FNP (boards study review)
- ANS-
"Healthy People 2020" - ANS-1. Access to health care and stepped forward health are both
principal issues for fitness policy
2. Continuance of Healthy People, published in 1900 by means of america Department of
Health and Human Services
three. Goals:
a. Increase the excellent and years of healthful life
b. Eliminate fitness disparities among Americans
four. Document includes loads of health targets primarily based on numerous attention area
five. Objectives relate ti same get entry to, availability, value, high-quality of care, and so on.
6. Used to understand health status of the country and plan prevention applications
7. Individuals, communities, and companies are responsible for figuring out the way to meet
the desires of Healthy People 2020
Abcess - ANS-1. A localized series of PURULENT fluid
2. >2 cm in length
Abnormal Uterine Bleeding - ANS-1. Extremely heavy bleeding (variable duration)
2. Infrequent and irregular beeding
three. Presentation:
a. Oligomonerrhea: Infrequent, irregular, frequency > forty days
b. Polymenorrhea: frequent, irregular; frequency < 18 day
c. Menorrrhagia: Regular frequency however bleeding immoderate and extended
d. Metrorrhagia: Bleeding b/t cycles
e. Menometrorrhagia: Prolonged, frequent, immoderate, irregular bleeding
f. Intermenstrual: Variable amount b/t cycles
Diagnostic Test
1. Initial: HCG (quantitive) RO ectopic pregnancy
a. Prolactin
b. TSH
c. CBC
d. PAP
e. STD
f. Urinalysis
Abortion - ANS-Pregnancy termination at any time priorate viability (20 weeks) either via
spontaneous expulsion or clinical/surgical
Overview
,1. Approximately 15% of pregnancies will abort spontaneously; the majority losses inside the
first trimester are result of chromosomal abnormalities that arise randomly and do now not
repeat in next pregnancies
2. Losses in second trimester are because of cervical incompetence, contamination uterine
abnormalities
three. Almost half of of pregnancies are unplanned:optionally available abortion account for
50-60 abortion in step with a hundred births among unmarried girls
S/s
1. Vaginal bleeding (varies)
2. Cramping/pelvic-strain
3. Low returned ache
4.Rupture of membranes
five. Hemodynamic modifications in vital signs and symptoms if hemorrhaging
Diagnostic Test (spontaneous AB)
1. HCG stages
2. Ultrasound
3. CBC,tper, and RH
four. Coagulation profile wanted
Management
1. Surgical Abortion
a. Vacuum D and C: to twelve weeks
b. D and E: 13-14 weeks to 20-22 weeks
c. Hysterectomy/hysterectomy
2. Medical: Indicated via forty nine days being pregnant
a. Mifepristone (Mifeprex) AKA RU 486 = ABORTION
b. Prostaglandin (Misoprostol) GI drugs NSAID prompted prophalaxis
Abruptio Placentae - ANS-Separation of the placenta from the uterine wall, completely or
partially
1. Complete abruption is an obstetrical emergency and useless hospitalized at the time of
event, fetal loss of life is very possibly
2. Abruption normally takes place within the second or 0.33 trimesters and can be initiated
via a number of factors
three. Hemorrhage can be sudden and existence threatening to the mom
four. Uncontrolled hemorrhage will result in disseminated intravascular coagulation (DIC)
Etiology
,1. Unknown
2. * Recurrence rate 5:17% after one prevalence; 25% after 2 occurrences
three. Contributing factors:
a. Trauma (Kicked, steerage wheel rams into ABD)
b. Chronic high blood pressure/pre-eclampsia/eclampsia
c. Cocaine use
d. Alcohol, cigarette use
e. Uterine tumor or structural abnormality
S/s
1. **Severe ABD ache**
2. Bright purple bleeding is heavy if uncontrolled
3. May be minimum to mild bleeding if abruption is hid
four. Uterus is inflexible is hid abruption
5. Shock
6. Fetal misery/absent FHTs
Tests
1. Ultrasound to neighborhood placental implantation (Note: Ultrasound isn't aloe diagnostic
of abruption)
2. EFM to monitor for fetal distress
three. CBS, kind, and RH for transmission, coagulation profiles to reveal hemodynamic
adjustments
Management
1. Immediate transport and referral:
Physician control
2. If hemorrhage and fetal misery are gift, immediately transport whilst mother will become
solid
Acne - ANS-Open comedones (blackheads)
