatigue, course hair,
hypothyroidism? facial puffiness, thick tongue, and maybe some cardiac side effects
What patient education must be included regarding Must be taken on an empty stomach before other medications
Synthroid administration?
What are signs and symptoms of a myxedema Low body temperature, edema, confusion, lethargy, tongue thickening,
coma? difficulty breathing
What medications can precipitate myxedema coma? Lithium or amiodarone
, Your patient who is on 75 mcg Synthroid PO daily Assess how the patient is taking their Synthroid
comes in for a 6 week follow up to check their TSH
level. When you get the results, their TSH is 0.1.
What should you do next as the NP?
What signs and symptoms are common in Anxiety, palpitations, cardiac abnormalities, tachycardia, diaphoresis,
hyperthyroidism? weight loss, and increased appetite, menstrual irregularities, amenorrhea,
tremors, lid lag, exophthalmos
What needs to be considered with PTU medication Need frequent lab work: CBC, and Thyroid panel
administration? Required to take PTU multiple times a day
What is the most common treatment for Grave's Radioactive iodine therapy
Disease?
Hyperthyroidism left untreated may lead to what Heart disease- patient's heart is in a constant high-output state, your heart
conditions? can't keep up with that all of the time, may lead to heart failure
Osteoporosis
Infertility
What is worst case scenario in hyperthyroid Thyroid storm- Temperature, HR, and BP- dangerously HIGH levels
patients? Puts body into compromised state, especially impacting your heart. Heart
starts to go into Letha dysrhythmias and even heart failure.
What are the 8 most common drug classes for Biguanides (Metformin)
diabetes medications? DPP-4 inhibitors
GLP-1 Agonists
SGLT-2 inhibitors
Insulin
Sulfonylureas
TZDs
Alpha-glycosides inhibitors
Why are type 1 diabetics insulin dependent? They have an autoimmune destruction of their beta cells
What are some examples of rapid acting insulin? Humalog, Novalog, Apidra
What is the onset, peak, and duration of rapid acting Onset: 15 minutes
insulin? Peak: 1 hour
Duration: 2-4 hours
What are some examples of short acting insulin? Regular insulin (Humulin R, Novolin R)
What is the onset, peak and duration of short acting Onset: 30 min- 1 hour
insulin? Peak: 2-4 hours
Duration: 6-8 hours
What are some examples of intermediate insulin? NPH (Humulin N, Novolin N)
What is the onset, peak, and duration of intermediate Onset: 1-2 hours
insulin? Peak: 6-12 hours
Duration: 24 hours
What are some examples of long acting insulin? Lantus, Levemir
What is the onset, peak and duration of long acting Onset: 2 hours
insulin? Peak: NONE
Duration: 24 hours
What is truly our GO TO oral diabetes medication? Metformin (Biguanides)
