NURSING 555 Leik-s Exam Tips-AANP
Leik’s Exam Tips + My Extra Good Stuff
Medication
1) Aspirin irreversibly suppresses platelet function for up to 7 days (due to irreversible
acetylation).
2) Discontinue ASA if patient complains of tinnitus (possible aspirin toxicity).
3) For chronic use, the recommended dose is 81 mg/day (some exceptions exist).
4) Aspirin given post-MI or after a stroke/TIA is considered tertiary prevention.
5) Avoid using in children with viral infections who are less than 16 years of age (Reye’s
syndrome).
1) Memorize the FDA category and dose of finasteride (Proscar 5 mg PO once a day).
Finasteride is also a teratogen. Cat X medication
2) Accutane is a potent teratogen. Reproductive-aged females must use 2 reliable forms of
birth control and must have a negative pregnancy test 1 month before, during, and 1 month
after Accutane.
3) High-dose vitamin A is teratogenic in animal studies—avoid “mega-doses” of vitamins in
pregnancy.
4) Avoid mixing warfarin with sulfa drugs—can increase INR and bleeding risk.
HEENT
■Treatment for otitis externa is Cortisporin Otic drops.
■ Otitis externa’s common bacterial pathogen is Pseudomonas.
■ Ruptured spleen is a catastrophic event. Avoid contact sports (i.e., 4 weeks) until ultrasound
documents resolution.
■ Betimol (timolol) which is an eye drop used for glaucoma, has the same contraindications as
oral beta blockers.
■ Cholesteatoma, periorbital sinusitis complication which can cause hearing loss in the affected
ear and is a “cauliflower like growth” accompanied by foul smelling discharge. Patient will have
history of chronic otitis media. TM not visible due to tumor. Refer to ENT.
■ Do not use amoxicillin if used in the past 3 months. Advance to second-line antibiotics such
as Augmentin which is a beta lactam or Ceftin.
■ Penicillin-allergic patients, use macrolides, sulfas (avoid cephalosporins, especially if had
Class I reaction or anaphylaxis from penicillins).
■ Learn to recognize a description of eye findings such as pinguecula, pterygium, chalazion.