Category: Nursing

N512- Low-grade Cervical Dysplasia Discussion

A Pap smear removes cervical cells to assess for pre-cancerous and cancerous cells. The pap test results will be classified as low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), or atypical glandular or squamous cells. The squamous cells of the cervix are found on the lining of the outer portion of the cervix N512- Low-grade Cervical Dysplasia Discussion. The inner portion of the cervix are where columnar cells are found. Both sites are considered the outer surface lining of the cervix.

Tissue cells in LSIL mean there are changes in the appearance of normal cells. Although the cells still appear somewhat normal, there may be some with odd shapes, some cells that are larger and more frequent in number across the surface lining of the cervix N512- Low-grade Cervical Dysplasia Discussion. These cells are involved in the lower one-third of the squamous epithelium.

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In HSIL, the abnormal cells are well observed in abnormal size and shape and are increased in number from the normal cells. These cells also only involve the surface of the outer lining of the cervix. N512- Low-grade Cervical Dysplasia Discussion HSIL can be moderate involving the lower two-thirds of the squamous epithelium, and the severe dysplasia involves the entire layer of the squamous epithelium (American Academay of Family Physicians, 2018; Rogel Center Center Michigan Medicine, n.d.; The John Hopkins University, n.d.; Zheng & Pruett, 2020).

Research has found that cervical dysplasia is commonly caused by a viral infection, specifically, the human papillovirus (HPV), which is also the most common cause of cervical cancer around the world. HPV is a DNA virus with many genotypes that cause skin infections and introduce infection into mucosal cells which help to explain the cell changes seen (World Health Organization, 2020). HPV is also associated with oropharynx, vaginal, and anus cancers. The oncogenic HPV type is not genetically inherited. The viral gene causes genes in the host cells to change (mutate) from the way they normally function by causing abnormal cell protein instructions to take over the way the normal healthy cells generate and grow giving rise to abnormal tissue growth (dysplasia) that can progress to tumors and cancer N512- Low-grade Cervical Dysplasia Discussion. In particular, the oncogenes of HPV will encode certain normal proteins in the host changing them to oncoproteins. Because these oncoproteins have been isolated, antibodies have been found to target these oncoproteins in which vaccines have been developed to help prevent HPV infection. For example, two HPV oncoproteins (E6 and E7) are found to disrupt normal cell function. E6 will adhere to and deactivate the p53 tumor suppressor gene, and the E7 will adhere to and deactivate the Rb tumor suppressor gene in the human body. These two genes are significant because out of the many strains of HPV, the HPV strain variations with E6 and E7 oncoproteins variations are related to a low risk or a high risk of developing cancer. The low risk types are associated with benign neoplastic growths whereas the high-risk types cause pre-cancerous changes in mucosal tissues. (Abcore, Inc., 2020; Hammer & McPhee, 2019)
N512- Low-grade Cervical Dysplasia Discussion
.

Ms. Van’s prognosis at this time is good since most mild cases of cervical dysplasia resolve on their own. Given Ms. Van’s age and knowing that HPV is a common cause of cervical dysplasia, it would be important to obtain a biopsy to assess for depth of the involvement and whether there is HPV influence. Even though an HPV related dysplasia progression to cervical cancer usually takes many years, knowing the type of HPV would provide a more definitive diagnosis, treatment plan, and prognosis for her. At this point, her prognosis is good. Due to her age, she may or may not clear the HPV on her own which can take up to two years in younger adults. If she were positive for HPV, close continued surveillance would be important. The American College of Obstetricians and Gynecologist (ACOG) recommend to repeat the Pap test in one year for LSIL (American College of Obstetricians and Gynecologist, 2020) N512- Low-grade Cervical Dysplasia Discussion.

 

References:

 

Abcore, Inc. (2020). 
Oncoproteins
. Retrieved from https://www.abcore.com/oncoproteins

American Academay of Family Physicians. (2018, November 13). 
Cervical Dysplasia
. Retrieved from https://familydoctor.org/condition/cervical-dysplasia/

American College of Obstetricians and Gynecologist. (2020). 
Abnormal Cervical Cancer Screening Test Results
. Retrieved from https://www.acog.org/patient-resources/faqs/gynecologic-problems/abnormal-cervical-cancer-screening-test-results

Hammer, G. D., & McPhee, S. (2019). 
Pathophysiology of Disease: An Introduction to Clinical Medicine
 (8 ed.). New Youk: McGraw-Hill Education Medical.

Rogel Center Center Michigan Medicine. (n.d.). 
Squamous Intraepithelial Lesion (SIL)
. Retrieved from https://www.rogelcancercenter.org/gynecologic-cancers/prevention/pre-cancerous-conditions/squamous-intraepithelial-lesion

The John Hopkins University. (n.d.). 
Cervical Dysplasia
. Retrieved from https://www.hopkinsmedicine.org/kimmel_cancer_center/cancers_we_treat/cervical_dysplasia/diagnosis_and_treatment/abnormal_pap_test.html

World Health Organization . (2020). 
Biologicals 
. Retrieved from https://www.who.int/biologicals/areas/human_papillomavirus/en/#:~:text=Human%20papillomavirus%20(HPV)%20is%20a,approximately%208%2Dkb%20in%20length N512- Low-grade Cervical Dysplasia Discussion.

Zheng, A. K., & Pruett, D. (2020). 
Abnormal Pap and Cervical Dysplasia
. Retrieved from https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116920/all/Abnormal_Pap_and_Cervical_Dysplasia

Discussion 1

See Van, a 35-year-old married Hmong-American woman recently underwent an annual Papanicolaou test (Pap smear) at her Certified Nurse Midwife’s practice, and the results were abnormal.  Her provider diagnosed her with low-grade cervical dysplasia.  What alterations at the cellular level would you expect to see with this diagnosis? Provide and discuss with your colleagues S. V.’s prognosis N512- Low-grade Cervical Dysplasia Discussion. Support your discussion with citations from the textbook, external credible literature and/or reliable electronic sources.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria.

Low Grade Cervical Dysplasia

            Pap smear is a test that is usually recommended during health exams for females especially when they become sexually active. If the result shows an abnormal growth on the surface lining of the cervix, implies you have cervical dysplasia. This disease ranges from mild to severe. To prevent the disease from progressing to a more severe form like invasive cervical carcinoma, early detection and treatment after proper screening is necessary (Hammer, G.D., & McPhee, S.J., 2019. P.57).

