NRNP 6566 week 6 knowledge check.
• Question 1
A 54 year old female has a 30 year pack smoking history. She recently underwent
pulmonary function testing which showed moderate obstructive lung disease. What
would your treatment plan (including medications) include for this patient?
Correct
Answer: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020
suggests that smoking cessation should be immediately pursued if the patient
is still smoking. Nicotine replacement (gum, inhaler, nasal spray, patch,
lozenge, or sublingual tablet) are reliable methods to assist in long term
smoking cessation. Varenicline, bupropion, and nortriptyline also increase long
term quit rates but should be one part of an intervention program and not the
sole intervention. Professional counseling and support have a positive impact
on smoking cessation.
Bronchodilators are the baseline medication for COPD patients. Patients can
be initiated on short acting beta agonists (SABA) or long term beta agonists
(LABA) based on their symptoms. Short acting medications come in various
forms including inhaler, nebulizer, pills, or liquid syrup. Long acting
bronchodilators are delivered via inhaler or nebulizer. Combinations of SABA
and LABA s are common in treatment plans for COPD patients. LABA have a
duration of action of 12 hours while SABA last for about 4-6 hours. SABA can
provide immediate symptom relief.
• Question 2
A 23-year-old male with Type 1 diabetes presents to the ER complaining of fatigue and
malaise. He tells you he has skipped his insulin injections the previous two days. His labs
are:
PH 7.10 Na 140 BUN 35
PCO2 10 K 4.1 Crt 1.1
PO2 112 Cl 105 BS 845
HCO3 4 CO2 5 + ketonemia
What is this patient's acid base status? What is your working diagnosis for this patient?
Correct
Answer: Metabolic acidosis with respiratory alkalosis
pH is low Normal HCO3 is 22-26 so 4 is low causing acidosis
Leading diagnosis – Diabetic Ketoacidosis
, Anion gap is elevated at 31
• Question 1
A 54 year old female has a 30 year pack smoking history. She recently underwent
pulmonary function testing which showed moderate obstructive lung disease. What
would your treatment plan (including medications) include for this patient?
Correct
Answer: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020
suggests that smoking cessation should be immediately pursued if the patient
is still smoking. Nicotine replacement (gum, inhaler, nasal spray, patch,
lozenge, or sublingual tablet) are reliable methods to assist in long term
smoking cessation. Varenicline, bupropion, and nortriptyline also increase long
term quit rates but should be one part of an intervention program and not the
sole intervention. Professional counseling and support have a positive impact
on smoking cessation.
Bronchodilators are the baseline medication for COPD patients. Patients can
be initiated on short acting beta agonists (SABA) or long term beta agonists
(LABA) based on their symptoms. Short acting medications come in various
forms including inhaler, nebulizer, pills, or liquid syrup. Long acting
bronchodilators are delivered via inhaler or nebulizer. Combinations of SABA
and LABA s are common in treatment plans for COPD patients. LABA have a
duration of action of 12 hours while SABA last for about 4-6 hours. SABA can
provide immediate symptom relief.
• Question 2
A 23-year-old male with Type 1 diabetes presents to the ER complaining of fatigue and
malaise. He tells you he has skipped his insulin injections the previous two days. His labs
are:
PH 7.10 Na 140 BUN 35
PCO2 10 K 4.1 Crt 1.1
PO2 112 Cl 105 BS 845
HCO3 4 CO2 5 + ketonemia
What is this patient's acid base status? What is your working diagnosis for this patient?
Correct
Answer: Metabolic acidosis with respiratory alkalosis
pH is low Normal HCO3 is 22-26 so 4 is low causing acidosis
Leading diagnosis – Diabetic Ketoacidosis
, Anion gap is elevated at 31
