UTA NURS 5338 Urgent Emergencies Study Guide: Acute Care and Rapid
Response Review
Describe the pharmacological treatment for gonorrhea - ANS ✔✔Ceftriaxone 500 mg IM as a
single dose, for persons weighing < 150 kg
For persons weighing > 150 kg, ceftriaxone 1gm IM as a single dose
Describe the pharmacological treatment for chlamydia - ANS ✔✔Doxycycline 100 mg PO BID for
7 days
During pregnancy, azithromycin 1 gm as a single dose to treat chlamydia
Alternative regimens:
Gentamicin 240 mg IM as a single dose + azithromycin 2 gm PO as a single dose
Cefixime 800 mg orally as a single dose + doxycycline 100 mg PO BID for 7 days (if chlamydia
CANNOT be excluded)
When assessing a patient, what is done first? - ANS ✔✔- Observe
- Inspect
- Listen
- Palpate, respectively
Describe assessment findings for appendicitis - ANS ✔✔Abdominal pain, usually severe;
localized to the right lower quadrant (RLQ)
Most common symptoms: anorexia, abdominal pain, nausea and vomiting (typically present in
this order)
Constipation and diarrhea occur after the pain
Describe acute abdominal pain - ANS ✔✔- severe, persistent pain
- sudden onset
,- nausea, vomiting
- abdominal distention
- fever, signs of shock
What is obturator sign? - ANS ✔✔- The patient lies on the back with hip and knee flexed at 90
degrees while the knee is stabilized and the ankle rotated away from the body
How is sepsis handled in the primary care setting? - ANS ✔✔refer patient to the ED
Describe treatment for an abscess - ANS ✔✔I&D
Describe assessment findings for cellulitis - ANS ✔✔Erythema
Warmth
Edema
Pain
Fever
Lymphadenopathy
Fissuring, scaling or maceration in toe webs may be source of colonization (treat with antifungal
agents such as econazole, naftifine)
History of recurrent abscesses
How is a puncture wound from an animal bite treated? - ANS ✔✔- typically not sutured closed
- treat with Augmentin
Describe assessment findings for bacterial vaginosis - ANS ✔✔Most women with BV are
asymptomatic
Fishy or musty vaginal odor, more prominent after sexual intercourse and menses
, Thin, homogenous discharge
No redness or edema
Normal bimanual exam
Describe the diagnostic study for bacterial vaginosis - ANS ✔✔Amsel's criteria specify that
diagnosis of BV requires three or more of the following clinical signs and symptoms:
- Homogenous, thin, gray-white discharge coating the vaginal wall
- Vaginal pH >4.5
- Positive whiff test: amine (fishy) odor after application of 10% KOH on vaginal discharge
sample
- Presence of more than 20% epithelial cells (clue cells) on saline microscopy: microscopic
evaluation of vaginal discharge on glass slide with normal saline shows few WBCs, and epithelial
cells are obscured with coccobacilli.
What is the most reliable predictor of bacterial vaginosis? - ANS ✔✔Presence of clue cells
identified by an experienced microscopist is the single most reliable predictor of BV
For hematuria caused by an STI, when should follow up scheduled? - ANS ✔✔one week
Describe assessment findings for acute bronchitis - ANS ✔✔Cough: dry and nonproductive,
then productive; may be purulent
URI symptoms
Fatigue
Fever due to bacterial infection; more common in smokers and patients with COPD
Fever due to viral cause (unusual after first few days)
Burning sensation in chest
Crackles, wheezes
Chest wall pain
Response Review
Describe the pharmacological treatment for gonorrhea - ANS ✔✔Ceftriaxone 500 mg IM as a
single dose, for persons weighing < 150 kg
For persons weighing > 150 kg, ceftriaxone 1gm IM as a single dose
Describe the pharmacological treatment for chlamydia - ANS ✔✔Doxycycline 100 mg PO BID for
7 days
During pregnancy, azithromycin 1 gm as a single dose to treat chlamydia
Alternative regimens:
Gentamicin 240 mg IM as a single dose + azithromycin 2 gm PO as a single dose
Cefixime 800 mg orally as a single dose + doxycycline 100 mg PO BID for 7 days (if chlamydia
CANNOT be excluded)
When assessing a patient, what is done first? - ANS ✔✔- Observe
- Inspect
- Listen
- Palpate, respectively
Describe assessment findings for appendicitis - ANS ✔✔Abdominal pain, usually severe;
localized to the right lower quadrant (RLQ)
Most common symptoms: anorexia, abdominal pain, nausea and vomiting (typically present in
this order)
Constipation and diarrhea occur after the pain
Describe acute abdominal pain - ANS ✔✔- severe, persistent pain
- sudden onset
,- nausea, vomiting
- abdominal distention
- fever, signs of shock
What is obturator sign? - ANS ✔✔- The patient lies on the back with hip and knee flexed at 90
degrees while the knee is stabilized and the ankle rotated away from the body
How is sepsis handled in the primary care setting? - ANS ✔✔refer patient to the ED
Describe treatment for an abscess - ANS ✔✔I&D
Describe assessment findings for cellulitis - ANS ✔✔Erythema
Warmth
Edema
Pain
Fever
Lymphadenopathy
Fissuring, scaling or maceration in toe webs may be source of colonization (treat with antifungal
agents such as econazole, naftifine)
History of recurrent abscesses
How is a puncture wound from an animal bite treated? - ANS ✔✔- typically not sutured closed
- treat with Augmentin
Describe assessment findings for bacterial vaginosis - ANS ✔✔Most women with BV are
asymptomatic
Fishy or musty vaginal odor, more prominent after sexual intercourse and menses
, Thin, homogenous discharge
No redness or edema
Normal bimanual exam
Describe the diagnostic study for bacterial vaginosis - ANS ✔✔Amsel's criteria specify that
diagnosis of BV requires three or more of the following clinical signs and symptoms:
- Homogenous, thin, gray-white discharge coating the vaginal wall
- Vaginal pH >4.5
- Positive whiff test: amine (fishy) odor after application of 10% KOH on vaginal discharge
sample
- Presence of more than 20% epithelial cells (clue cells) on saline microscopy: microscopic
evaluation of vaginal discharge on glass slide with normal saline shows few WBCs, and epithelial
cells are obscured with coccobacilli.
What is the most reliable predictor of bacterial vaginosis? - ANS ✔✔Presence of clue cells
identified by an experienced microscopist is the single most reliable predictor of BV
For hematuria caused by an STI, when should follow up scheduled? - ANS ✔✔one week
Describe assessment findings for acute bronchitis - ANS ✔✔Cough: dry and nonproductive,
then productive; may be purulent
URI symptoms
Fatigue
Fever due to bacterial infection; more common in smokers and patients with COPD
Fever due to viral cause (unusual after first few days)
Burning sensation in chest
Crackles, wheezes
Chest wall pain
