Leik - FNP review 2023 with questions and answers

Labs to order if Digoxin overload suspected electrolytes, creatinine, and serial EKG's First line for atrial fibrillation Coumadin. INR of 5 to 8 without bleeding hold for 1 to 2 doses, then recheck every 2 to 3 days until normal. Those taking thiazides may also find relief with osteoporosis. it stimulates formation of osteoclasts. Those taking thiazides can have which adverse effects hyperglycemia, hypokalemia, increased lipids, increased uric acid. Thiazides may worsen what conditions diabetes, gout, HPL, and electrolyte imbalances If a patient is allergic to sulfa what diuretic should they avoid thiazides. instead, use triamterene or amiloride Chlorhtalidone is longer acting and more potent than HCTZ. true or false? true who are loop diuretics prescribed to edema from heart failure, cirrhosis, renal disease, hypertension. black box warning for loop diuretics extreme diuresis Adverse effects of loop diuretics hypovolemia, loss of electrolytes, pancreatitis, jaundice, rash, ototoxicity What are aldosterone antagonists like spironolactone used for? hirsutism, hypertension, severe heart failure Adverse effect of spironolactone galactorrhea and hyperkalemia. black box warning for spironolactone increase of benign and malignant tumors. beta blockers are first line for post-myocardial infarction beta blockers are used for migraine prophylaxis, angina, arrythmias, hyperthyroidism cardioselective beta blockers include atenolol and metropolol beta blockres may cause what complication in diabetics they mask the hypoglycemic response. what are contraindications of beta blockers asthma, copd, bronchitis, emphysema, bradycardia A patient with an ace develops a cough. What should you do? stop and switch to an ARB for same renal protective effects. what to monitor when giving captopril CBC. it may cause neutropenia, leukopenia, and agranulocytosis the prescriber should be careful not to mix the calcium channel blocker verapamil with what antibiotics erythromycin and clarithromycin. Contraindications of giving calcium channel blockers av block, bradycardia, congestive heart failure grapefruit juice when taken with calcium channel blockers can cause toxicity. true or false? true drug interactions with calcium channel blockers intraconazole, macrolides when are alpha blockers given hypertension with co-existing BPH terazosin dosing 1 mg PO at bedtime a good alternative for gram positive infections in those who are penicillin allergic is macrolides. Clindamycin is associated with what infection C. diff Initial treatment of COPD antichollinergics. ipratropium bromide what antibiotics are pregnancy category D doxycycline, minocycline, tetracycline tetracyclines will not impact effectiveness of birth control pills. true or false? false 1st line for chlamydial infections and atypical bacteria doxycyline common side effect of minocycline dizziness and vertigo taking expired tetracycline may result in what medical conditions nephropathy and fanconni syndrome Macrolides are generally category B which macrolide are pregnancy category C clarithromycin and telithromycin Those with myasthenia gravis should not take which antibiotic? erythromycin and telithromycin. telithromycin has a black box warning azithromycin may interact with what atrial fibrillation medication? coumadin doxycycline has a common instruction not to take with food . why is this? it binds with iron, calcium, magnesium, and zinc. The instructions should really say not to take with dairy minocycilne may decrease the efficacy of contraceptives. true or false. true adverse effects of macrolide and tetracyclines include ototoxicity, GI distress, and twisting of points a patient has a history of jaundice. which macrolide antibiotic is contraindicated? telithromycin, or ketek macrolide can cause what cardiac anomaly prolonged QT and twisting of points Which generation cephalosporins have the broadest spectrum 3rd generation extended spectrum which generation of cephalosporins have the lowest gram negative coverage 3rd generation Cephalosporins appropriate for cellulitis and mastitis include Cephalexin, keflex. Cephalosporins appropriate for sinusitis and otitis media include Cefuroxime, cefprozil, and ceflacor. 2nd generations. ceftin, cefzil, and ceclor Cephalosporins appropriate for gram negative infections like neisseria gonorrhae include ceftriaxone, cefizime, and cefdinir. cephalosporins and penicillins will never kill what bacteria MRSA First line for otitis media amoxicillin first line for sinusitis amox clav first line for syphillis benzathine penicillin first line for gonorrhea cefitriaxone first line for MRSA bactrim or clindamycin for 5 to 10 days never use what antibiotic in mononucleosis amoxicillin dicloxacillin is for penicillinase producing staph skin infections like impetigo and mastitis avoid use of what drugs with the quinolone due to risk of cardiac adverse effects amiodarone, macrolides, TCA's, antipsychotics, or electrolyte imbalances children can have the quinolones. True or false? false, not for those under 18. giving antacids or sucralfate with the quinolones helps to reduce adverse effects. True or false. false, it actually reduces efficacy due to binding those with myasthenia gravis can take quinolone. True or false? false. travelers diarrhea ciprofloxacin 500 mg BID x 3 cutaneous anthrax ciprofloxacin 500 mg BID 7 to 10 days Bioterrorism related inhalation cipro 500 mg BID x 60 days first line for pseudomonas pneumonia ciprofloxacin. per the CDC, stop using cipro to treat what gonorrheal infection sulfonamides are active against gram negative sulfa type drugs include Cox-2, bactrim, furosemide, HCTZ, dapsone, glyburide, glipizide. Those with G6Pd would not take what