What is dissemination?
Getting the research information out to those who need to know it!
Publication - highest level
Presenting at National
... [Show More] Conference
Presenting at Local Conference
Journal Club where one person reviews an article
What does a 17 on MMSE mean?
Moderate cognitive impairment
What is Tegretol in the CYP450 system?
Inducer -->will lower dose of Lamictal and BCP's
What do BCP's do to Lamictal?
Inducer - will lower dose of Lamictal
What is a Type I research error?
There IS a difference but you say there isn't a difference.
What is a Type II research error?
There is NO difference but you say there is a difference.
What is pseudo-dementia?
Cognitive impairment secondary to depression that clears when treated in the elderly. Dementia won't improve.
Is it normal for a 1 month old to have a palmar grasp?
Yes.
What is a drug 1/2 life?
The time it takes for 50% of a drug to be eliminated from the body.
What 3 atypicals can be used with teens?
Zyprexa, Abilify, Seroquel - low doses
What is a risk of using Tramadol?
Serotonin Syndrome as it is very serotonergic.
What is the allele seen in Asians that increase the risk of SJS?
HLAB-1502
When might you see toxic epidermal necrolysis?
With worsening of SJS
How many generations do you include for a genogram?
1st degree - mother, father, siblings
2nd degree - grandparents & cousins
3rd degree -
What does messenger RNA code for?
Amino Acids
What is epigenetics?
Factors that affect genes - environmental, smoking, stress, etc...
What part of the brain is involved with OCD?
Basal Ganglia
Occipito-Frontal
What happens to the brain during adolescence?
Dendritic pruning
Emotions are controlled by amygdala
By adulthood, PFC involved as well
When do males typically present with schizophrenia?
10-25 yo
When do females typically present with schizophrenia?
25-35 yo
What does Erythromycin to trileptal?
You will need to decreases the level because Trileptal(inducer) and erythromycin is a inhibitor
ACE Inhibitors are the drug of choice for what?
Heart Failure
HTN
What are some psychiatric side effects seen with some asthma drugs
Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor
What should you watch for with Tegretol?
Agranulocytosis and Hyponatremia
What are the 3 CK muscle enzyme tests?
CKBB, CKMM, CKMB
Which one of the 3 muscle enzymes are related to cardiac muscle damage?
CKMB
What is the risk of a seriously elevated CKMB?
Polymyositis
Rhabdo
What is a normal CKMB?
0.3 mcg/L
What psychoactives does Detrol interact with?
Topamax
KCL
Zonegran
What CN are you assessing when you have the patient shrug their shoulders?
CN XI - Spinal Accessory
What do you see in labs with HIV & Dementia?
CD4 <200
Viral Load is high
<20% get it with antiretroviral treatment
What is the scoring with the Beck Depression Inventory?
Self-Report - 0-63
0-13 - minimal
14-19 - mild
20-28 - moderate
29-63 - severe
What is sensitivity?
Helps rule-out disease = True Positive = Snout
What is specificity?
Helps rule-in disease = True Negative = Spin
What does a sed rate measure?
Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour.
What is a normal sed rate or ESR?
0-22 males
0-29 females
What is a retic count?
Measures % of reticulocytes in blood (immature RBC's) Indicates whether enough RBC's are being produced by bone marrow.
What does a decreased retic count indicate?
Anemia - acute or chronic bleeding
What does an increased retic count indicate?
Bone marrow disorder or Vitamin Deficiency
What does an abnormal retic ount indicate in general?
Doesn't diagnose anything. First step is ID source of the issue.
What happens when you mix tegretol and macrolides?
Increase tegretol levels.
What happens if a pregnant women takes Accutane?
Birth defects.
What labs do you get with RA?
Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP - helps confirm diagnosis.
CRP and ESR are both increased in RA but NOT in osteoarthritis.
Where does the NP Code of Ethics come from?
ANA
When do you assume informed consent?
Unconscious
Incompetent
Life Threatening Situation
What are the legal ramifications of treating w/o informed consent?
Same as with informed consent
Who can declare a patient incompetent and appoint a guardian?
Only a court
Does impaired judgment mean one is incompetent?
No.
Can an advanced directive ever be revoked?
Yes, at any time.
What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact?
Nothing. They are all the same.
Does the de facto rule of proxy apply in same sex marriages?
No.
How do Asians see HC providers?
As in a position of authority.
Expect to give instructions and help make decisions
What does it mean when an Asian patient does not make eye contact with the NP?
SIgn of respect
What is the evil eye?
When a stronger or more powerful person looks at a weaker person - often infant/child resulting in a hex which presents in illness such as HA, fever, diarrhea, disturbed sleep, increased fussiness.
How do you protect from the evil eye?
Red ribbon on an infant
Amulet for adults
How do you treat for evil eye?
Access traditional healer + traditional care.
For there to be a duty to a patient, what must exist?
Relationship
What is a proximate cause?
Connection between A + B.
For there to be damages, what must exist first?
Negligence
What is an occurrence basis liability insurance?
"occurred" during the policy period, no matter when the claim is brought against the insured
What is a claims made/based liability insurance?
provides coverage for a claim that is brought within the policy period, no matter when the loss occurred.
Who sets the minimum requirements for NP's?
Board of Nursing
State
What are the various controlled substance classes?
Schedule I - nobody has these - not good for health - heroin, PCP, MDMA, researchers can get it sometimes.
Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate
Schedule III - Moderate Abuse Potential - hydrocodone, codeine
Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine
Schedule V - Very low abuse potential - anti-tussives, lomotil
What classes of CS's is the NP approved to prescribe?
Schedules III-V ONLY.
Where does 50% of healthcare funds come from?
The government
Who is eligible for Medicare?
>65 or under 65 with diability, ANY age with renal disease.
What is incident to billing?
Means MD initiates treatment and NP is an extension of the care and directly under the supervision of the MD.
Allows NP to get reimbursed at 100% rather than 85%.
How are Medicaid benefits determined?
State determines qualification - Partnership between State and Fed Govt.
Must be impoverished
Must be US resident and low or very low income.
Can you have Medicare and Medicaid?
Yes, impoverished elderly but Medicaid is always payor of last resort.
Is dental care included in Medicaid?
Yes, <21 gets basic dental as part of the Medicaid plan.
What is the purpose of HIPAA?
National standards for electronic HC transactions
National ID for providers, health plans and employers.
Not SIMPLY Confidentiality.
What must be signed prior to any healthcare in the state
Notice of Privacy Practices Statement
What happens if a patient refuses to sign an ROI?
Can decline to treat
Health plan may condition enrollment on provision of consent
When is HIPAA not required?
Emergency treatment
Substantial communication barriers and consent is inferred
Involuntary committment
Is it ok to announce a patient's name in a waiting room?
Yes, no other way to give care.
Is it ok to leave a message on a patient's vm?
Yes, but should be limited.
What is the impact of steroid inhalers on children?
Slows bone growth and may decrease ultimate height.
What is the long-term impact of using steroid inhalers?
Cataracts, glaucoma, thinning of bones and skin
What is included in the treatment of fibromyalgia?
Sleeping meds
Antidepressants
Pain meds [Show Less]