Term
| Guidelines for Breast self examination? |
|
Definition
| Beginning early 20s, educated about benefits and limitations. |
|
|
Term
| Guidelines for clinical breast exam? |
|
Definition
Women 20-30s
Part of periodic health exam
-every 3 years
- if > 40: annually |
|
|
Term
Guidelines for mammography?
What about MRI? |
|
Definition
Annually starting at age 40
Women at high risk (> 20% lifetime) |
|
|
Term
| Screening guidelines for colorectal cancer? |
|
Definition
Men and Women > 50 years
FOBT: fecal occult blood test
-Colonoscopy if positive |
|
|
Term
| Screening guidelines for colonoscopy? |
|
Definition
| Every 10 years starting at age 50 unless pt has risk factors (polyps, family history, crohns, UC) |
|
|
Term
Prostate cancer screening guidelines?
What about AA men? |
|
Definition
*The ACS does not support routine screening, discuss potential benefits and liitations
Men > 50 years
-DRE and PSA
AA men: with a strong family history should start at 45 |
|
|
Term
| Screening guidelines for PAP? |
|
Definition
3 years after starting intercourse, but no later than 21.
-Screening q year with conventional PAP
-3 normal tests after 30 yrs, may do q 2-3 years. |
|
|
Term
| What cancer screening guideline to you prefer? |
|
Definition
|
|
Term
What is asthma?
Upper or lower airway?
Tests?
Abnormal finding? |
|
Definition
chronic airway disorder, variable and reacurring symptoms, airway obstruction, brochial hyperresponsiveness. REVERSIBLE WITH SABA.
Lower
Spirometry
Reduction in forced expiratory volume at 1 second, or peak expiratory flow rate |
|
|
Term
What type of plan would you use for a patient with asthma?
Describe it. |
|
Definition
Asthma action plan
Green, yellow, red zones: with clear instructions on what to do with symptoms, or peak flow. |
|
|
Term
| What are the first 4 stages of tx for asthma > 12 years? |
|
Definition
Step 1: SABA (albuterol)
Step 2: Low dose ICS (pulmicort)
Step 3: medium dose ICS
Step 4: Medium dose ICS + LABA |
|
|
Term
| What are the main S/S of asthma? |
|
Definition
Wheezing
Cough (morning and night)
Chest tightness
Breathlessness |
|
|
Term
| Common triggers of asthma? |
|
Definition
| exposure to smoke, air pollution |
|
|
Term
| What guidelines do you prefer to use for asthma? |
|
Definition
| National asthma education and prevention program |
|
|
Term
| Guidelines for diagnosis of chronic bronchitis? |
|
Definition
| Excessive mucus production for 3 or more months per year, for atleast 2 consecutive years |
|
|
Term
|
Definition
| Obstructive airflow disease that is not fully reversible. |
|
|
Term
| What are the types of COPD? |
|
Definition
| Emphysema, Chronic bronchitis |
|
|
Term
| What guidelines do you use for diagnosis and treatment of COPD? |
|
Definition
GOLD
Global Obstructive Lung Disease |
|
|
Term
|
Definition
80% can be caused by tobacco use
-STOP SMOKING! |
|
|
Term
| GOLD guidelines for therapy at each stage? |
|
Definition
-Stage 1: FEV1 at 1 sec to forced vital capacity= < 70%
FEV1: > 80 of predicted
-Stage 2: < 80% of predicted
-3: < 50
-4: < 30 |
|
|
Term
What is the backbone drugs for COPD patients?