See Van in our case study was diagnosed with low-grade cervical dysplasia which is the mild form of the disease. This means that the abnormal cells are found on the surface of the cervix (epithelium). 
Human papillomavirus (HPV) infection is generally the cause for
 
Cervical dysplasia
(Stoppler, 2016). Cervical dysplasia is generally cause by HPV. Therefore, it is important to take the necessary precautions to prevent the infection from the virus. HPV vaccine is usually given between the ages of 9 to 26 and according to the Center of disease prevention and control recommendation it should be given between the ages of 11 and 12 (Blackburn, K.B., 2018) N512- Low-grade Cervical Dysplasia Discussion.

Low-grade cervical dysplasia usually goes away by itself and it does not mean you have cancer, or you’ll get cancer in the future (Nathan-Garner, L., 2017). The fact that See Van’s was diagnosed early and with the right treatments, she has very low chances for the disease to progress and develop into cancer. See Van is 35 years old and if she was not vaccinated, she should discuss about the benefit of the HPV vaccine with her Certified Midwife’s practice. This will prevent her from having the disease again after treatment.

Five years ago, my cousin when for her yearly physical and her pap smear came back abnormal. Her doctor referred her to a gynecologist who did a biopsy of her cervices. She was diagnosed with moderate grade cervical dysplasia. The doctor discussed different treatment options with her. She was so scared that the disease may affect her chances of having a baby because she just got married and they had plans of having their own baby. The doctor told her to try to conceive as soon as possible and will be closely monitored. She got pregnant two months later and she had frequent pap smears. She carried her pregnancy to term without issues and immediately after birth, she had a partial hysterectomy. Her gynecologist still scheduled her for a pap smear after a year and the result was normal.

Having an abnormal result after a regular yearly test can be very scary. Early detection of cervical dysplasia is important because the damage is still on the epithelia cell of the cervix. At this stage the disease has a very good prognosis. It is necessary to get HPV vaccine when recommended by your doctor because HPV infection is the main cause of the disease N512- Low-grade Cervical Dysplasia Discussion.

 

References:

Hammer, G.D. & McPhee, S.J., (2019). Pathophysiology of disease: An introduction to

clinical medicine (8
th
 ed.). New York, NY: McGraw-Hill Education/Medical.

Blackburn, K.B., (2018). 
HPV vaccine: What age is too late? 
MD Anderson Center.

The University of Texas. Retrieved from 
https://www.mdanderson.org/publication/focus-on-
health/focus-on-health-june-2018/hpv-vaccine-when-is-it-too-late.htm.

Nathan-Garner, L., (2017). 
Abnormal Pap test? What to know about cervical dysplasia? MD

Anderson Center. The University of Texas. Retrieved from https://www.mdanderson.org/cancerwise/abnormal-pap-test–what-to-know-about-cervical-dysplasia.html

Stoppler, M.C., (2016). 
Cervical Cancer Symptoms, Stages, and Treatment. Retrieved from

https://medicinenet.com/cervical_dysplasia/article.htm. N512- Low-grade Cervical Dysplasia Discussion

Module 3 Overview

Introduction

This week we will explore pharmacotherapy for special populations such as pediatrics, geriatrics, the pregnant patient and nursing mothers, as well as examining the interactions of over-the-counter medications to prescribed therapies.  The advanced practice nurse must be familiar with pathophysiologic changes related to age and disease.  Considerations for prescriptive therapy must be based upon the uniqueness of each diverse patient.

Learning Objectives

After completing this module, you will be able to:

Utilize advanced nursing and pharmacological interventions in select case studies to resolve complex and biological, psychological, physiological and pathophysiologic conditions.

Synthesize pathophysiologic changes related to the lifespan and recommend approiate evidence-based prescribing behaviors

Teach patients, family members, and others from diverse populations regarding safe and effective use of drugs and natural products.

Reading & Resources

Read Chapters 4, 5, 6, 7 & 14 In Arcangelo, V. P., & Peterson, A. M. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.

Learning Activities

Discussion
: Participate in Discussion 3.

Test
: Complete Progress Test 2. Click on the Progress Test 2 link for more details.

Discussion 3

M. L. is a 15-year-old Hispanic female who plays soccer for her school team. She has noticed that when running, she sometimes has trouble catching her breath. She also reports an increased runny nose and itchy eyes. She has a frequent dry cough and is awakened with coughing spells at least four times a week. Her mother and father have seasonal allergies and her mother has asthma. This morning she woke up and heard “funny sounds” when she took a breath. Her coughing increased when she took a deep breath. In her nose, the mucosa is pale and swollen bilaterally. Her lungs have bilateral expiratory wheezing; respirations are 22 and PEF is 400. Her heart shows a normal sinus rhythm, with no murmurs or gallops; pulse is 72; and there is no cyanosis.

Diagnosis: Mild Persistent Asthma

In this discussion forum:

Discuss specific goals of pharmacotherapy for treating M. L.’s mild persistent asthma.

Discuss the drug therapy a CNP would likely prescribe and why.

Discuss the parameters for monitoring the success of the therapy.

Discuss age appropriate health promotion recommendations you would consider for M. L.

Remember to respond to at least two of your peers. Please see the Course Syllabus for Discussion Participation Requirements and Grading Criteria.

