AANP Adult gerontology primary care
nurse practiotioner 2024 study guide
Rovsing's Sign - ANSPalpation in LLQ ilicits pain in RLQ indicates appendicitis
To get more questions with correct answers email jamesdickson3161@gmail.com - ANS
NYHA classes of Heart Failure - ANSI No limitation of physical activity. Ordinary physical activity does not
cause undue fatigue, palpitation, dyspnea (shortness of breath).
II Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue,
palpitation, dyspnea (shortness of breath).
III Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue,
palpitation, or dyspnea.
IV Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any
physical activity is undertaken, discomfort increases.
Step 2- Mild presistent Asthma (FEV1/PEF > 80% predicted. Symptoms > 2 days/week. Albuterol as
needed. Low dose ICS ex Flovent. Alt cromolyn, montelukast, nedocromil, theophylline.
Step 3- Mod presistent (FEV1 or PEF 60-80% predicted. Daily Symptoms. SABA plus low dose ICS or med
dose ICS or low dose with leukotriene inhibitor (singulair, theophylline, zileuton).
Step 4- Severe presistent asthma (FEV1/PEF <60% predicted. Symptoms most of day. High dose ICS plus
long acting B2 agonist plus oral steroid daily (prednisone).
Peak Expiratory Flow Rate (HAG):
Green Yellow Red Zone: - ANSPEF based on Height Age Gender. Blow hard using spirometer highest value
recorded.
, 80-100% expected volume Green Zone maintain or reduce meds
50-80% expected volume Yellow Zone increase maintenance therapy. Or Having exacerbation.
Below 50% expected volume Red Zone call 911 give epinephrine inj.
PPD - ANSNeg- No firm bump forms at the test site, or a bump forms that is smaller than 5 mm (0.2 in.).
A firm bump that is 5 mm (0.2 in.) in size suggests a TB infection in people who are in a high-risk group.
HIV, immunocompromise, exposed.
A firm bump that is 10 mm (0.4 in.) in size suggests a TB infection in people who are in a moderate-risk
group. healthcare workers, immigrants, homeless.
A firm bump that is 15 mm (0.6 in.) in size suggests a TB infection in people who are in a low-risk group
no risk for tb.
Overdose toxcitity GI upset, arrhythmias, confusion visual changes (yellow/green tinge vision- scotomas).
Tx with digibind. order dig level, electrolytes, creatinine ekg.
Thiazide Diuretics - ANSPt with both htn and osteoporosis have an extra benefit from thiazides. thiazide
diuretics decrease calcium excretion by the kidneys and stimulate osteoclasts formation. Patients with
serious sulfa allergies should avoid thiazide diuretics. Potassium sparing diuretics can be used as
alternative.
Chlorthalidone (hygroton), hydrochlororthiazide (esidrix, microzide), indapamide (lozol), metolazone
(zaroxolyn); indicated for decreased fluid volume, inexpensive, effective, useful in severe hypertension,
effective orally, enhances other antihypertensives; adverse reactions: hypokalemia symptoms,
hyperuricemia, glucose tolerance, hypercholesterolemia, sexual dysfunction; observe for postural
hypotension, caution with renal failure gout and client taking lithium; hypokalemia increases risk for
digitalis toxicity, administer postassium supplements.
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