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Nurse Practitioner Certification Examination and Practice Preparation 4th Edition, Fitzgerald, 2015/
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Nurse Practitioner Certification Examination and Practice Preparation 4th Edition, Fitzgerald, 2015 | Nurse Practitioner (NP) School Study Aid
Asthma
- Obstructive lung disease
- Bronchial Hyperresponsiveness
- History of Atopic Disease
- Beta2 agonists
- Corticosteroids
- Curschmann's spirals
- Hypertrophy of smooth muscle
- Reversible
- Charcot Leyden crystals
- Methacholine challenge
- Wheezing
- Cough
- Initially decreased PaCO2
- Pulsus paradoxus
2 mins
Persistent Severe Asthma
- Diagnosis
- Symptoms (Bronchoconstriction) and Rescue Inhaler Use: Multiple/ Day
- With Minimal Activity
- Nighttime Awakening: Nightly
- < 60% Predicted FEV1
- > 5% Decrease FEV1/FVC
2 mins
Stages of Asthma Treatments
- Mild Intermittent
- Short-acting Inhaled Beta-Agonist
- Mild Persistent
- Low-Dose Inhaled Corticosteroid
- Montelukast (Leukotriene Receptor Antagonist)
- Moderate Persistent
- Low to Medium-dose Inhaled Corticosteroid
- Zileuton
- Severe Persistent
- High-Dose Inhaled Corticosteroid
- Systemic Corticosteroids
- Omalizumab (Allergies)
2 mins
Asthma Implementation and Education
- Medication
- Oxygen
- Corticosteroids
- Ipratropium (Anticholinergic)
- Albuterol
- Implementation
- Inhaler/nebulizer
- Pulse Oximetry
- Pursed Lip Breathing
- Education
- Carry Inhaler
- Rinse Mouth after Inhaler
- Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
2 mins
Intermittent Asthma
- Diagnosis
- Symptoms (Bronchoconstriction) and Rescue Inhaler Use ≤ 2 / Week
- No Interference With ADLs
- Nighttime Awakening < 2 / Month
- > 80 % of Predicted FEV1
1 min
Persistent Mild Asthma
- Diagnosis
- Symptoms (Brochoconstriction) and Rescue Inhaler Use > 2 Days / Week
- Nighttime Awakening 3-4 / Month
- Greater or equal to 80 % of Predicted FEV1
1 min
Persistent Moderate Asthma
- Diagnosis
- Symptoms (Bronchoconstriction) and Rescue Inhaler Use Daily
- Nighttime Awakening > 1 / Week
- 60-80% Predicted FEV1
- FEV1/FVC Decreased 5%
2 mins
Montelukast (Singulair)
- Mechanism
- Leukotriene Receptor Blocker
- Indications
- Allergic Rhinitis
- Asthma Prophylaxis
- Exercise Induced Bronchospasm
- Side Effects
- Fatigue
- Headache
- Mood Changes
- Suicidal Thoughts
- Considerations
- Increased Risk of Churg Strauss
2 mins
Prednisone (Glucocorticoids)
- Mechanism
- Glucocorticoid
- Indications
- Inflammatory Conditions
- Organ Transplant Rejection
- Side Effects
- Cataracts and Glaucoma
- Cushing's Syndrome
- Osteoporosis
- Immunosuppression
- Hyperglycemia
- Ulcers
- Considerations
- Adrenal Insufficiency
- Taper Gradually
2 mins
Albuterol (Proventil)
- Mechanism
- Short-Acting Beta-2 Agonist
- Indications
- Bronchospasm
- Asthma
- Side Effects
- Angina
- Tachycardia
- Tremor
1 min
Cromolyn (Mast Cell Stabilizers)
- Mechanism
- Mast Cell Stabilizer
- Indications
- Asthma Prophylaxis
- Bronchial Inflammation
- Allergic Rhinitis
- Side Effects
- Cough
- Bronchospasm
- Consideration
- Fixed Schedule Administration