NURS 6512 Midterm Exam Review (Week 1-6)

Building A Complete Health History

Communication techniques used to obtain a patient’s health history

Recording and documenting patient information

SOAP note documentation

Subjective vs objective information when documenting

Ethical decision making and beneficence

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Diversity and Health Assessments

Cultural awareness and diversity

Socioeconomic, spiritual, and lifestyle factors affecting diverse populations

Functional assessments

NURS 6512 Midterm Exam Review (Week 1-6)

 

Assessment Tools and Diagnostic Tests in Adults and Children

Growth, Development, and Measurements in children and adults

Nutritional assessment to include recommended water intake and energy requirements

Macronutrients vs Micronutrients

Significance of a food diary

NURS 6512 Midterm Exam Review (Week 1-6)

BMI measurements for normal, overweight, obesity, morbid obesity

Pernicious Anemia

Examination techniques and equipment

Diagnostic Assessment tools and tests to include tuning forks, BP monitoring, use of stethoscope, otoscope, ophthalmoscope

 

Assessment of the Skin, Hair, and Nails

Skin lesion characteristics

Documenting skin lesions using “ABCD” rule

Anatomy and physiology of skin layers

Abnormal nail findings in older adults

Psoriatic skin lesions

NURS 6512 Midterm Exam Review (Week 1-6)

Vesicular skin characteristics

Normal vs abnormal hair distribution during aging

Characteristics of hair distribution

Assessment of Head, Neck, Eyes, Ears, Nose, and Throat

Cranial Nerves associated with the HEENT system

Normal assessment findings of an adolescent’s nose and throat

Normal examination findings of an infant’s fontanelles

Examination findings of a patient with hypothyroid and hyperthyroid

Techniques for examining the HEENT systems

NURS 6512 Midterm Exam Review (Week 1-6)

Examination findings for a patient with sinus symptoms

Appropriate tuning fork frequencies to approximate vocal frequencies

Examining the oral mucosa

Hearing loss findings when examining the elderly patient

Examination techniques used to examine the trachea and thyroid

 

Assessment of the Abdomen and Gastrointestinal System

Organs involved in the alimentary tract

Correct assessment order for examining the abdomen

Examination technique and findings of the liver

Examination findings associated with appendicitis

Examining McBurney’s sign

Assessment of abdominal pain in women

Landmarks for abdominal examination

Characteristics of bowel sounds heard during auscultation

NURS 6512 Midterm Exam Review (Week 1-6)

,

NRNP 6531 week 3 Knowledge Check: Module 1: Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions

Question 1

The Centor criteria for diagnosis of Group A B-hemolytic streptococcus includes which of the following?

Fever history

Tender, swollen anterior cervical lymph nodes

Positive rapid antigen detection test

A and B only

A, B, and C

1 points

A and B only

NRNP 6531 week 3 Knowledge Check: Module 1: Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions Question 2

Marvin has sudden eye redness that occurred after a strenuous coughing episode. You diagnose a subconjunctival hemorrhage. Your next step is to

a.

Refer him to an ophthalmologist

b.

Order antibiotics

c.

Do nothing other than provide reassurance

d.

Consult with your collaborating physician

1 points

Do nothing other than provide reassurance

Question 3

Which of the following is a predisposing condition for furunculosis?

a.

Diabetes mellitus

b.

Hypertension

c.

Peripheral vascular disease

d.

Chronic fatigue syndrome

1 points

Diabetes Mellitus

Question 4

If a patient presents with a deep aching, red eye and there is no discharge, you should suspect:

a.

Iritis

b.

Allergic conjunctivitis

c.

Viral conjunctivitis

d.

Bacterial conjunctivitis

1 point

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Iritis

Question 5

Which of the following statements about malignant melanomas is true?

a.

They usually occur in older adult males

b.

The patient has no family history of melanoma

c.

They are common in blacks

d.

The prognosis is directly related to the thickness of the lesion

 

NRNP 6531 week 3 Knowledge Check: Module 1: Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions 1 points

The prognosis is directly related to the thickness of the lesion

Question 6

A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?

Any recent trauma

Difficulty swallowing

Stiffness in the right shoulder

Change in sleeping habits

1 points

Any recent trauma

 

Question 7

Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?

a.

Cataracts

b.

Glaucoma

c.

Retinal detachment

d.

Iritis

1 points

Retinal detachment

 

Question 8

Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate?

An antihistamine intranasal spray

A decongestant nasal spray

Ipratropium

Omalizumab

1 points

Decongestant nasal spray

NRNP 6531 week 3 Knowledge Check: Module 1: Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions Question 9

Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices?

a.

It is important to “undercode” so that one does not get charged with Medicare fraud

b.

The practice of “overcoding” is essential in this age of decreasing reimbursements

c.

Failing to bill for billable services will lead to unnecessarily low revenues

d.

Time spent with the patient is a very important determinant of billing

1 points

Failing to bill for billable services will lead to unnecessarily low revenues

Question 10

A 19 year old basketball player complains of itching in the crural folds, buttocks, and upper thighs. The lesions are well demarcated and are half-moon shaped. The area is red, irritated, and there are small breaks in the skin from scratching. What is this patient’s diagnosis and how should it be treated?

a.

Tinea cruris; treat with a topical antifungal cream

b.

Eczema; treat with a topical steroid

c.

Scabies; treat with permethrin cream

d.

Syphilis; treat with penicillin

1 points

Tinea cruris

Question 11

A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tinea pedis. What is the best initial treatment option for this patient?

Prescribe an antifungal powder for application between her toes and in her shoes and a topical prescription strength antifungal cream for other affected areas. Monitor for a secondary bacterial infection.

Prescribe an oral antifungal for 4 to 12 weeks. Monitor BUN and creatinine at 1 week, 2 weeks, and every month thereafter.

Prescribe an oral antifungal for 4 to 12 weeks. Monitor liver enzymes, BUN, and creatnine at 1 week, 2 weeks, and every month thereafter.

Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary bacterial infection.

1 points

Prescribe and antifungal powder for application between her toes and in her shoes and a topical prescription strength antifungal cream

Question 12

A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him:

a.

“It is the most common cause of death in patients with skin cancer.”

b.

“It can be cured with surgical excision or radiation therapy.”

c.

“It is a slow growing skin cancer that rarely undergoes malignant changes.”

d.

“It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.” NRNP 6531 week 3 Knowledge Check: Module 1: Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions

1 points

It can be cured with surgical excision or radiation therapy

Question 13

Your 31-year-old patient, whose varicella rash just erupted yesterday, asks you when she can go back to work. What do you tell her?

a.

Once all the vesicles are crusted over

b.

When the rash is entirely gone

c.

Once you have been on medication for at least 48 hours

d.

Now, as long as you stay away from children and pregnant women

1 points

Once all the vesicles are crusted over

Question 14

Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?

a.

Pharmacological therapy

b.

A labyrinthectomy

c.

A vestibular neurectomy

d.

Wearing an earplug in the ear with the most hearing loss

1 points

A vestibular neurectomy

NRNP 6531 week 3 Knowledge Check: Module 1: Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions Question 15

Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to:

a.

Quit smoking

b.

Maintain aggressive hypertension therapy

c.