What is a controller drug? |
|
Definition
ipratropium bromide (atrovent) anticholingergic
ICS (flovent) |
|
|
Term
| Common respiratory pathogen associated with smoking? |
|
Definition
|
|
Term
| Pathogen associated with CAP: most common? |
|
Definition
|
|
Term
| What are the lifestyle modifications according to JNC 7? |
|
Definition
Weight reduction (BMI 18-25)
DASH DIET
Na Reduction
Aerobic activity (30 minutes per day)
Moderation of alcohol: < 2 drinks per day |
|
|
Term
|
Definition
| Joint national committee on prevention, detection, evaluation, and treatment of hypertension |
|
|
Term
| Most important goal of HTN tx? |
|
Definition
| avoidance of target organ damage |
|
|
Term
| What are compelling indications according to the JNC 7? |
|
Definition
CHF
Post MI
High CVD risk
Diabetes
Chronic kidney disease
Recurrent stroke prevention |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Dietary approach to stop hypertension
-fruits, veggies, lowfat dairy
-reduced saturated and total fat |
|
|
Term
| Tx for stage 2 without compelling indications? |
|
Definition
| 2 drug combo: thiazide and ACE |
|
|
Term
| Tx of HTN with compelling indications? |
|
Definition
| each compelling indication has different drug classes to use |
|
|
Term
Pt is 138/89 on third office visit with elevated BP.
First step? |
|
Definition
compelling indications?
if no, then lifestyle modification |
|
|
Term
| How does a thiazide diuretic work? |
|
Definition
| inhibit Na and chloride ions from distal convoluted tubules |
|
|
Term
| How does a ACE inhibitor work? |
|
Definition
Renin-angiotensin-aldosterone system
-Renin is produced by the kidney which stimulates..
-Angiotension which is converted to ..
-Angiotension II (this causes arteriolar vasoconstriction) which stimulates the adrenal gland to produce..
-Aldosterone which causes Na and H20 reabsorption
ACE inhibitor prevents the conversion of angiotension I to II, which stops the cascade of arteriolar vasoconstriction and Na reabsorption. |
|
|
Term
| How does a calcium channel blocker work? |
|
Definition
Blocks voltage gated calcium channels, which decreased intracellular calcium.
Decreased calcium decreases the force of cardiac muscle contraction, and results in less contraction of vascular smooth muscle..Increased arterial diameter, or dilation. |
|
|
Term
|
Definition
|
|
Term
|
Definition
Lungs,
GI tract,
Vascular smooth muscle |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Blocks the action of sympathetic nervous system at beta adrenergic receptors |
|
|
Term
|
Definition
|
|
Term
| Diastolic murmur, rumble throughout |
|
Definition
|
|
Term
| Diastolic snap, tall p waves, afib |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| test used to evaluate murmurs? |
|
Definition
|
|
Term
| cornerstone of CHF therapy |
|
Definition
|
|
Term
| preferred diuretic with CHF? |
|
Definition
| spironolactone: potassium sparring |
|
|
Term
| Risk factors for osteoporosis? |
|
Definition
estrogen deficiency
postmenopausal women
small framed women |
|
|
Term
| most common sites for osteoporosis? |
|
Definition
|
|
Term
|
Definition
1500mg/d calcium (citrate works best)
1500 IU/d Vit D
Biphosphonates (boniva, fosamax)
consider estrogen replacement |
|
|
Term
| Screening test for osteoporosis? |
|
Definition
| DXA scan, dual energy xray absoptiometry |
|
|
Term
| how do biphosphonates work? |
|
Definition
| interfere with the action of osteoclasts, which break down bone. |
|
|
Term
|
Definition
|
|
Term
| What guidelines would you use to manage coumadin therapy? |
|
Definition
| warfarin protocol, family practice notebook |
|
|
Term
| what antibiotic is safe for all trimesters of pregnancy? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| antibiotic of choice for pregnancy with UTI |
|
Definition
|
|
Term
|
Definition
|
|
Term
| 2012 vax schedule for Gardasil? |
|
Definition
| Includes males ages 11-12 |
|
|
Term
| What guidelines do you use to diagnose diabetes mellitus? |
|
Definition
| American Diabetes Association |
|
|
Term
DM can be diagnosed in 4 different ways..
what are they? |
|
Definition
1. Fasting glucose > 126
2. Random glucose > 200 with symptoms (PPP)
3. 2 hr plasma glucose with 75 g glucose load of > 200
4. HA1c > 6.5 |
|
|
Term
| What are the goals for glycemic control? |
|
Definition
ADA:
a1c: <7%
Fasting: 70-130
BP: <130/80
Postpradial: 2hr < 140
Bedtime: 100-140 |
|
|
Term
|
Definition
a1c q 3 months
FLP annually
urine microalbumin: annual
Cr:annual
EKG: initial eval
thyroid: as indicated |
|
|
Term
| When to use insulin in T1D? |
|
Definition
|
|
Term
|
Definition
Disease of insulin deficiency. Associated with ketoacidosis.