Closed comedones (whiteheads)
S/s
1. Pustules ans papules (pimples, pimples), at the face and torso
2. Comedones (blackheads, whiteheads)
three. **Cyst-refer (forestall fundamental intervention)
4. **Scarring-refer (stop fundamental intervention)
(Golden Rule Tip)- Least invasive, and least expensive to get to diagnosis or treatment first
Labs/diagnostics
1. None
Area: Face, Shoulders, chest and again
Management (start here first)
1. Non-pharmacologic treatment plans (wash numerous instances a day)
, 2. Avoid oils primarily based products
3. Use oil-loose cleaners and moisturizers
2. Pharmacologic dealers
a. Comedolytic sellers: effects after 90 days, lotions less hectic than gels
-benzoyl peroxide: Bacertialcidal (first line)
-Salicylic acid (Neutrogena), maximum not unusual
-Azelaic acid (Azelex)
-Tretinoin (Retin-A) growth danger for sunburn (preg category C)
-Tazarotene (Tazorac): steeply-priced Preg category X
b. Combination sellers (maximum common)
-Benzoyl peroxide + Erythromycin (Benzamycin) 2 frequent
-Benzoyl peroxide gel + Clindamycin (BenzaClin)
c. Topical anitbiotics
-Clindamycin (most frequently used topical
-Erythromycin (2d most often used)
-Tetracycline (Not commonly used
d. Oral antibiotics
-Tetracycline: Most widley prescribed; contraindicated in being pregnant < nine YOA
- Erythromycin
-Minocycline
-Doxycycline
-Clindamycin
e. Oral contraceptives
-Ortho Tri-Cyclin and:
-Estrostep
(can also cause melasma-hyperpigmentation brown bloches
-colasma-pigment exchange, masks-like appearance in pregnancy
f. Other treatment plans
- Periodic intralesional triamocinolone (Kenalog) injections
-Refer for debrasion
Isotretinoin (accutane) sever=refer
Acne Rosacea - ANS-Chronic and relapsing skin inflammatory (no remedy).
S/s
- Acne-like papules and pustules, typically pink head or blond or blue eyes
-Ocular signs and symptoms (pink eyes, dry eyes, or continual blephritis)
Classic Case:
Light-skinned person to older with Celtic background complains of continual and small
acne-like papules and pustules around the nose, mouth, and chin.
- ANS-
"Healthy People 2020" - ANS-1. Access to health care and stepped forward health are both
principal issues for fitness policy
2. Continuance of Healthy People, published in 1900 by means of america Department of
Health and Human Services
three. Goals:
a. Increase the excellent and years of healthful life
b. Eliminate fitness disparities among Americans
four. Document includes loads of health targets primarily based on numerous attention area
five. Objectives relate ti same get entry to, availability, value, high-quality of care, and so on.
6. Used to understand health status of the country and plan prevention applications
7. Individuals, communities, and companies are responsible for figuring out the way to meet
the desires of Healthy People 2020
Abcess - ANS-1. A localized series of PURULENT fluid
2. >2 cm in length
Abnormal Uterine Bleeding - ANS-1. Extremely heavy bleeding (variable duration)
2. Infrequent and irregular beeding
three. Presentation:
a. Oligomonerrhea: Infrequent, irregular, frequency > forty days
b. Polymenorrhea: frequent, irregular; frequency < 18 day
c. Menorrrhagia: Regular frequency however bleeding immoderate and extended
d. Metrorrhagia: Bleeding b/t cycles
e. Menometrorrhagia: Prolonged, frequent, immoderate, irregular bleeding
f. Intermenstrual: Variable amount b/t cycles
Diagnostic Test
1. Initial: HCG (quantitive) RO ectopic pregnancy
a. Prolactin
b. TSH
c. CBC
d. PAP
e. STD
f. Urinalysis
Abortion - ANS-Pregnancy termination at any time priorate viability (20 weeks) either via
spontaneous expulsion or clinical/surgical
Overview
,1. Approximately 15% of pregnancies will abort spontaneously; the majority losses inside the
first trimester are result of chromosomal abnormalities that arise randomly and do now not
repeat in next pregnancies
2. Losses in second trimester are because of cervical incompetence, contamination uterine
abnormalities
three. Almost half of of pregnancies are unplanned:optionally available abortion account for
50-60 abortion in step with a hundred births among unmarried girls