Stick to a low-fat, low-sodium diet

d.

Continue with his exercise program

1 points

Quit smoking

Question 16

Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?

a.

Aspirin

b.

NSAIDs

c.

Opioids

d.

Antihistamines

1 points

Antihistamines

Question 17

Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:

a.

Herpes simplex

b.

Aphthous ulcers

c.

Candidiasis

d.

Oral cancer

1 points

Candidiasis

Question 18

Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect?

a.

Varicella

b.

Herpes zoster

c.

Syphilis

d.

Rubella

1 points

Herpes Zoster

Question 19

What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

a.

You must initiate the plan of care for the patient

b.

The physician must be on-site and engaged in patient care

c.

You must be employed as an independent contractor

d.

You must be the main health care provider who sees the patient

1 points

The physician must be on-site and engaged in patient care

Question 20

Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is:

a.

Sex hormones

b.

Trauma or inflammation

c.

A dietary change

d.

Scurvy

Trauma or inflammation

NRNP 6531 week 3 Knowledge Check: Module 1: Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions

Question 1

A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory?

a.

Inferior wall

b.

Anterior wall

c.

Apical wall

d.

Lateral wall

1 points

Question 2

Other than smoking cessation, which of the following slows the progression of COPD in smokers?

a.

Making sure the environment is free of all pollutants

b.

Eliminating all pets from the environment

c.

Engaging in moderate to high levels of physical activity

d.

Remaining indoors with air conditioning as much as possible

1 points

Question 3

Which of the following is not a risk factor for coronary arterial insufficiency?

a.

Hyperhomocysteinemia

b.

Smoking

c.

Genetic factors

d.

Alcohol ingestion

1 points

Question 4

Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication?

a.

It is not effective during an acute asthma attack.

b.

It may take 2 to 3 days to begin working.

c.

This drug works within 10 minutes.

d.

This drug may be used by patients 6 years and older.

1 points

Question 5

Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure?

a.

Increase her Lisinopril to 20mg daily

b.

Add a thiazide diuretic to the Lisinopril 5mg daily

c.

Discontinue the Lisinopril and start a combination of ACE Inhibitor and calcium channel blocker

d.

Discontinue the Lisinopril and start a diuretic

1 points

Question 6

What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?

a.

Asthma

b.

Emphysema

c.

Chronic obstructive lung disease

d.

Chronic bronchitis

1 points

Question 7

Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?

a.

Xanthines

b.

Antihistimines

c.

Steroids

d.

Anticholinergics

1 points

Question 8

Which type of lung cancer has the poorest prognosis?

a.

Adenocarcinoma

b.

Epidermoid carcinoma

c.

Small cell carcinoma

d.

Large cell carcinoma

1 points

Question 9

Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?

a.

Mild intermittent

b.

Mild persistent

c.

Moderate persistent

1 points

Question 10

Which drug category contains the drugs that are the first line Gold standard therapy for COPD?

a.

Corticosteroids

b.

Inhaled beta-2 agonist bronchodilators

c.

Inhaled anticholinergic bronchodilators

d.

Xanthines

1 points

Question 11

Which of the following best describes hypertrophic cardiomyopathy?

a.

A weakened and enlarged myocardium

b.

Poor ventricular filling and weakened myocardium

c.

Enlarged left ventricle and septum

d.

None of the above

1 points

Question 12

Risk factors for acute arterial insufficiency include which of the following?

a.

Recent myocardial infarction

b.

Atrial fibrillation

c.

Atherosclerosis

d.

All of the above

1 points

Question 13

A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free?

a.

A long-acting bronchodilator

b.

An inhaled corticosteroid and cromolyn

c.

Theophylline and a short acting bronchodilator

d.

A bronchodilator PRN and an inhaled corticosteroid

1 points

Question 14

Management of a patient with hypertension and an abdominal aortic aneurysm would include:

a.

computed tomography scan without contrast

b.

changing the patient’s BP medications

c.

referral to a cardiologist

d.

immediate cardiac catheterization

1 points

Question 15

A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with:

a.

Mitral regurgitation

b.

Systolic heart failure

c.

Cardiac myxoma

d.

Diastolic heart failure

1 points

Question 16

A patient presents to the office with a blood pressure 142/80. This patient is classified as having:

a.

Normal blood pressure

b.

Prehypertension

c.

Stage 1 hypertension

d.

Stage 2 hypertension

1 points

Question 17

Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes?

a.

Chronic sinusitis

b.

Acute bronchitis

c.

Bacterial pneumonia

d.

Acute exacerbation of chronic bronchitis

1 points

Question 18

The most common correlate(s) with chronic bronchitis and emphysema is(are):

a.

Familial and genetic factors

b.

Cigarette smoking

c.

Air pollution

d.

Occupational environment

1 points

Question 19

Which of the following is not a goal of treatment for the patient with cystic fibrosis?

a.

Prevent intestinal obstruction

b.

Provide adequate nutrition

c.

Promote clearance of secretions

d.

Replace water-soluble vitamins

1 points

Question 20

In order to decrease deaths from lung cancer:

a.

All smokers should be screened annually

b.

All patients should be screened annually

c.

Only high risk patients should be screened routinely

d.

Patients should be counseled to quit smoking

N512 Advanced Pathophysiology Module Two: Cardiovascular Disease Across the Life Span

Module 2 Overview

Introduction

In this module students will review the normal anatomy and physiology of the heart and analyze the pathophysiology and clinical manifestations of selected cardiovascular disorders, including arrhythmias, congestive heart failure, valvular heart disease, and coronary artery disease.

Learning Objectives

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After completing this module, you will be able to:

Review normal physiology of the cardiovascular system

Explain pathophysiological alterations in the cardiac cycle.

Analyze the pathogenesis of alterations in heart function.

Summarize the major clinical manifestations and complications of alteration in heart functions

N512 Advanced Pathophysiology Module Two: Cardiovascular Disease Across the Life Span

Reading & Resources

Read Chapters 10 In Hammer, G. & McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education / Medical

Optional readings:

Lindsell, C. J., Anatharaman, V., Diercks, D., et al. (2006). The internet tracking registry of acute coronary syndrome: A multicenter registry of patients with suspicion of acute coronary syndromes reported using the standardized reporting guidelines for emergency department chest pain studies. 
Annals of Emergency Medicine, 48
(6), 666-677. N512 Advanced Pathophysiology Module Two: Cardiovascular Disease Across the Life Span

Ringstrom, E., & Freedman, J. (2006). Approach to undifferentiated chest pain in the emergency department: A review of recent medical literature and published practice guidelines. 
Mt. Sinai Journal of Medicine, 73
(2), 499-505.