Usually occurs in younger persons <30.
PPP common |
|
|
Term
|
Definition
Most common form
Major risk factors are heredity and obesity
Patho:
Combo of peripheral insulin resistance..glucose isn't reaching able to get into cells... and later inadequate secretion of pacreatic beta cells.
Liver keeps producing glucose at the same rate bc insulin is the hormone that tells it to stop. This cycle leads to hyperglycemia. |
|
|
Term
How does a biguanide work?
-example of one?
-benefits of this?
-risks?
-Monitor? |
|
Definition
Reduces hepatic glucose production
-metformin(glucophage)
-cheap, lowest risk of hypoglycemia
-rare risk of lactic acidosis
-renal function |
|
|
Term
|
Definition
|
|
Term
| How would you boost HDL>? |
|
Definition
Omega 3s.
Fish oil, Cod oil
Exercise |
|
|
Term
| How to lower cholesterol? |
|
Definition
Decrease saturated fat.
Oils
Deep fried foods
Good alternative: use vegtable oil, and eat more fish. |
|
|
Term
| How to lower triglycerides? |
|
Definition
| Decrease amount of carbs and sugar in diet. |
|
|
Term
| USPSTF recommedations for T2D screening? |
|
Definition
| The USPSTF recommends screening for type 2 diabetes in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 mm Hg. |
|
|
Term
| management goals for diabetes? |
|
Definition
Preprandial glucose < 100 mg/dl*
Bedtime glucose < 120 mg/dl
A1C < 7%** (many now using 6.5%)
Lower for new diagnosis, long life expectancy
Higher for longstanding (> 12 yrs), advanced complications, limited life expectancy
ACCORD trial found excessively rapid or aggressive control associated with increased risk
Monitor every 3 months
Blood pressure < 130/80* **
LDL cholesterol < 100 mg/dl*
( < 70 mg/dl with cardiovascular disease) |
|
|
Term
| What is the Kanas Practice Act? |
|
Definition
| State Statutes, Rules and Regs, Education policy |
|
|
Term
| What is the IOM: Future of Nursing? |
|
Definition
Transforming the health care system, and how NPs should play a fundemental role in this transformation.
NPs should be equal partners with physicians.
The IOM defines “clinician” as “an individual who uses a recognized scientific knowledge base and has the authority to direct the delivery of personal health care services to patients,” and goes on to note that this clinician “may be a physician, nurse practitioner, or physician assistant.” |
|
|
Term
| What is Peplau's theory of nurse client relationship? |
|
Definition
| Building trust/relationships with patients improves compliance and outcomes. |
|
|
Term
| What is the transtheoretical model? |
|
Definition
| Used in numerous interventions to change people’s behavior. Stages of change. Precontemplation, contemplation, preparation, action, and maintenance. |
|
|
Term
| What is the health belief model? |
|
Definition
| Health seeking behavior is influenced by a person’s perception of a threat posed by a health problem, and the value associated with actions aimed at reducing the threat. Patient compliance and preventative health care practices is an interesting concept that can relate to my future practice. Changing a patients’ belief about benefits of compliance related to prevention can be applied to a wide range of health care concerns, such as; obesity and smoking (Polit & Beck, 2008). These concepts form the Health Belief Model which is a widely used model in healthcare today. |
|
|
Term
| What are the ATP III guidelines? |
|
Definition
| Adult treatment panel guidelines for high cholesterol. |
|
|
Term
|
Definition
|
|
Term
| Desirable Total Cholesterol? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| How do you determine Coronary Heart Disease Risk? |
|
Definition
Framingham tables.