2 mins
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
- Causes
- Inhaled Toxins
- Smoking
- AAT Deficiency
- Assessment
- Emphysema
- Chronic Bronchitis
- Asthma
- Considerations
- Spirometry
- Slow Progression
2 mins
Theophylline
- Indications
- Asthma
- Mechanism
- Inhibits Phosphodiesterase
- Increases cAMP
- Side Effects
- Cardiotoxicity
- Neurotoxicity
- Blocks Adenosine Action
53 secs
Pneumonia Assessment
- Risk Factors
- Older Adult
- Immunocompromised
- Long Term Care
- Assessment
- Shortness of Breath (SOB)
- Hypoxemia
- Cough and Sputum Production
- Wheezing or Crackles
- Fever
- Pleuritic Pain
- Diagnosis
- Chest X-ray
2 mins
Pneumonia Intervention
- Interventions
- Humidified Oxygen
- Deep Breathing Exercises
- Position of Comfort
- Increase Fluid Intake
- Manage Fever
- Medications
- Antibiotics
- Mucolytics
- Expectorants
- Considerations
- Pneumococcal Vaccine
- Sepsis
- Acute Respiratory Failure (ARF)
- Prevention Education
2 mins
Mycobacterium Tuberculosis Characteristics
- Characteristics
- Mycolic Acid Cell Wall
- Acid-fast
- Carbolfuchsin Stain Red
- Lowenstein-Jensen Agar
- Serpentine Cord Factor
- Primary TB
- Primary TB
- Caseating Granuloma
- Ghon Focus
- Hilar Lymph Nodes
- Ghon Complex
- Reactivation TB
- Reactivation TB
- Reactivation in Apex
3 mins
Mycobacterium Tuberculosis Disease
- CONSTITUTIONAL SYMPTOMS/PULMONARY TUBERCULOSIS
- Fever
- Night Sweats
- Weight Loss
- Hemoptysis
- EXTRA-PULMONARY TUBERCULOSIS
- Extrapulmonary Disease
- Addison's Disease
- CNS
- Liver
- Kidneys
- GI
- Bones
- Pott's Disease
3 mins
Tuberculosis Intervention
- Hospital Care
- Airborne Isolation
- Drug Therapy
- Combination Drug Therapy (RIPE)
- 6-12 Months
- Considerations
- DOT
- BCG Vaccination
- Medication Education
- 3 Negative Sputum Specimens
- Infection Control
2 mins
Tuberculosis Skin Mantoux Test (PPD)
- Delayed Hypersensitivity (Cell Mediated Response)
- Intradermal Injection
- Read 48-72 hours
- Positive Results
- ≥ 5 mm Induration
- Immunosuppressed
- ≥ 10 mm Induration
- High Risk Patients
- ≥ 15 mm Induration
- Considerations
- Chest X-Ray
3 mins
Common Causes of Pneumonia: Children (4 Weeks - 18 Years)
- Runts May Cough Chunky Sputum
- RSV (Viruses)
- Mycoplasma
- Chlamydia pneumoniae
- Chlamydia trachomatis
- Streptococcus pneumoniae
1 min
Common Causes of Pneumonia: Adults (18 - 40 Years Old)
- Mycoplasma
- Streptococcus pneumoniae
- Chlamydia pneumoniae
41 secs
Common Causes of Pneumonia: Elderly (65+ Years Old)
- Influenza Virus
- Haemophilus influenzae
- Anaerobes
- Streptococcus pneumoniae
- Gram-Negative Rods
59 secs
Rifampin
- Tuberculosis (TB)
- Blocks RNA Polymerization
- Haemophilus influenzae Type B
- Leprosy
- Meningitis
- P450 inducer
- Red-orange urine
55 secs
Common Causes of Pneumonia: Middle-Aged Adults (40 - 65 Years Old)
- Streptococcus pneumoniae
- Mycoplasma
- Haemophilus influenzae
- Anaerobes
- Viruses
1 min
Common Causes of Pneumonia: Neonates (< 4 Weeks Old)
- Group B Streptococci
- E. coli
44 secs
Isoniazid
- Indications
- Tuberculosis (TB)
- Mechanism of Action
- Requires Catalase Peroxidase