Learning Activities

Discussion
: Participate in Discussion 2.

Discussion 2

Jackie Johnson, a 35 y.o. African-American, married female, advertising executive, presents to the emergency department with complaints of chest pain. The pain is described as 8 on a scale ranging from 1 to 10, retrosternal, and sharp in nature. It radiates to the back, is worse with taking a deep breath, and is improved by leaning forward. N512 Advanced Pathophysiology Module Two: Cardiovascular Disease Across the Life Span On review of systems, she has noted a “flulike illness” over the last several days, including fever, rhinorrhea, and cough. She has no medical history and is taking no medications. She denies tobacco, alcohol, or drug use. On physical examination, she appears in moderate distress from pain, with a blood pressure of 125/85 mm Hg, heart rate 105 bpm, respiratory rate 18/min, and oxygen saturation of 98% on room air. She is currently afebrile. Her head and neck examination is notable for clear mucus in the nasal passages and a mildly erythematous oropharynx N512 Advanced Pathophysiology Module Two: Cardiovascular Disease Across the Life Span. The neck is supple, with shotty anterior cervical lymphadenopathy. The chest is clear to auscultation. Jugular veins are not distended. Cardiac examination is tachycardic with a three-component high-pitched squeaking sound. Abdominal and extremity examinations are normal.

In this discussion:

Provide and discuss this patient’s likely diagnosis with your colleagues. Why do you support this “likely” diagnosis?

Discuss your differential diagnoses clinical reasoning. Why do you support this list of potential differential diagnoses?

Provide and discuss what the most common causes of this disease are, and which is most likely in this patient?

Identify the pathophysiologic mechanism for her chest pain.

Develop a plan of care post-discharge based upon your recommendations living arrangements and social supports.

Support your discussion with citations from the external literature and your textbook. N512 Advanced Pathophysiology Module Two: Cardiovascular Disease Across the Life Span

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria.

N512- Advanced Pathophysiology Module 1 Overview

Introduction

In this module students will learn about the pathophysiology of genetic disease and neoplasia. Emphasis will be placed on students’ mastery of the mechanisms of mutation, inheritance patterns, and prevalence of genetic disease, and on the molecular and biochemical bases of neoplasia.

Learning Objectives

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After completing this module, you will be able to:

Explore key concepts related to the genetic basis of disease

Examine the spectrum of pathophysiologic characteristics of infectious diseases

Explain the pathophysiological alterations noted in neoplastic developments

N512- Advanced Pathophysiology

Reading & Resources

Read Chapters 2, 4 & 5 In Hammer, G. & McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education / Medical

Visit
 Learn.Genetics.Utah.edu 
to learn more about genetic imprinting.

Optional Reading:

Kruyer, H., Milla, M., Carbonell, P., Ballesta, F., & Estivill, X. (1994). Fragile X syndrome and the (CGG)n mutation: Two families with discordant MZ twins. 
American Journal of Human Genetics, 54
(3), 437-442. (this is a classical study) N512- Advanced Pathophysiology

Activities

Introductions
: Introduce yourself in the Introductions forum.

Discussion
: Participate in Discussion 1. N512- Advanced Pathophysiology

Assignment
: Complete & Submit Assignment 1. Click on the Assignment 1 link for more details.

Review
: Review the Final Project details by clicking on the Final Project link at the top of the course in the Course Documents section or in Module 8.

Discussion 1

See Van, a 35-year-old married Hmong-American woman recently underwent an annual Papanicolaou test (Pap smear) at her Certified Nurse Midwife’s practice, and the results were abnormal.  Her provider diagnosed her with low-grade cervical dysplasia. N512- Advanced Pathophysiology What alterations at the cellular level would you expect to see with this diagnosis? Provide and discuss with your colleagues S. V.’s prognosis. Support your discussion with citations from the textbook, external credible literature and/or reliable electronic sources.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria.

assignment 1

The purpose of this paper is to address the following clinical scenario with the use of your textbook, external credible literature, and/or reliable electronic sources. Use the guide below to draft your paper and review the rubric to ensure you have met the assignment criteria. The expected length of the paper is approximately 4-5 pages, which does not include the cover page and reference page(s) N512- Advanced Pathophysiology.

Lisa Anderson, a 22 y.o., Caucasian single parent, is referred for genetic counseling by her pediatric Nurse Practitioner. She has a 3-year-old boy with developmental delay and small joint hyperextensibility. The pediatric Nurse Practitioner has diagnosed fragile X-associated mental retardation. She is currently pregnant with her second child at 14 weeks of gestation. The family history is unremarkable N512- Advanced Pathophysiology.

 

Please use the following headings/subheadings as a guide to draft your paper:

Introduction (including a brief purpose statement)

Identify the genetic mutation responsible for fragile X-associated mental retardation.

Describe and discuss how it causes the clinical syndrome of developmental delay, joint hyperextensibility, large testes, and facial abnormalities.

Identify which parent is the probable carrier of the genetic mutation?

N512- Advanced Pathophysiology

Explain why this parent and the grandparents are phenotypically unaffected.

Discuss the likelihood that the unborn child will be affected?

VII. Conclusion

In regards to APA format, please use the following as a guide:

Include a cover page and running head (this is not part of the 4-5 page limit)

Include transitions in your paper (i.e. headings or subheadings)

Use in-text references throughout the paper

N512- Advanced Pathophysiology

Use double space, 12 point Times New Roman font

Spelling, grammar, and organization are appropriate

Include a reference list (this is not part of the 4-5 page limit)

Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. ANA)

Assignment 1 Rubric

Criteria

60 Points

55 Points

50  Points

40 Points

Earned Points

Content: Application & Analysis

Responds correctly and/or appropriately to all questions and criteria. Content is excellent.

Demonstrates a high level of critical thinking, shows significant insight or creative thought about the topic, and does not merely recite the text/resources. Uses concepts and terminology correctly.  Detail rich and specific.

