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NUR 6000 EXAM 4 | QUESTIONS AND ANSWERS | 2025-2026 | GRADED A+
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Reasons children get more ear infections Eustachian tubes are shorter and more horizontal developing immune system adenoids are relatively larger than in adults Tx of mild otitis media start with Tylenol and Motrin if unresolved after 48-72 hours start PO amoxicillin Severe Otitis Media Immediately start amoxicillin Chronic OM or resistant OM Augmentin and referral to ENT
Allergic Conjunctivitis S/S itchy, burning, thin watery discharge from eyes, redness, congestion, sneezing, all in both eyes Allergic conjunctivitis TX H1 blocker PO or drops, if not resolved by this add mast cell stabilzer to prevent release of inflammatory mediators, takes days to weeks to work if unsuccessful use glucocorticoid drops Benzoyl peroxide antibitoic/keratolytic: unclogs pores and suppresses growth of P. acnes May cause dryness, burnign, itching or peeling of the skin: if this occurss reduce from 2-3 times a day Topical retinoids: trientinoin VA derivative: unplugs comedomes and prevents acne development mild-moderate acne Doxycycline:
avoid scented skin products Dexamethasone: topical relives inflammation and ithcing can cause stretch marks, hypopigmentation, thinning of skin, acne and hair growth if uncontrolled by this add topical immunosuppressant Rapid acting insulin Lispro: onset: 5-10 minutes peaks 30-90 minutes give wihtin 15 minutes of meals Short-acting/regular insulin humalin R onset: 30-60 minutes peak 2-5 hours give wihtin 30 minutes of meal can be mixed wiht NPH Treats DKA
Intermediate acting insulin NPH: onset 1-2 hours peak 4-12 hours, last 24 hours can be mixed with regualr insulin Long-acting insulin: onset 1-2 hours, no peak Bigaunides: metformin increases insulin sensitivity, decreases hepatic production of glucose, and decreases intestinal absorption of glucose Teach that loose stills and decreased appetite will subside Sulfonylureas: Glyburide stimulates insulin release and may improve insulin binding and number of receptors Avoid concurrent use with NSAIDs as it can increase drug levels of glyburide if switching to another in drug class closley monitor BG
Caution in cardiac patients especially those taking nitrates as they can dramatically drop BP and cause reflex tachycardia can cause priapism Papavarine (Papacon) help achieve erections Testosterone therapy treats hypogonadism: fatigue, weight issues, sexual issues, and hair loss improves sex drive, weight loss, increased muscle mass can cause edema, acne, high K+, increased risk of clotting Topical testosterone apply to shoulders, upper arms, or back cleanse before skin to skin contact with women can shower or bath after 5-6 hours can cause birth defects if transferred to pregnant woman
Depo-provera: progestin injections suppresses ovulation adn thickens cervical mucus given every 3 months can cause irregular bleeding, HA, acne, and weight gain estrogen/progesterone combination patch suppresses ovulation applied once per week can cause breast tenderness, HA, local skin irritation, nausea, cramps and thromboembolic events Mini pills: progestin only thickens cervical mucus no risk of thromboembolic events d/t no estrogen maintain tight control of dosing, even hours late can make a difference estrogen/progesterone combination pills inhibits ovulation, thickens cervical mucus, and thins endometrium CI: in those who smoke and have history of clots. can cause HA, nausea, and abdominal cramps, lower dose of estrogen
Benzodiazepines: alprazolam enhances GABA given for anxiety, panic attacks, fear of public speaking and phobias addictive, short term use, taper drug to discontinue can cause respiratory depression Beta-blockers: propranolol CV disorders and public speaking anxiety lessens physiological symptoms of anxiety anxiolytic: buspirone short term use for anxiety and insomnia can cause HA, dizziness, sedation and nausea good for those with insomnia TCAs amitriptyline depression and anxiety decreases depressive symptoms sedation, orthostatic hypotension, prolonged QT, increased risk of MI or stroke
anticholingeric effects T-tachycarida C- cardiac effects A-anticholingeric effects S- sexual dysfunction closley monitor HR/BP/mental health increased risk of suicide in young adults and children Tetracyclic AD option for those who cannot take TCAs can cause somnolence and dizziness can cause serotonin syndrome do not use with MAOIs SSRI (fluoxetine) anxiety, depression , OCD, PTSD, panic attacks takes up to 4 weeks for effects SE: N/V, increased risk of suicide, HA, insomnia, dizziness and sexual dysfunction avoid use with MOAIs and TCA's --> serotonin syndrome: HTN, increased HR, hyperreflexia and agitation