antibiotic sulfonamides Contraindications for sulfonamides 3rd trimester pregnancy, G6PD, sulfa allergy Patients with a UTI on coumadin should not be treated with what antibiotic Bactrim, due to risk of bleeding The typical male presenting with G6PD presents with jaundice and was treated with what a sulfa drug. like Bactrim, a cox 2, HCTZ dextromethorphan is contraindicated within how many days of MAOI 14 what is given for PCP in HIV patients Bactrim a topical sulfa drug for burns sulfadiazine first line NSAID for those at high risk for GI bleed Cox 2 Aspirin irreversibly supresses platelet function for 7 days patient with tinnitus taking aspirin discontinue No need to taper prednisone if patient is not on chronic steroids Superpotent - class 1 clobetasol, temovate potent halocinomide, halog moderate triamcinolone, kenalog least potent hydrocortisone topical steroid occlusion for severe psoriatic plaques. apply super potent agent like clobetasol and cover in plastic. should not be used greater than 2 weeks. HPAA axis dysfunction septic joint do not inject steroids digoxin eye issue halo, blurred, yellow to green. needs eye exam ethambutal and linezolid eye issue optic neuropathy, needs eye exam corticosteroid eye issue cataract, glaucoma, optic neuritis. needs eye exam quinolone eye issue retinal detachment. viagra, cialis, levitra eye issue ischemic neuropathy, blurred vision, cataracts accutane eye issue decreased night vision, cataract topamax eye issue acute angle-closure glaucoma, increased ICP, mydriasis plaquenil eye issue neuropathy and permanent vision loss cisapride black box serious arrhythmia. v fib and tack. QT prolongation. twisting of points. need baseline EKG and serum electrolyte and creatinine theophylline level 5-15 sign of theophylline toxicity persistent vomiting Schedule 2 drugs demerol, dilaudid, oxycontin, amphetamine, cocaine schedule 3 drugs T3, vicodin, anabolic steroids, testosterone schedule 4 drugs benzos, lunesta, ambien schedule 5 drugs less than 200 mg codeine, lyrics, lomotiil schedule 6 drugs can be mailed to patient. some states allow lower level controlled drugs to be mailed category X drugs finasteride, accutane, coumadin, misoprostol, androgenic hormones, live virus vaccines, thalidomide, methomazole Proscar, finasteride category and dose Category X, 5 mg PO daily pregnancy protocol for accutane 2 forms of birth control, negative pregnancy test 1 month before, during, and 1 month after use avoid mixing warfarin with sulfa drugs for what reason? increases INR and bleeding risk saw palmetto BPH isoflavones estrogen like effects causes 75% of deaths from skin cancers melanoma mammogram annually 45 to 54 annually Mammogram every two years 55 and up Mammogram stop 75 cervical cancer stop screening 65 years unless risks like previous abnormalities colorectal cancer 50 to 75, then consider alternative screening until 85, then stop males, lipid disorder screening start 35 average risk. 20 to 35 if increased risk females, lipid disorder start 45. unless risk. then start 20 to 45 years skin cancer counseling ages 10 to 24 years avoid sunlight from 10 am to 4 pm depression screening age 12 to 18 years each visit obesity screen age 6 years breast cancer risks most common is age greater than 50. then long estrogen exposure. early menarche, late menopause, nulliparity cervical cancer risks early onset of sex, multiple partners, immunosupression, smoking. live attenuated flu vaccine ages 2 to 49 years antivirals avoided with flu for how long? 48 hours before and 14 days after the flu vaccine dirty wounds and tetanus give a booster if the last shot was more than 5 years prior age 7 years and older tetanus use only TD, and Tdap cannot give tetanus if what disorder guillain-barre syndrome what is done if a patient has a tetanus prone wound and the immunization status is unknown give TD shot and tetanus immunoglobulin injection do not give a shingles vaccine to someone who has no history of chicken pox or shingles. they will get it. shingles may cause exacerbation of what conditions asthma and polymyalgia rheumatica shingles contraindicated in who cancers and immunocompromise youngest age zostavax can be given 50 diagnosed with fluorescent dye. fern like lines on corneal surface herpes keratitis. infectious. corneal blindness dilated oval shaped pupils, cupping, nausea, halos acute angle closure glaucoma cauliflower ear, foul smelling, hearing loss, erosion of CN 7 cholasteatoma. life threatening, high mortality, sinus infection, severe headache and fever, rapid decline of consciousness cavernous sinus thrombosis. ER severe sore throat, hot potato voice peritonsillar abcess, needs I and D markedly swollen neck, low grade fever, gray to yellow pseudomembrane coats the pharynx diptheria hairy leukoplakia hairy like projections from edges of tongue. HIV infection. caused by EBV Herpes keratitis presentation herpetic rash on temple. secondary to shingles. needs zovirax. avoid steroid antibiotic for corneal abrasion erythromycin or polytrim. 3 to 5 days. follow up in 24 hours most common type of glaucoma. gradual. pressure greater than 22 primary open angle glaucoma. timolol. dont use beta blockers even if only in eyes for patients with asthma, copd, heart block, heart failure American cancer society breast cancer 40 years US preventive services task force breast cancer 50 years stop screening for cervical cancer 65 years colorectal cancer screening routine ages 50 to 75 colorectal cancer screening advanced ages 76 to 85 years individualize screening methods colorectal cancer screening stop 85 years FOBT testing must be 3 consecutive tests minimum fast for lipids 9 hours lipid screening ages to start 35 for males and 45 for females, consider 20 and up if risk for both genders