Responds correctly and/or appropriately to all questions and criteria. Content is good.

Demonstrates some critical thinking throughout the paper and may also show some insight or creative thinking about the topic. Mostly uses concepts and terminology correctly (1-2 issues). Minor detail inconsistencies (1-2).

Responds correctly and/or appropriately to at least one question OR if only one question, partially responds to question. Does not address all criteria. Content is minimal.

Demonstrates at least one critical thinking skill in the paper.  Attempts to use concepts and terminology correctly.  Several detail inconsistencies (3-5).

Paper is unclear and does not address the questions and/or criteria. Content does not meet requirements. Many inconsistencies and conflicting information (6+). N512- Advanced Pathophysiology

 

 

/60

Criteria

20 Points

16 Points

14 Points

12 Points

Earned Points

Quality: Supporting Research & Sources

All work is accurately cited (where applicable) and appropriately supports content with research, text, multimedia, and/or other resources.  References are relevant and enhance the topic.

Most of the work is accurately cited (where applicable) and adequately supports content with research, text, and/or resources.  One issue with reference or use of one inappropriate reference.  References are relevant to the topic.

2-3 issues with references, including the use of inappropriate references to support content. May fail to provide references to support content.  1-2 references are not relevant to the topic and/or distract from the topic at hand.

4 or more issues with references, including the use of inappropriate references to support content OR failure to include references (where applicable).  No supporting references are used OR they are used but 3+ references are not relevant to the topic.

/20 N512- Advanced Pathophysiology

Criteria

10 Points

8 Points

7 Points

6 Points

Earned Points

Organization

Paper is well-organized. Ideas are clear and arranged logically. Transitions are smooth, no flaws in logic. N512- Advanced Pathophysiology

Paper is organized. Ideas are usually clear and arranged in an acceptable sequence (1-2 issues). Transitions are usually smooth (1-2 issues), good support.

Paper lacks organization. There are many problems with the approach (3-5 issues with organization). Some difficulty understanding ideas.  Issues with support and transitions (3-5).

Paper is poorly organized and difficult to understand. Many issues with support and transitions (6+). Ideas are arranged illogically and do not make sense.

 /10

Accuracy & Basic Writing Mechanics

Error-free, including APA formatting, reflecting clear understanding of various forms of expression and careful editing.

Very few (less than 3) errors in spelling, grammar, syntax, and/or punctuation. Very few (less than 3) issues with APA formatting. Occasional poor choice of word.

4-5 errors in spelling, grammar, syntax, and/or punctuation. 4-5 issues with APA Formatting. Writing may be difficult to understand at times N512- Advanced Pathophysiology.

More than 5 errors in spelling, grammar, syntax, and/or punctuation.  Many (6+ issues with APA formatting.  Writing is difficult to understand in many instances.

 

Discussion 1

See Van, a 35-year-old married Hmong-American woman recently underwent an annual Papanicolaou test (Pap smear) at her Certified Nurse Midwife’s practice, and the results were abnormal.  N512- Advanced Pathophysiology Her provider diagnosed her with low-grade cervical dysplasia.  What alterations at the cellular level would you expect to see with this diagnosis? Provide and discuss with your colleagues S. V.’s prognosis. Support your discussion with citations from the textbook, external credible literature and/or reliable electronic sources.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria N512- Advanced Pathophysiology.

The Hmong-American population has historically had a disparity with access to care.  Though in this case, it appears the SV is dialed into the healthcare system.  The cellular alterations most commonly associated with low-grade cervical dysplasia are due in large part to the junction of two different types of cellular tissue.  Human Papillomavirus is also a common cause of cervical dysplasia. N512- Advanced Pathophysiology The incidence of HPV is widely established to be a leading cause of low-grade cervical dysplasia and is associated with multiple sexual partners as well as early sexual activity.  The pap smear will show a squamous intraepithelial lesion of an LSIL.  There are over a hundred different strains of HPV.  The pap smear is a sample of cells from the squamocolumnar junction of the cervix where the columnar epithelium overlaps the smooth squamous epithelium.  junction area allows metaplasia that causes squamous cells to replace columnar cells. This transition point is often the site of dysplastic activity within the cells.  These changes are what often lead to cervical dysplasia N512- Advanced Pathophysiology.  HPV can attack the basal cells of the squamous epithelium of the cervix.  The DNA of the HPV replicates inside the host cell.  These changes are evident in a pathology evaluation of the cellular samples taken during the pap smear. (Cooper, 2020). The cells obtained during the pap smear will have an abnormal appearance on the pathology evaluation.

SV’s prognosis is a good one provided she is scrupulous with her designated follow up as additional pap smears may be required within 3-6 months.  Often, there is no treatment for the dysplasia except to follow them more closely and monitor frequent pap smears to see if there are signs of the cellular changes that can occur in neoplasia N512- Advanced Pathophysiology.  Provided SV continues to have access to care and follows the guidance of her midwife, her prognosis looks promising provided she continues to follow the guidance of her healthcare professional and continue to have per prescribed pap smears.

 

Fang, D. M., M.S.W., Lee, Serge,PhD., M.S.W., Stewart, S., PhD., Ly, M. Y., M.S.W., & Chen, Moon S, Jr,PhD., M.P.H. (2010). Factors associated with pap testing among hmong women.
 Journal of Health Care for the Poor and Underserved, 21
(3), 839-50. Retrieved from http://americansentinel.idm.oclc.org/login? N512- Advanced Pathophysiology

 

Adunlin, G., Cyrus, J. W., Asare, M., & Sabik, L. M. (2019). Barriers and facilitators to breast and cervical cancer screening among immigrants in the united states.
Journal of Immigrant and Minority Health, 21
(3), 606-658. doi:http://dx.doi.org.americansentinel.idm.oclc.org/10.1007/s10903-018-0794-6

 

Shin-Young, L., & Lee, E. E. (2018). Cancer screening in koreans: A focus group approach.
 BMC Public Health, 18
doi:http://dx.doi.org.americansentinel.idm.oclc.org/10.1186/s12889-018-5147-9 N512- Advanced Pathophysiology

 

Cooper DB, McCathran CE. Cervical Dysplasia. [Updated 2020 May 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430859/

 

