ANCC FNP Board Exam Study Guide Part
1
Treatment for persistent bronchitis
-Chronic bronchitis is a type of COPD this is characterized by infection of the bronchi, causing
extra mucus; traits of continual bronchitis consist of prognosis after age 35, weight problems,
copious amounts of purulent sputum, multiplied Hct degree
-Treat with SABA (albuterol), inhaled anticholinergics (ipratropium)
-Normal Findings of Lungs: Lower lobes vesicular breath sounds (soft and occasional)
Upper lobes; Bronchial breath sounds louder
Actinic keratosis
-Older to elderly fair-skinned adults
-numerous dry, round, crimson to pink-coloured, slow-growing lesions that don't heal
-lesions commonplace on solar-exposed regions (cheeks, nostril, face, fingers, again)
-precancerous precursor of squamous mobile carcinoma
-common sunburns as child places individual at higher threat
-diagnosed with biopsy
-treat with cryotherapy (small number) or five-FU(5% fluorouracil) cream (massive number)
comply with up with derm.
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Seborrheic keratosis
,-smooth, round, wart-like fleshy growths on trunk (totally on again)
-can variety in coloration from light tan to black
-appear to be pasted on
-asymptomatic
-benign
Fingernail hematoma remedy
-Trephination - make hole in nail via drilling or piercing and allow blood to drain
Hypothyroid
-Primary - elevated TSH; low T4; low or normal T3
-Subclinical - accelerated TSH; ordinary T4; ordinary T3
-Common reason is Hashimoto's (autoimmune) - Hashimoto and Hypo each have O
-Symptoms are variable - may consist of fatigue
-Treatment - levothyroxine (Synthroid) daily in AM on empty stomach
-Starting dose of levothyroxine (Synthroid) is 25-50mcg
-Check TSH each 6-8 weeks to monitor remedy
Hyperthyroid
-Primary - low TSH; excessive T4; normal or excessive T3
-Subclinical - low TSH; everyday T4; ordinary T3
-Most commonplace reason is Grave's Disease (autoimmune) - Grave and Hyper both have R
-Common signs - female; rapid weight reduction; expanded heart rate; tremors; sweating;
irritability; anxiety; hyperactivity; insomnia; diarrhea; amenorrhea; high blood pressure;
exophthalmos; warmness intolerance; goiter
-Treatment - Propylthiouracil (PTU); Methimazole (Tapazole); Radioactive iodine (reasons
hypothyroid for life, contraindicated in pregnancy)
-Thyroid Storm (thyrotoxicosis) - acute worsening of symptoms; can be caused by pressure or
contamination; search for LOC, fever, stomach ache; life-threatening; on the spot hospitalization
wanted
Increased hazard of ectopic pregnancy
-Risk elements - previous ectopic, salpingitis, tubal surgical operation, current IUD use,
preceding cervicitis, records of PID
-Symptoms - abdominal pain (worsens whilst supine or with jarring), vaginal bleeding,
amenorrhea, low grade fever, ache referred to proper shoulder (can also imply rupture)
, Hypertension Meds Part 1
-African-American without or with diabetes - preliminary picks include thiazide diuretic or CCB
-Non-Black without or with diabetes - preliminary picks consist of thiazide diuretic, CCB, ACE, or
ARB
-Thiazide diuretic - "ide"; incredible synergist; keep away from in sulfa hypersensitivity; favorable
in osteopenia/osteoporosis; aspect consequences consist of hyperglycemia (warning in
diabetics), hyperuricemia (gout assault), hypertriglyceridemia and hypercholesteremia (test lipid
profile), hypokalemia (potentiates digoxin toxicity and increases chance for arrhythmia),
hyponatremia (hold diuretic, limit fluid, update K+); lowers BP handiest 2-8 factors
-ACE inhibitor - "pril" and ARB - "sartan" - use in excessive renin states; drug of choice in
diabetics (protects kidneys); pregnancy category C/D; side effects encompass dry/hacking
cough (extra with ACE), hyperkalemia, angioedema (uncommon, existence-threatening);
contraindicated in mild to excessive kidney disease; do no longer use ACE and ARB together.
Hypertension Meds Part 2
-Beta blocker - "lol"; desirable as add-on remedy, no longer simple HTN; keep away from abrupt
discontinuation, wean slowly to keep away from rebound HTN; contraindications include
asthma, COPD, continual bronchitis, emphysema, second and 1/3-diploma coronary heart block
(k with 1st diploma), sinus bradycardia; do now not use Propranolol for HTN
-Calcium channel blocker - "pine"; first choice for ISH (isolated systolic HTN); aspect outcomes
include headaches (vasodilation), ankle edema (vasodilation, benign), coronary heart
block/bradycardia (depresses cardiac muscle and AV node), reflex tachycardia (nifedipine);
contraindicated in second and third diploma coronary heart block, bradycardia, CHF
Hypertension Meds Part three
-Heart Failure: ACEI or ARB as first-line, plus BB, plus diuretic
-DM: ACE/ARB first line, IF African American, can start with CCB or Thiazide
-CKD: ACE/ARB first line, can upload CCB or Thiazide
-Stroke Hx: ACE/ARB first line, upload CCb or Thiazide as second-line pills.
-African American inspite of DM Thiazides and CCBs.
-Bilateral Renal artery stenosis: ACE AND ARB will WORSEN or cause acute renal failure.
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Risk factors for post-menopausal osteoporosis