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NURS5463 Exam 2 -with 100% verified solutions 2024-

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high probability for DVT? Wells Score > high probability for PE? Wells criteria > high risk for bleeding 0-3 months?

2 risk factors = no anticoagulation contraindicated in renal patients and mechanical heart valve patients? Factor Xa inhibitor 1st line anticoagulation in cancer patients? LMWH all VTE treated in what patients? cancer patients CI in GFR < LMWH and Fondaparinux, prescribe heparin high risk for VTE via padua prediction? 4, need pharmacologics unless high risk of bleeding >

low risk padua prediction <4 in nonsurgical patients? no prophylaxis needed prophylaxis in orthopedic patients? LMWH for 10-14 days most common inherited thrombophilia? Factor V Leiden PCR testing- G20210A? Prothrombin Mutation mutation on chromosome 3 PROS1 mutation in PRrotein S deficiency anticoagulants except heparin and LMWH & VTE within 3 months interferes with what testing? free protein S levels, protein C function assay, and antithrombin functional assay hemophilia A factor deficiency? factor VIII, sex linked recessive factor replacement and dDAVP treatment? hemophilia A factor? in hemophilia B? factor IX

? prolonged in hemophilias? PTT ADAMTS13 deficient <10% confirms Dx? Thrombotic thrombocytopenia purpura TTP plasma vWF <30 and factor VIII normal? Von Willebrand Disease treatment of type 1 and some of type 2 vWD? dDAVP treatment of some type 2 and all type 3 vWD? recombinant vWF LDH high, bilirubin high? TTP and ITP dexamethasone slows destruction of plts in? TTP and ITP

transfuse plt in TTP or ITP when? severe bleeding or plt <30, plt destruction and the severe form? HIT 2 DX of HIT 2? ELISA OD >1.5 and high 4T score probability and serotonin release assay 1st choice DOAC in nonbleeding HIT 2 patients? Argatroban IV to reduce HIT thrombosis prolonged PTT in any factor deficiency except? VII bleeding immediately after trauma, petechiae? Thrombocytopenia <150, delayed bleeding in joints, tissue hematomas? Coagulopathies

thrombocytopenia causes? post op within 2-4 days, cancer, cirrhosis, infections, malignancy, SLE spontaneous bleeding, petechiae present? plt <10, 1st diagnostic in ovarian cancer suspected patients? pelvic exam and transvaginal US surgical exploration definitive dx in? ovarian cancer CA 125 >35 marker in 80%? ovarian cancer 1st line diagnostic in uterine cancer? pelvic sonogram; biopsy if lining >4mm bone pain in the vertebrae? multiple myeloma dx multiple myeloma?

xray and bone marrow biopsy PLUS related organ impairment or presence of biomarker with near end organ damage more likely in African americans? multiple myeloma and TTP diagnostic for testicular cancer? testicular US, doesn't transilluminate AFP >15, HCG >5, LDH> testicular cancer TNM cancer staging except in> brain, spine, and blood cancers Uric acid >8, AKI, phos >6.5, K >6, Ca <7? Tumor lysis syndrome tx and prevention of tumor lysis syndrome? Rasburicase IV or Allopurinol (prevention only), IV hydration and loop diuretics tx of dyspnea with Superior vena cava syndrome>

endovenous recannulization with SVC stent bone mets most common in? prostate cancer tumor markers not used as? screening tools most will experience tumor lysis syndrome with treatment? hyperleukocytosis patients- Hydroxurea for emergent chemo hypoglycemia that doesn't respond to glucagon? ETOH intoxication due to preventing liver from releasing glucose hallmark of ETOH withdrawal? tremors to DTs hypertension, tachycardia, agitation & hallucinations? severe ETOH withdrawal >48 hrs after last drink seizures in ETOH withdrawal? 30% of withdrawal pts, 50% DTs may follow

labs in ETOH withdrawal? megaloblastic anemia, thrombocytopenia, elevated lipase, elevated CK levels from adrenergic hyperactivity, altered electrolytes thiamine in ETOH pts? prevents Wernicke encephalopathy nystagmus, hypotonia, hallucinations, hypotension, respiratory depression? Benzo overdose- Xanax may precipitate withdrawal seizures, no effect on respiratory depression? Romazicon respiratory depression- RR <12, GCS <12, bradycardia, miosis, hypotension? opioid overdose noncardiogenic pulmonary edema? heroin use- opioid doesn't appear in urine drug screen?

fentanyl reverses opioids, q 20-60 min or infustion? Narcan reverses opioids and extended time due to decreased gut motility? activated charcoal flu-like illness with dilated pupils and tremors? opioid withdrawal, no life-threatening signs, seizures, or AMS treatment of opioid withdrawal? clonidine, methadone, buprenex, acetaminophen, and lopramide toxic salicylate levels?