Cervical dysplasia is also known as cervical intraepithelial neoplasia.  It is a premalignant disorder that is characterized by abnormal growth of the epithelial lining of the cervix (Smith & Holle, 2018).  Cervical dysplasia affects 3600 out of 100,000 people each year and the peak incidence is at 26 years old (Smith & Holle, 2018) N512- Advanced Pathophysiology.  Human Papillomavirus (HPV) is a common cause of cervical dysplasia.  Risk factors that increase the risk of HPV include: an illness that suppresses the immune system, taking immunosuppressant drugs, having numerous sexual partners, giving birth prior to age 16, having sexual intercourse before the age of 18, and smoking cigarettes (Smith & Holle, 2018).  Cervical dysplasia is detected by a Pap smear test and based on the abnormalities of the cells ranges from mild to severe (Smith & Holle, 2018).  Cell dysplasia is defined as a decline to a less mature cell without a specific identity (Moasser & Weiyun, 2019). N512- Advanced Pathophysiology On See Van’s Pap smear one would expect to see these mentioned immature cells.  Most HPV infections and low-grade lesions will resolve on their own within 8 months (Smith & Holle, 2018).  Typically a person will have a follow up Pap test to see if the cells have changed.  If the results are concerning the doctor may recommend a colposcopy to identify suspicious areas for biopsy (Smith & Holle, 2018). See Van will need to follow up with her gynecologist for a follow up Pap smear to determine cellular changes.  If resolved she would be advised to practice safe sex including monogamy. If her cells have progressed she may need to undergo treatments like “cryotherapy, laser surgery, loop electrosurgical excision procedure (LEEP) surgical ablation, and surgical excision” (Smith & Holle, 2018).  Treatment of cervical dysplasia is found to be beneficial in 80-90% of cases (Smith & Holle, 2018).  SV has a good prognosis if she is compliant with follow up, testing, and recommendations from her gynecologist. N512- Advanced Pathophysiology

 

References

 

Mark M. Moasser, M., & Weiyun, Z. Ai, P. M. (2019). Neoplasia. In G. D. Hammer, & S. J. McPhee, Pathophysiology of Disease: An Introduction to Clinical Medicine (pp. 89-139). NewYork: McGraw-Hill Education.

 

Smith, N., Holle, M. (2018). Cervical Intraepithelial Neoplasia (Cervical Dysplasia) and Human Papillmavirus. Cinahl Information Systems. Retrieved from 
https://web-a-ebscohost-com.americansentinel.idm.oclc.org/nrc/pdf?vid=8&sid=9f1f73aa-e078-4144-a2e9-e416593a7a31%40sdc-v-sessmgr03

 

Module 2 Overview

Introduction

In this module students will review the normal anatomy and physiology of the heart and analyze the pathophysiology and clinical manifestations of selected cardiovascular disorders, including arrhythmias, congestive heart failure, valvular heart disease, and coronary artery disease N512- Advanced Pathophysiology.

Learning Objectives

After completing this module, you will be able to:

Review normal physiology of the cardiovascular system

Explain pathophysiological alterations in the cardiac cycle.

N512- Advanced Pathophysiology

Analyze the pathogenesis of alterations in heart function.

Summarize the major clinical manifestations and complications of alteration in heart functions

Reading & Resources

Read Chapters 10 In Hammer, G. & McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education / Medical

Optional readings:

Lindsell, C. J., Anatharaman, V., Diercks, D., et al. (2006). The internet tracking registry of acute coronary syndrome: A multicenter registry of patients with suspicion of acute coronary syndromes reported using the standardized reporting guidelines for emergency department chest pain studies. 
Annals of Emergency Medicine, 48
(6), 666-677 N512- Advanced Pathophysiology.

Ringstrom, E., & Freedman, J. (2006). Approach to undifferentiated chest pain in the emergency department: A review of recent medical literature and published practice guidelines. 
Mt. Sinai Journal of Medicine, 73
(2), 499-505.

Learning Activities

Discussion
: Participate in Discussion 2.

Discussion 2

Jackie Johnson, a 35 y.o. African-American, married female, advertising executive, presents to the emergency department with complaints of chest pain. The pain is described as 8 on a scale ranging from 1 to 10, retrosternal, and sharp in nature. It radiates to the back, is worse with taking a deep breath, and is improved by leaning forward N512- Advanced Pathophysiology. On review of systems, she has noted a “flulike illness” over the last several days, including fever, rhinorrhea, and cough. She has no medical history and is taking no medications. She denies tobacco, alcohol, or drug use. On physical examination, she appears in moderate distress from pain, with a blood pressure of 125/85 mm Hg, heart rate 105 bpm, respiratory rate 18/min, and oxygen saturation of 98% on room air. She is currently afebrile. Her head and neck examination is notable for clear mucus in the nasal passages and a mildly erythematous oropharynx. The neck is supple, with shotty anterior cervical lymphadenopathy. The chest is clear to auscultation. Jugular veins are not distended. Cardiac examination is tachycardic with a three-component high-pitched squeaking sound. Abdominal and extremity examinations are normal N512- Advanced Pathophysiology.

In this discussion:

Provide and discuss this patient’s likely diagnosis with your colleagues. Why do you support this “likely” diagnosis?

Discuss your differential diagnoses clinical reasoning. Why do you support this list of potential differential diagnoses?

Provide and discuss what the most common causes of this disease are, and which is most likely in this patient?

Identify the pathophysiologic mechanism for her chest pain N512- Advanced Pathophysiology.

Develop a plan of care post-discharge based upon your recommendations living arrangements and social supports.

Support your discussion with citations from the external literature and your textbook.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria N512- Advanced Pathophysiology.

NURS 6521 Mid-Term Exam Summary & Study Guide

NURS 6521

Mid-Term Summary & Study Guide

 

100-question Exam which will assess your knowledge on the Learning Resources from Weeks 1-6

Time limit of 2 hours

Multiple choice or multiple selection

NURS 6521 Mid-Term Exam Summary & Study Guide

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Pharmacokinetics:

Understand the implications of changing renal function on creatinine and drug dosing.

What is the impact of the following on drug levels and dosing: NURS 6521 Mid-Term Exam Summary & Study Guide

Cirrhosis

Protein binding

Drug interactions

Half-life

Routes of Administration and Dosage Forms:

Understand the different routes of administration and dosage forms and some of the challenges and benefits associated with these routes and forms.

