Nurse Practitioner Certification Examination and Practice Preparation 4th Edition, Fitzgerald, 2015 | Nurse Practitioner (NP) School Study Aid
Folate Deficiency
- Macrocytic Anemia
- Megaloblastic Anemia
- Malabsorption
- Dietary
- Tea and Toast
- Alcoholics
- Medication-induced
- Methotrexate
- Trimethoprim
- Increased Requirement
- Hemolytic Anemia
- Pregnancy
Macrocytic Anemia Causes
- MCV > 100
- B12 Deficiency
- Folate Deficiency
- Orotic Aciduria
- Alcoholism
- Liver Disease
- Reticulocytosis
Microcytic Anemia Causes
- MCV < 80
- Thalassemias
- Chronic Disease or Illness
- Lead Toxicity
- Late Iron Deficiency
- Sideroblastic Anemia
Normocytic Hemolytic Anemia Causes
- Hereditary Spherocytosis
- RBC Enzyme Deficiency
- Hemoglobin C Defect
- Paroxysmal Nocturnal Hemoglobinuria (PNH)
- Sickle Cell Anemia
- Autoimmune
- Microangiopathic
- Mechanical Destruction
- Prosthetic Cardiac Valves
- Infection
- Snake Venom
Hematocrit (Hct) Lab Values
- Women: 36% - 46%
- Men: 41% - 53%
Hemoglobin (Hgb) Lab Values
- Men: 13 - 17 g/dL
- Women: 12 - 16 g/dL
Anemia Lab Values
- Iron Deficiency Anemia
- Serum Iron Decreased
- Transferrin Increased
- Ferritin Decreased
- % Transferrin Saturation Decreased
- Pregnancy and OCP Use
- Serum Iron Normal
- Transferrin Increased
- Ferritin Normal
- % Transferrin Saturation Decreased
- Anemia of Chronic Disease
- Serum Iron Decreased
- Transferrin Decreased
- Ferritin Increased
- % Transferrin Saturation Decreased or Normal
- Hemochromatosis
- Serum Iron Increased
- Transferrin Decreased
- Ferritin Increased
- % Transferrin Saturation Increased
Normocytic Nonhemolytic Anemia Causes
- MCV 80-100
- Anemia of Chronic Disease/Inflammation
- Aplastic Anemia
- Chronic Kidney Disease
- Early Iron Deficiency
Valproic Acid
- First Line Tonic-Clonic Seizure Treatment
- Bipolar Disorder
- Migraine Prophylaxis
- Increases GABA Concentration
- Blocks Voltage-Gated Na+ Channels
- GI Distress
- Contraindicated in Pregnancy
Valproic Acid (Valproate) Side Effects
- Vomiting
- Alopecia
- Liver Toxicity
- Pancreatitis/Pancytopenia
- Retain Fat (Weight Gain)
- Oedema (Edema)
- Appetite Increase
- Tremor
- Enzyme Inhibitor (P450)
Phenytoin
- Status Epilepticus
- Tonic-Clonic Seizures
- Blocks Na+ Channel Activation
- Inhibition of Glutamate Release
- Class IB Antiarrhythmic
- Teratogenic
- Macrocytic Megaloblastic Anemia
- Induce Cytochrome P450
- Drug-induced Lupus
- Neuropathy
- Hirsutism
- Gingival Hyperplasia
Carbamazepine
- First-line Seizure Medication
- First Line for Trigeminal Neuralgia
- Stabilizes Inactive State of Na+ Channels
- Stevens-Johnson Syndrome
- Induce Cytochrome P450
- Teratogen
- Hepatotoxicity
- Blood Dyscrasias
Levothyroxine
- Hypothyroidism
- Myxedema Coma
- Isomer of Thyroid Hormone (T4)
- T3 has Higher Potency
- Hyperthyroid Symptoms
Proton Pump Inhibitors (PPIs)
- "-prazole" Suffix
- Zollinger-Ellison Syndrome
- Gastritis
- Peptic Ulcer
- Gastroesophageal Reflux Disease (GERD)
- Inhibit H+/K+/ATPase
- Hip fracture
- Pneumonia
Tetracycline Mechanism
- Binds to 30 S to Prevent Attachment of Aminoacyl tRNA
- Limited CNS Penetration
- Divalent Cations Inhibit Absorption
