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Family Nurse Practitioner Certification Intensive Review 3rd Edition, Leik, 2018 | Nurse Practitioner (NP) School Study Aid
Myocardial Infarction Assessment
- Assessment
- Substernal Chest Pain
- Crushing or Dull Sensation
- Arm, Jaw, and Neck
- > 20 Minutes
- Unrelieved by Nitro
- Palpitations
- Diaphoresis
- Fear of Impending Doom
- Nausea and Vomiting
- Shortness of Breath
- Considerations
- Monitor for Arrhythmias
2 mins
Myocardial Infarction Diagnosis
- Diagnosis
- 12 Lead ECG
- ST Elevation
- Q Wave
- T Wave Inversion
- Troponin T and I
- CK-MB
- Considerations
- Early ECG
- Cardiac Stress Test
2 mins
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Types of Heart Failure
- Left Sided
- Pulmonary Congestion
- Right Sided
- Peripheral Edema
- High Output
- Unable to Meet Metabolic Needs
1 min
Bacterial Endocarditis
- Signs and Symptoms
- Fever
- New murmur
- Janeway Lesions
- Splinter Hemorrhages
- Roth spots/round white spots on retina
- Osler nodes/tender lesions on finger or toe pads
- Anemia
2 mins
Endocarditis Interventions
- Interventions
- IV Antibiotics
- 4-6 Weeks
- Anticoagulants
- Good Hygiene
- Considerations
- Closely Monitor
- Antibiotic Prophylaxis
- Dental Procedures
- Invasive Procedures
1 min
Abdominal Aortic Aneurysm
- Screening
- Screen Males 65-75 Who've Ever Smoked
- Diagnosis
- Ultrasound
- Treatment
- Observation
- Asymptomatic and < 5 cm in Size
- Surgical Repair
- > 5.5 cm in Abdomen
- Emergent Surgery
- Ruptured or Symptomatic
2 mins
Abdominal Aortic Aneurysm (AAA) Assessment
- Mechanism
- Atherosclerosis
- Assessment
- Bruit
- Pulsation in Abdomen
- Abdominal or Lower Back Pain
- Tearing Pain
- Diagnosis
- Ultrasound
- Considerations
- Rupture
- Shock
- Surgical Repair
1 min
Anaphylaxis Intervention
- Intervention
- Assess Airway and Oxygen Needs
- Reassure Patient with Anxiety
- Supine Position
- Methylprednisolone (Solu-medrol)
- Epinephrine
- Diphenhydramine (Benadryl)
- Medical Alert Bracelet
2 mins
Stevens-Johnson Syndrome
- Etiologies
- Drugs
- Symptoms
- < 10% of Body Surface Area (BSA) Involved
- 10-30% BSA Overlaps with Toxic Epidermal Necrolysis (TEN)
- Fever
- Affects Skin and Mucous Membranes
- Bullae Formation
- Necrosis
- Sloughing of Skin
- High Mortality Rate
- Treatment
- Supportive Care
- IVIG (Intravenous Immunoglobulin)
3 mins
Rocky Mountain Spotted Fever
- Rickettsia rickettsii
- Dermacentor Wood Tick
- Endemic to East Coast
- Fever
- Headache
- Rash Starts on Wrist and Ankle
- Rash migrates towards the trunk
- Thrombocytopenia
- Hyponatremia
- Elevated liver enzymes
59 secs
Lyme Disease
- Mechanism
- Transmitted by Ticks (Vector-borne)
- Signs and Symptoms
- Flu-like Symptoms
- Bulls Eye Rash (Erythema Migrans)
- Joint Pain and Stiffness
- Facial Paralysis
- Considerations
- Antibiotics
- Prevention
2 mins
Varicella Zoster Virus (VZV)
- Herpesvirus 3
- Characteristics
- Enveloped
- Double Stranded DNA
- Signs and Symptoms
- Chickenpox
- Pneumonia
- Encephalitis
- Trigeminal and Dorsal Root Ganglia
- Shingles
- Diagnosis
- Tzanck Test
- Multinucleated Giant Cells
- Cowdry A Inclusion
- Treatment
- Acyclovir
2 mins
Melanoma Mechanism and Characteristics
- Mechanism
- Associated with Sunlight Exposure
- Mutation in B-RAF kinase
- Large Number of Moles
- Fair-Skinned People at Higher Risk