S/s
1. Vaginal bleeding (varies)
2. Cramping/pelvic-strain
3. Low returned ache
4.Rupture of membranes
five. Hemodynamic modifications in vital signs and symptoms if hemorrhaging
Diagnostic Test (spontaneous AB)
1. HCG stages
2. Ultrasound
3. CBC,tper, and RH
four. Coagulation profile wanted
Management
1. Surgical Abortion
a. Vacuum D and C: to twelve weeks
b. D and E: 13-14 weeks to 20-22 weeks
c. Hysterectomy/hysterectomy
2. Medical: Indicated via forty nine days being pregnant
a. Mifepristone (Mifeprex) AKA RU 486 = ABORTION
b. Prostaglandin (Misoprostol) GI drugs NSAID prompted prophalaxis
Abruptio Placentae - ANS-Separation of the placenta from the uterine wall, completely or
partially
1. Complete abruption is an obstetrical emergency and useless hospitalized at the time of
event, fetal loss of life is very possibly
2. Abruption normally takes place within the second or 0.33 trimesters and can be initiated
via a number of factors
three. Hemorrhage can be sudden and existence threatening to the mom
four. Uncontrolled hemorrhage will result in disseminated intravascular coagulation (DIC)
Etiology
,1. Unknown
2. * Recurrence rate 5:17% after one prevalence; 25% after 2 occurrences
three. Contributing factors:
a. Trauma (Kicked, steerage wheel rams into ABD)
b. Chronic high blood pressure/pre-eclampsia/eclampsia
c. Cocaine use
d. Alcohol, cigarette use
e. Uterine tumor or structural abnormality
S/s
1. **Severe ABD ache**
2. Bright purple bleeding is heavy if uncontrolled
3. May be minimum to mild bleeding if abruption is hid
four. Uterus is inflexible is hid abruption
5. Shock
6. Fetal misery/absent FHTs
Tests
1. Ultrasound to neighborhood placental implantation (Note: Ultrasound isn't aloe diagnostic
of abruption)
2. EFM to monitor for fetal distress
three. CBS, kind, and RH for transmission, coagulation profiles to reveal hemodynamic
adjustments
Management
1. Immediate transport and referral:
Physician control
2. If hemorrhage and fetal misery are gift, immediately transport whilst mother will become
solid
Acne - ANS-Open comedones (blackheads)
Closed comedones (whiteheads)
S/s
1. Pustules ans papules (pimples, pimples), at the face and torso
2. Comedones (blackheads, whiteheads)
three. **Cyst-refer (forestall fundamental intervention)
4. **Scarring-refer (stop fundamental intervention)
(Golden Rule Tip)- Least invasive, and least expensive to get to diagnosis or treatment first
Labs/diagnostics
1. None
Area: Face, Shoulders, chest and again
Management (start here first)
1. Non-pharmacologic treatment plans (wash numerous instances a day)
, 2. Avoid oils primarily based products
3. Use oil-loose cleaners and moisturizers
2. Pharmacologic dealers
a. Comedolytic sellers: effects after 90 days, lotions less hectic than gels
-benzoyl peroxide: Bacertialcidal (first line)
-Salicylic acid (Neutrogena), maximum not unusual
-Azelaic acid (Azelex)
-Tretinoin (Retin-A) growth danger for sunburn (preg category C)
-Tazarotene (Tazorac): steeply-priced Preg category X
b. Combination sellers (maximum common)
-Benzoyl peroxide + Erythromycin (Benzamycin) 2 frequent
-Benzoyl peroxide gel + Clindamycin (BenzaClin)
c. Topical anitbiotics
-Clindamycin (most frequently used topical
-Erythromycin (2d most often used)
-Tetracycline (Not commonly used
d. Oral antibiotics
-Tetracycline: Most widley prescribed; contraindicated in being pregnant < nine YOA
- Erythromycin
-Minocycline
-Doxycycline
-Clindamycin
e. Oral contraceptives
-Ortho Tri-Cyclin and:
-Estrostep
(can also cause melasma-hyperpigmentation brown bloches
-colasma-pigment exchange, masks-like appearance in pregnancy
f. Other treatment plans
- Periodic intralesional triamocinolone (Kenalog) injections
-Refer for debrasion
Isotretinoin (accutane) sever=refer
Acne Rosacea - ANS-Chronic and relapsing skin inflammatory (no remedy).
S/s
- Acne-like papules and pustules, typically pink head or blond or blue eyes
-Ocular signs and symptoms (pink eyes, dry eyes, or continual blephritis)
Classic Case:
Light-skinned person to older with Celtic background complains of continual and small
acne-like papules and pustules around the nose, mouth, and chin.
