Shared Flashcard Set

Details

Gerontological nurse practitioner
GNP certification exam questions
61
Health Care
Graduate
02/06/2011

Additional Health Care Flashcards

 


 

Cards

Term
Obesity is defined as what % higher than BMI?
Definition
> 30%
Term
Medications that can increase appetite include...
Definition

antidepressants

tranquilizers

B adrenergic agents

narcoleptics

hormones

steroids

Term
problems associated with obesity include:
Definition

DM

CAD

HTN

Ca

HLD

gallstones

arthritis

increased morbidity

Term
appetite supressing drugs include:
Definition

orlistat

noloxone

sibutramine

biculine

amphetamines (not recommended)

ephedrine

fenfluramine

Term
dysphagia
Definition

food doesn't transport easily from mouth to esophagus

difficulty starting swallow

probs with liquids > oropharyngeal than esophageal

Term
oropharyngeal dysphagia symptoms
Definition

dysarthria

wet/hoarse voice

nasal regurg

cough during swallow

Term

oropharyngeal dysphagia 3 causes

Definition

1. 80% central and peripheral NS lesion or muscular diseases

 

2. Structural lesions

 

3. upper esophageal sphincter disorders

Term
esophageal dysphagia  2 causes
Definition

1. motility

2. mechanical

Term
odynophagia
Definition
painful swallowing
Term
meds that cause esophageal injury
Definition

tetracycline

doxy

potassium

ferrous sulfate

theophylline

alendroante

ASA

quinidine

corticosteroiods

NSAIDS

ascorbic acid

Term
treat
Definition
Term
esophageal dysphagia definition
Definition

difficulty with food and liquid moving through esophagus

normally 2-3 seconds for liquid

8-10 seconds for solids

Term
diagnostics for dysphagia
Definition

blood work to r/o metabolic/endocrine

barium swallow

endoscopy

esophageal manometry (motility)

CXR

refer - speech therapy, GI, dentist, neurology

 

 

 

 

Term
manage/tx dysphagia
Definition

address cause

r/o malignancy

speech therapy

postural maneuvers

change food consistency

muscle strengthening

nutritional RV

Term
cachexia defn
Definition

increased protein breakdown

increased metabolic demands

change in protein synthesis

increased cytokinin production

Term
manifestations of cachexia
Definition

anorexia

wgt loss

metabolic alterations

weakness

Term
causes of cachexia
Definition

ca

pulmonary disease

end stage cardiac

RA

end stage dementia

Term
pharmacokinetics affected by aging
Definition

1. absorption decreases

2. distribution decreases d/t + lean body mass, - albumin, - fat stores

3. metabolism - decreased liver metab

4. excretion - decreased GFR

Term
common CNS adverse rxns to meds
Definition

sedate

memory loss

dizzy

depression

confusion

Term
common anticholinergic adverse rxns to meds
Definition

blurred vision

urine retention

constipation

dry mouth

Term
Drugs commonly causing adverse CNS rxns
Definition

A - Antipsychotics

B - BB's and benzos

C - cimetidine

 D - diuretics

etc - narcs

steroids

reserpin (anti-htn)

 

 

Term
Drugs commonly causing adverse anticholinergic effects
Definition

antipsychotics

colinergic angonists (acetylcholine, pilocarpine)

TCA

Term
Drugs commonly causing balance and movement problems
Definition

aspirn

aminoglycosides

BB

neuorleptics

lasix

metronidazole

vasodilators

metoclopramide

dilantin

Term
drugs commonly causing bone/support structure c/o's
Definition

steroid

heparin

lithium

Term
Safe drug use affected by:
Definition

polypharmacy (usually take 13 meds/year)

self medication

OTC

herbals

take friends meds

Term
factors which influence polypharmacy:
Definition

multiple comorbidities

multiple prescribers

OTC

herbal

pill for every ill

 

Term
prevent polypharmacy by:
Definition

consult pharmacist

bring all meds in

education

limit to essentials

avoid combo products

lowest effective dosing

Term
Polypharmacy puts pts at risk for:
Definition

comorbidities

extra expense

adverse rxns

depression

nursing home

Term
OTC common culprits in polypharmacy
Definition

cimetidine

decongestants

NSAIDS

niacin

antacids

laxatives

calcium

Term
SE's of aloe
Definition

increases toxicity of cardiac glycosides and

thiazide diuretics

Term
feverfew SE's
Definition
potentiates anticoagulants
Term
garlic SE's
Definition

increases effects of oral anticoagulants

affects blood sugar control

Term
ginko SE's
Definition
increases oral anticoagulants
Term
ginseng SE's
Definition

decreases lasix

estrogenic effects

Term
hawthorn SE's
Definition
interferes with antiHTN, cardiac meds
Term
St John's wort SE's
Definition

increases effects of SSRI's

and antidepressants

Term
kava kava SE's
Definition

increases effects of benzos

ETOH and CNS depressants

Term
licorice
Definition

interacts with cardiac glycosides

and thiazides

Term
green tea SE's
Definition
increases effects of anticoagulants
Term
renal disease effects
Definition

decreases by 40% by age 70 y.o.

reduced drug elimination

check CrCl and reduce dosing

Term
hepatic disease effects on drug metabolism
Definition

increased serum levels of meds

reduce dose

Term
cardiac effects on drug metabolism
Definition
reduced perfusion reduces therapeutic outcome
Term
absorption affected by...a
Definition
antacids - take 1 hour before or 4 hours after
Term
distribution of meds affected by....
Definition
CV disease
Term
metabolism of meds affected by...
Definition
liver disease, so reduce dose
Term
elimination of meds affected by...
Definition

70 years of age or older is significantly reduced

lower therapeutic doses

 

 

monitor for safe dosing and adverse reactions with renal insufficiency

Term
disulfiram reaction
Definition

medication for chronic ETOH abuse

causes: htn, anxiety, restlessness after ETOH consumed

Term
disulfiram effect
Definition
adverse reaction to ETOH intake similar to that caused by disulfiram
meds that cause this reaction include: metronidazole, 1st generaltion sulfonylureas, cephalosporins
Term
CREST
Definition
symptoms of scleroderma: c=calinosis
R=raynauds
E=esophagela dismotility
S=sclerodactyl (thickening of skin on fingers/toes)
T=telangiectasis
Term
Parkinsons - deficit in what?
Definition
dopamine
Term
alzheimers - deficit in what neuotransmitter?
Definition
acetylcholine
Term
TB exposure (ie: a + TB test) should be treated how?
Definition
treat until disease r/o with sputum culture treat with: isoniazide daily X 6-9 months OR twice weekly X 6-9 mths rifampin daily X 4 months
Term
serotonin sydrome characterised by:
Definition
agitation, tachy, hallucinations, diaphoresis, hyperreflexia, myoclonus, tremor
Term
Common culprits in causing serotonin syndrome:
Definition
MAOI's, SSRI, opiods
Term
normal dig level
Definition
.8-2
Term
normal lithium level
Definition
.5-1.3
Term
normal dilantin level
Definition
10-20
Term
normal phenobarb level
Definition
10-40
Term
normal theophylline level
Definition
10-20
Term
normal valproic acid level
Definition
40-100
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