- Growth Phases
- Radial Growth Phase
- No Metastasis
- Vertical Growth Phase
- Depth of Tumor Correlates with Risk of Metastasis
1 min
Types of Malignant Melanoma
- Superficial Spreading
- Most Common Cause of Melanoma
- Nodular
- Aggressive and Rapidly Arising
- Acral-Lentiginous
- Males
- Asians and African Americans
- Lentigo Maligna
- Geographic Shape
- Sun Exposed Areas
2 mins
Melanoma Diagnosis
- Signs
- ABCDE Mnemonic
- Asymmetry
- Border irregularity
- Color variation
- Diameter > 6mm
- Evolution over time
- Diagnosis
- S-100 Tumor Marker
- LDH (Lactate Dehydrogenase) Screens for Metastasis
- Treatment
- Wide Local Excision
- Adjuvant Therapy
1 min
Basal Cell Carcinoma of the Skin
- Pathophysiology
- Most Common Skin Cancer
- 2/3 of Cases Due to UV Light Exposure
- Pink, Pearl-like Lesions
- Rolled Borders
- Telangiectasias
- Commonly Upper Lip
- Diagnosis
- Shave Biopsy
- Pallisading Nuclei
- Treatment
- Mohs Micrographic Surgery
2 mins
Appendicitis
- Mechanism and Characteristics
- Fecalith leading to obstruction and infection
- Most commonly affects teenagers
- Presentation
- Initial peri-umbilical visceral pain
- Subsequent somatic right lower quadrant pain
- Diagnosis
- Rebound tenderness
- Positive psoas sign
- Pain at McBurney's point
- Leukocytosis
- Fever
- Treatment
- Appendectomy
1 min
Acute Appendicitis Treatment
- Diagnosis
- CT Scan
- Treatment
- Immediate Appendectomy
- NPO
- IV Fluids
- Antibiotics
- Perforation
- Tertiary Intention
- Antibiotics Until Afebrile
2 mins
Acute Pancreatitis Disease
- Autodigestion of Pancreas by Pancreatic Enzymes
- Symptoms
- Epigastric Abdominal Pain Radiating to Back
- Anorexia
- Nausea
- Labs
- Increased Amylase and Lipase
- Complications
- Disseminated Intravascular Coagulation (DIC)
- Infection
- Hypocalcemia
- Systemic Inflammatory Response Syndrome (SIRS)
- Acute Respiratory Distress Syndrome (ARDS)
- Pancreatic Pseudocyst
- Hemorrhage
3 mins
Diverticulosis and Diverticulitis Assessment
- Diverticulosis
- Outpouching
- Diverticulitis
- Inflamed Diverticula
- Assessment
- Abdominal Pain
- Abdominal Distention
- Flatulence
- Fever
- Rectal Bleeding
- Alternating Constipation and Diarrhea
- Considerations
- Peritonitis
2 mins
Diverticulosis and Diverticulitis Interventions
- Interventions
- High Fiber Diet
- Reduce Intra-abdominal Pressure
- Stool Softeners
- Exercise
- Anticholinergics
- Considerations
- Antibiotics
- Bowel Resection
2 mins
Cholecystitis Causes
- Gallbladder Inflammation
- 6 Fs
- Female
- Fair (Caucasian)
- Fat (Obese)
- Fertile (Pregnant)
- Forty (Advanced Age Over 40)
- Flatulence
2 mins
Cholecystitis Assessment
- RUQ Pain
- Referred Shoulder Pain
- Clay Colored Stools
- Jaundice
- Nausea and Vomiting
- Dyspepsia (Indigestion)
- Fever
- Considerations
- Increased WBCs
- Fatty or Spicy Foods
- Ultrasound
2 mins
Cholecystitis Interventions
- Supportive Therapy
- Antibiotics
- Low Fat Diet
- NG Tube
- Analgesics
- Lithotripsy
- Cholecystectomy
- T Tube
2 mins
Clostridioides difficile (Clostridium difficile)
- Characteristics
- Gram-Positive
- Bacillus
- Anaerobe
- Clindamycin and Ampicillin
- Toxin A Enterotoxin
- Damages Brush Border of Gut
- Toxin B Cytotoxin
- Damages Cytoskeletal Structure
- Signs and Symptoms
- Diarrhea
- Pseudomembranous Colitis
- Toxic Megacolon
- Diagnosis
- Detect Toxins in Stool