Understand when it is OK to crush (or not crush) certain dosage forms and why NURS 6521 Mid-Term Exam Summary & Study Guide.

Which routes of administration have the fastest and slowest rates of absorption?

Know the relative onset, monitoring and appropriate use of various dosage forms including:

Patches (ie; fentanyl, rivastigmine)

Suppositories (ie; acetaminophen)

Sublingual tablets

Tablets

Liquid (know common measures)

Injectables

Sublingual

Nasogastric

Elixir (contains alcohol)

 

Therapeutics:  
Gastrointestinal, Cardiac, Respiratory, Neurology, Musculoskeletal

Understand the mechanism of action, side effects, appropriate use and contraindications for the classes of drugs and individual drugs listed below. Also, know the key patient education points including cautions, expected effects, and appropriate use (with food, empty stomach, etc.).

Anti-diarrheals (diphenoxylate HCl with atropine sulfate, loperamide, bismuth subsalicylate)

Laxatives (fiber, osmotics, stimulants, other) NURS 6521 Mid-Term Exam Summary & Study Guide

Therapy for various gastrointestinal disorders including antiemetics, ulcers, irritable bowel syndrome, Crohn’s ulcerative colitis (ie; alosetron, PPIs like omeprazole, Mesalamine, ranitidine, etc.)

Cough, cold, and sinus therapies including antihistamines and cough suppressants (ie; dextromethorphan, loratadine, fexofenadine, nasal decongestants

Cardiac Medications – Digoxin (understand toxicity, dosing, use), Statins, Colestipol, Nitroglycerin

Blood pressure medications (calcium channel blockers, ACE Inhibitors, diuretics, beta-blockers, nitroprusside, others)

Diuretics (spironolactone, furosemide, hydrochlorothiazide)

Inhalers (albuterol, ICS, LABA, anticholinergics) NURS 6521 Mid-Term Exam Summary & Study Guide.

Asthma – Theophylline, zafikurlast, steriods and others

Gout and arthritis therapies (allopurinol, etanercept, sulfinpyraxone, methotrexate)

Antineoplastics (etoposide, 5FU, cisplatin, bicalutamide, others)

Agents for thyroid disease (Levothyroxine, methimazole and others)

Multiple sclerosis therapies (Dantrium, Glatirimer, Baclofen, Tizanidine, others)

Antiepileptics (phenytoin, ethosuximide, diazepam, others)

Osteoporosis (calcitonin, others)

Hypoglycemics (glyburide, glipizide, metformin, insulin, etc.)

Meds for Hyperlipidemia

Anticholinergics/Cholinergics

Pain (opioids, muscle relaxants, NSAIDs, acetaminophen, topical lidocaine, etc.)

Orlistat

Adrenergic agonists

NURS 6521 Mid-Term Exam Summary & Study Guide

 

Terminology:

Efficacy

Pharmacokinetics

Pharmacodynamics

Drug tolerance

Addiction

Dependence

Withdrawal

First pass effect

Idiosyncratic response

Medication Reconciliation

NURS 6521 Mid-Term Exam Summary & Study Guide

 

Other Topics:

Which drug classes produce withdrawal if stopped abruptly? When is withdrawal life threatening?

Understand the appropriate use of herbal therapies

Understand components of cultural competence

How can adverse drug events be minimized?

Why do drugs require clinical study and FDA approval?

Know common teaspoon, tablespoon, and milliliter conversions

Know DEA schedules and examples of therapies in each scheduled class (1-5). What are the special prescribing restrictions for these various classes?

Which medications should be taken with food? Which on an empty stomach?

What is the purpose of the MedWatch Program?

Symptoms and treatment of drug intoxication from cocaine, opioids, marijuana

Appropriate use of reversal agents for digoxin, opioids, etc.

Antihistamines

H1, H2 blockers

NURS 6521 Mid-Term Exam Summary & Study Guide

NURS 6512 Midterm Exam Review (Week 1-6)

Building A Complete Health History

Communication techniques used to obtain a patient’s health history

Recording and documenting patient information

SOAP note documentation

NURS 6512 Midterm Exam

Subjective vs objective information when documenting

Ethical decision making and beneficence

 

Diversity and Health Assessments

Cultural awareness and diversity

Socioeconomic, spiritual, and lifestyle factors affecting diverse populations

Functional assessments

NURS 6512 Midterm Exam

ORDER A PLAGIARISM-FREE PAPER HERE

Assessment Tools and Diagnostic Tests in Adults and Children

Growth, Development, and Measurements in children and adults

Nutritional assessment to include recommended water intake and energy requirements

Macronutrients vs Micronutrients

Significance of a food diary NURS 6512 Midterm Exam

BMI measurements for normal, overweight, obesity, morbid obesity

Pernicious Anemia

Examination techniques and equipment

Diagnostic Assessment tools and tests to include tuning forks, BP monitoring, use of stethoscope, otoscope, ophthalmoscope

 

Assessment of the Skin, Hair, and Nails

Skin lesion characteristics

Documenting skin lesions using “ABCD” rule

Anatomy and physiology of skin layers

Abnormal nail findings in older adults NURS 6512 Midterm Exam

Psoriatic skin lesions

Vesicular skin characteristics

Normal vs abnormal hair distribution during aging

Characteristics of hair distribution

Assessment of Head, Neck, Eyes, Ears, Nose, and Throat

Cranial Nerves associated with the HEENT system

Normal assessment findings of an adolescent’s nose and throat

Normal examination findings of an infant’s fontanelles

NURS 6512 Midterm Exam

Examination findings of a patient with hypothyroid and hyperthyroid

Techniques for examining the HEENT systems

Examination findings for a patient with sinus symptoms

Appropriate tuning fork frequencies to approximate vocal frequencies

Examining the oral mucosa

Hearing loss findings when examining the elderly patient

Examination techniques used to examine the trachea and thyroid

 

Assessment of the Abdomen and Gastrointestinal System

Organs involved in the alimentary tract

Correct assessment order for examining the abdomen

Examination technique and findings of the liver

Examination findings associated with appendicitis

Examining McBurney’s sign

Assessment of abdominal pain in women

Landmarks for abdominal examination

Characteristics of bowel sounds heard during auscultation

NURS 6512 Midterm Exam