40-50mg/dL causes respiratory alkalosis and metabolic acidosis salicylate toxicity salicylate toxicity?

hypoglycemia, fluid and electrolyte imbalances, CNS toxicity in chronic use, GI bleeding, decreased platelet adhesiveness activated charcoal for acute ingestion? salicylate toxicity treatment of salicylate toxicity? bicarb infusion, hemodialysis level >120 or >100 after 6hrs post- ingestion, glucose, replace potassium neurotoxic leading to respiratory paralysis in bites? coral snake significant venom injection? early and intense pain treatment of snake bite? Anti-venom, no ice/tourniquets/ETOH, no blood products needed hyperkalemia, hypoglycemic, hypotension, fatigue, vitiligo, hyperpigmentation? Addison's Disease

ACTH 250mcg Stimulation Test? Dx of Addison's disease- no change in cortisol levels adrenal insufficiency and hypothyroidism suspected? corticosteroids admin prior to thyroid hormone severe shock, unresponsive to treatment? adrenal crisis little mineralocorticoid activity, doesn't interfere with serum cortisol? Dexamethasone- stress dose steroid admin 200-350mg/day diagnose Cushing disorders? Dexamethasone Suppression Test- steroid made by body doesn't decrease treatment of Cushing disorder? treating signs- HTN and DM management, surgical removal of pituitary or adrenal tumors (Cushing Disease) Treatment of Cushing disorder? Propranolol, Thionamides (PTU or Methimazole)

inhibits conversion of T4 to T3? Propranolol and PTU most common precipitating factor of Myxedema Coma? Infection; No leukocytosis, only bands or left shift, hypothermia IV Levothyroxine 500-800mcg followed by daily dosing 100mcg? Myxedema Coma hyponatremia, hypo-osmolality, elevated urine osmolality? SIADH common in post-op patients? SIADH, Thrombocytopenia treatment of SIADH? water restriction, hypertonic saline in severe hyponatremia < urine specific gravity <1.005 and urine osmolality <200? DI DDAVP prevents water excretion?

in central DI hydrochlorothiazide prevents water excretion in? Nephrogenic DI hypertension, hyperglycemia, hypercalcemia, erythrocytosis? Pheochromocytoma AM hyperglycemia from hormones, no nocturnal hyperglycemia? Dawn Phenomenon 3AM hypoglycemia followed by 7AM rebound hyperglycemia? Somogyi Effect causes fluid retention, avoid in HF, causes hepatic toxicity? TZDs (zones) hypoglycemia in the hospital? Sulfonylureas (Gli) TDD? 0.4-0.6 u/kg/day

low serum osmo, anion gap metabolic acidosis, ketones, low CO2? DKA high serum osmo, no ketones, dehydrated, AMS? HHS calculate? in DKA and HHS? water deficit and corrected Na betahydroxybutyrate serum? measures ketones in DKA pts low T3, T4, and TSH? in ill pts- doesn't mean hypothyroid ill patient with TSH >20, and low T4? Dx of hypothyroidism standard therapy for cerebral edema? Dexamethasone- lacks mineralocorticoid

tertiary AI? abrupt cessation of glucocorticoid therapy- give Hydrocortisone IV day of surgery less likely for HPA suppression? glucocorticoids for less than 3 weeks and alternate day dosing <10mg HPA suppression with? prednisone >20mg >3 weeks, bedtime dosing >5mg, cushings appearance oral antibiotics started for acne? Moderate Acne- papules and pustules more prominent than comedones inflammatory chronic skin disorder Rosacea metronidazole, ivermectin, permethrin cream, doxycycline treatment? type 1 & 2 of Rosacea preventatives include sunscreen, soap free cleansers, foundation, avoid triggers? Rosacea

chronic-immune mediated skin disease; interleukin- Psoriasis symmetrical oval plaques, pink-red base with silvery scale? Psoriasis streptococcal infection? Guttate psoriasis chronic inflammatory skin disease, itchy, symmetrical eczema, atopic dermatitis Clobetasol (high potency) & Triamcinolone (low potency) topicals used to treat psoriasis and Eczema Pimecrolimus and Tacrolimus? treat psoriasis and Eczema on face and genitalia diagnosis of stasis dermatitis? skin characteristics- red, scaly, edema, ulceration; and venous insufficiency

Clobetastol, compression, elevation, prevent dry skin? treatment of acute stasis dermatitis