- Treatment
- Metronidazole
- Vancomycin
3 mins
Clostridium difficile (Clostridioides difficile) Treatments
- Oral Vancomycin
- Fidaxomicin
- Metronidazole
- Stool Transplant
2 mins
Testicular Carcinoma Assessment
- Cause/Mechanism
- Seminoma Germ Cells
- Non-Seminoma Germ Cells
- Assessment
- Painless Scrotal Mass
- Testicular Swelling
- Acute Pain Rare
- Elevated Serum Tumor Markers
- Considerations
- Males Between 15-35 Years Old
- Cryptorchidism
- Testicular Self Exam
2 mins
Prostate Cancer Assessment
- Most Common Cancer in Men
- Assessment
- Mimics BPH
- Metastasis to Back
- Low Back Pain
- Fatigue
- Considerations
- Prostate Specific Antigen (PSA)
- Digital Rectal Examination (DRE)
- Transrectal Ultrasound (TRUS)
- Biopsy
2 mins
Depression Assessment
- Physical Changes
- Anergia
- Self Neglect
- Decreased Libido
- Vegetative Signs
- Mood
- Sad Affect
- Worthlessness
- Guilt
- Anger and Irritability
- Cognitive
- Ineffective Problem Solving
- Slowed Thinking
1 min
Suicide Risk Factors
- Depression
- Previous Attempt
- No Support System
- Access to Firearms or Medications
- Substance Abuse
- Physical or Sexual Abuse
- Chronic Illness or Pain
- Extremes of Age
2 mins
Suicide Assessment
- SAD PERSONS Scale
- Verbal Cues
- Direct (Overt) Statements
- Indirect (Covert) Statements
- Behavioral Cues
- Giving Away Prized Possessions
- Sudden Improvement in Mood
- Putting Personal Affairs in Order
- Lethality of Plan
- Detail of Plan
- Availability of Means
- Proposed Method
- Suicide Precautions
- Safe Environment
- One-on-One Monitoring
- No Suicide Contract
2 mins
Neuroleptic Malignant Syndrome
- FEVER Acronym
- Fever
- Encephalopathy
- Vital Signs Unstable
- Elevated Enzymes
- Rigidity of muscles
- Reversal Agent
- D2 Agonists
- Bromocriptine
- Dantrolene
2 mins
Temporal Arteritis
- Giant Cell Arteritis
- Granulomatous
- Old Females
- Clinical Features
- Polymyalgia Rheumatica
- Unilateral Headache
- Jaw Claudication
- Blindness
- Lab Findings
- Increased ESR
- Normal Serum Creatine Kinase
- Treatment
- Steroids
2 mins
Subarachnoid Hemorrhage
- Bleeding into Subarachnoid Space
- Mechanisms
- Trauma
- Aneurysm Rupture
- AVM Rupture
- Vasospasm causes Ischemia
- Signs & Symptoms
- "Worst Headache Of My Life"
- Diagnosis
- Noncontrast Head CT
- Lumbar Puncture
- Angiography
- Considerations
- Surgery
- Blood Pressure Control
- Intracranial Pressure Control
- Nimodipine for Vasospasm Prophylaxis
3 mins
Meningitis Assessment
- Assessment
- Nausea and Vomiting
- Fever
- Nuchal Rigidity
- Severe Headache
- Purpura
- Seizures
- Photophobia
- Infants and Young Children
- Opisthotonus Position
- High-Pitched Cry
- Bulging Fontanel
2 mins
Meningitis Interventions
- Drug Therapy
- IV Antibiotics
- Dexamethasone
- Analgesics
- Antipyretics
- Considerations
- Closely Monitor for Increased ICP
- Bed Rest
- Preventative Vaccinations
- Droplet-Airborne Precautions
2 mins
Subdural Hematoma
- Mechanism
- Tear of Bridging Veins
- Slow Bleeding, Over Time
- Imaging
- Subdural Space
- Crescent-shaped on CT
- Crosses Suture Lines
- Midline Shift
- Causes
- Elderly
- Whiplash
- Abusive Head Trauma (Shaken Baby Syndrome)
2 mins
Detached Retina
- Assessment
- Flashes of Light
- Floaters
- Curtain Like Shadow
- Interventions
- Eye Patch
- Bed Rest
- Surgical Emergency
- Considerations
- No Vigorous Activity
2 mins