- Decreases Mycolic Acid Synthesis
- Fast vs Slow Acetylators
- Side Effects
- B6 Deficiency
- Neurotoxicity
- Hepatotoxicity
- Drug-induced Lupus
1 min
Mycoplasma Pneumoniae
- Characteristics
- No Cell Wall and No Gram Stain
- Cholesterol Membrane
- Eaton's Agar
- Mulberry Colonies
- Disease
- Atypical pneumonia
- Military Recruits
- Cold IgM Autoimmune Hemolytic Anemia
- Erythema Multiforme
- Treatment
- Tetracycline
- Erythromycin
2 mins
Streptococcus Pneumoniae Characteristics
- Characteristics
- Gram-Positive
- Diplococci
- Lancet-Shaped
- Catalase-Negative
- Optochin-Sensitive
- Bile Soluble
- Alpha-Hemolytic
- Polysaccharide Capsule
- Positive Quellung Reaction
- IgA Protease
1 min
Streptococcus Pneumoniae Disease
- Signs and Symptoms
- Sickle Cell Anemia
- Sepsis in Patients with Splenectomy
- Rusty Sputum
- MOPS
- Meningitis
- Otitis Media
- Pneumonia
- Sinusitis
2 mins
Legionella Disease
- Signs and Symptoms
- High Fever
- Diarrhea
- Increased Liver Enzymes
- Hyponatremia
- Type IV Renal Tubular Acidosis
- Severe Atypical Pneumonia
- Pontiac Fever
- Treatment
- Fluoroquinolones
- Macrolides
2 mins
Fluoroquinolones Antibiotics
- -floxacin
- Mechanism of Action
- Inhibits Topoisomerase II & IV
- Bactericidal
- Indications
- Gram-negative Rods
- Pneumonia
- Gastrointestinal Infections
- Urinary Tract Infection
- Genital Infections
- Drugs
- Levofloxacin
- Ciprofloxacin
- Has Pseudomonas Coverage
- Considerations
- Avoid Polyvalent Cations
3 mins
Tetracycline Mechanism
- Binds to 30 S to Prevent Attachment of Aminoacyl tRNA
- Limited CNS Penetration
- Divalent Cations Inhibit Absorption
- Must Not Take with Milk, Antacids, Iron
1 min
Tetracycline Drug Names and Indications
- Drug Names
- Demeclocycline
- Minocycline
- Doxycycline
- Fecally Eliminated
- Can be Used in Renal Failure
- Indications
- Antidiuretic Hormone Antagonist
- Chlamydia
- Rickettsia
- Borrelia burgdorferi
- Helicobacter Pylori
- Mycoplasma Pneumonia
3 mins
Tetracycline Toxicities
- Inhibition of Bone Growth in Children
- Teratogen
- Discoloration of Teeth
- Photosensitivity
- GI Distress
2 mins
Macrolides
- Mechanism of Action
- Bacteriostatic
- Bind to 23S rRNA of 50S Subunit
- Inhibit Protein Synthesis by Blocking Translocation
- Macrolides
- Erythromycin
- Azithromycin
- Clarithromycin
- Indications
- Gram-Positive Cocci
- Atypical Pneumonia
- Chlamydia
- Considerations
- Resistance by Methylation of 23S rRNA Binding
2 mins
Macrolides Side Effects
- Side Effects
- Diarrhea
- Prolonged QT Interval
- P450 Inhibitor
- Cholestatic Hepatitis
- Skin Rash
- Eosinophilia
3 mins
Lung Cancer Assessment
- 2nd Most Common Cancer
- Assessment
- Chronic Cough
- Hoarseness
- Abnormal Breath Sounds
- Hemoptysis
- Chest Pain
- Anorexia or Weight Loss
- Considerations
- Symptoms Appear Late in Disease
2 mins
Cancer Warning Signs (CAUTION)
- CAUTION
- Change in Bowel or Bladder Habits
- A Sore That Does Not Heal
- Unusual Bleeding or Discharge
- Thickening or Lump in the Breast or Elsewhere
- Dyspepsia (Indigestion)
- Obvious Change to Warts or Moles
- Nagging Cough
1 min
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