Indicates 10 year risk of CHD. |
|
|
Term
| WHen would you consider using drug therapy for increased LDL? |
|
Definition
| >130 with CHD risk equivalents |
|
|
Term
| first step in treating LDL > 100? |
|
Definition
| Therapeutic lifestyle changes |
|
|
Term
| What drug class are statins? |
|
Definition
| HMG CoA reductase inhibitors |
|
|
Term
How do statins work?
What are some side effects? |
|
Definition
By blocking a key enzyme the body uses to make cholesterol in the liver
Myopathy
Inc liver enzymes |
|
|
Term
| How would you handle END OF LIFE care for a patient? |
|
Definition
-Start with having a discussion with the patient and family to find out their wishes.
-Encourage them to make it legal (advance directives)
-Educate about treatment options regarding life support and pain management.
-Consult/collaborate with hospice/palliative care if prognosis is less than 6 months. |
|
|
Term
| What is the APRN Consensus model |
|
Definition
| Movement for certification and licensure of APRNs to be effectively aligned to ensure patient safety while expanding patient access to APRNs |
|
|
Term
|
Definition
Problem
Intervention
Comparison
Outcome |
|
|
Term
|
Definition
| Deals with "rightness or wrongness" of human behavior. |
|
|
Term
Describe the nursing code of ethics.
Hippocratic oath |
|
Definition
Significant resource for professional morality.
-with privileges comes responsibility
-how you should conduct yourself as a professional
-protects your best interest, provides support in a dilemma.
Oath to practice in specific ways |
|
|
Term
|
Definition
vascular disease
whites
male
htn
COPD
advanced age
history of hernias
family history |
|
|
Term
| how large should an AAA be before elective repair? |
|
Definition
|
|
Term
| % of blockage in carotid before CEA |
|
Definition
|
|
Term
| specific findings in infective endocarditis |
|
Definition
high grade fever possible-depending on organism
petechiae on conjunctiva, palate, buccal mucosa and extremities-late finding
splinter hemorrhages- linear sublingual hemorrhages
Janeway's lesions-nontender macules on palms and soles
Osler's nodes- painful nodes on finger and toe pads-last several days |
|
|
Term
| causes of diastolic dysfunction |
|
Definition
htn cardiac disease
hypertrophic or restrictive cardiomyopathy |
|
|
Term
| causes of systolic dysfunction |
|
Definition
CAD
Diabetes
Valvular heart disease |
|
|
Term
| associated s/s with diastolic dysfunction |
|
Definition
s4
htn
pulmonary congestion
LVH |
|
|
Term
| associated s/s with systolic dysfunction |
|
Definition
cardiomegaly
soft heart sounds
s3
mitral regurg
edema
JVD
low EF on echo |
|
|
Term
|
Definition
|
|
Term
| symptoms of aortic stenosis |
|
Definition
| chest pain, syncope, dyspnea |
|
|
Term
Epidemilogic terms:
sensitivity |
|
Definition
SnNout
SeNsitive test when Negative to rule OUT disease
Lilelihood of true-positive results with disease. |
|
|
Term
Epidemilogic terms:
Specificity |
|
Definition
SpPiN
Specific test, when Positive, helps to rule IN the disease
Likelihood of a true-negative results in those who are healthy (disease free) |
|
|
Term
| Who should begin prostate screening at age 45? |
|
Definition
| African american men and men with strong family history. |
|
|
Term
| When should you OFFER prostate examination |
|
Definition
|
|
Term
| How often for for colonoscopy? |
|
Definition
| q 5yrs starting at age 50 |
|
|
Term
| Tests used for colon cancer only, no screening for polyps |
|
Definition
| fecal immunochemical test, FOB, stool DNA |
|
|
Term
| How to figure out estimated blood sugar given an A1C |
|
Definition
|
|
Term
| What age to begin screening oral health |
|
Definition
|
|
Term
| Recommendation for zostervax |
|
Definition
| 60+ with immunosuppression |
|
|