- Must Not Take with Milk, Antacids, Iron
Tetracycline Drug Names and Indications
- Demeclocycline
- Minocycline
- Doxycycline
- Fecally Eliminated
- Can be Used in Renal Failure
- Antidiuretic Hormone Antagonist
- Chlamydia
- Rickettsia
- Borrelia burgdorferi
- Helicobacter Pylori
- Mycoplasma Pneumonia
Tetracycline Toxicities
- Inhibition of Bone Growth in Children
- Teratogen
- Discoloration of Teeth
- Photosensitivity
- GI Distress
Iron Deficiency Anemia
- Malnutrition/Malabsorption
- Hemorrhage
- Microcytic, Hypochromic Anemia
- Decreased Heme Synthesis
- Decreased Reticulocytes
- Decreased Ferritin
- Increased Red Cell Distribution Width (RDW)
- Poikilocytosis
- Anisocytosis
- Increased Central Pallor
Levodopa/Carbidopa (Sinemet)
- Parkinson's Disease
- Increase Dopamine in Brain
- Cross blood-brain barrier
- Increase bioavailability
- Arrhythmias
- Dyskinesia
Iron (Ferrous Sulfate)
- Ferrous Salts
- Anemia
- GI Distress
- Nausea and Vomiting
- Dark Stools
- Take Between Meals
- Liquid can Stain Teeth
- Keep out of Reach from Children
- Caution with GI Disorders
- Avoid Antacids
Vitamin B12 (Cobalamin) Mechanism and Deficiency
- Cobalamin
- Large reserve pool in the liver
- Homocysteine to methionine
- Methylmalonyl CoA to succinyl CoA
- Macrocytic Megaloblastic Anemia
- Hypersegmented Neutrophils
- Neurologic defects
- Posterior column
- Lateral corticospinal tract
- Spinocerebellar tract
Beta Thalassemia
- Microcytic, Hypochromic Anemia
- Mediterranean Populations
- Decreased Beta-Globin
- Increased HbA2
- No Intervention
- Blood Transfusions
- Hemochromatosis
- Crew-cut on Skull X-Ray
- Electrophoresis
Hypokalemia
- < 3.5 mEq/L
- Muscle Weakness
- Arrhythmia
- U Wave
- Ileus
- Hyporeflexia
- IV K+ Infusion at 5-10 mEq/hr
- Give Orally with Food
- Monitor Respiratory Status
Anaphylaxis Intervention
- Epinephrine
- Reassure Patient with Anxiety
- Supine Position
- IV Fluids
- Diphenhydramine (Benadryl)
- Methylprednisolone (Solu-medrol)
- Assess Airway and Oxygen Needs
- Medical Alert Bracelet
Erythropoietin
- Stimulates RBC Production
- Chronic Renal Failure
- Anemia
- Increased Risk of Thrombosis
- Pelvic and Limb Pain
- Hypertension
- Do Not Shake
- Monitor Hemoglobin (Hgb) Weekly
- May Accelerate Tumor Progression
NSAIDs
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
Penicillin
- Gram Positive
- Spirochetes
- Bind PBPs
- Block Transpeptidase Cross-linking of Cell Wall
- Activate Autolytic Enzymes
- Bactericidal
- Hypersensitivity Reactions
- Hemolytic Anemia
- Beta-lactamase Sensitive
Aspirin
- Fever
- Pain and Headache
- Cardiovascular Disease (CAD)
- Irreversible inhibition of COX-1 and COX-2
- Suppress Thromboxanes and Prostaglandins
- NSAID
- Reye's Syndrome
- Tinnitus
- Peptic Ulceration
- Mixed Acidosis/Alkalosis
- Nephropathy
Aspirin Poisoning (Salicylism) Assessment
- Nausea and Vomiting
- Tinnitus
- Confusion
- Hyperventilation
- Respiratory Alkalosis
- Metabolic Acidosis
- Coma
- Hyperthermia
Albuterol (Proventil)
- Short-Acting Beta-2 Agonist
- Bronchospasm
- Asthma
- Angina
- Tachycardia
- Tremor
Epinephrine
- Alpha Agonist
- Beta Agonist
- Hypotension
- Anaphylaxis
- Allergy
- Glaucoma