By Rhonda Hensley EdD APRN BC, Angela Williams APRN EdD(c)
From lecture room to perform your personal scientific trainer via your aspect! here is the precise go-to consultant for making judgements in scientific settings! skilled practitioners trainer you as you study 30 of the commonest sufferer proceedings and rule out each one differential till you achieve the proper prognosis.
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Additional info for Clinical Coach for Nurse Practitioners (Davis's Clinical Coach)
If perforation occurs, pain will be more generalized. Pain from appendicitis may awaken a child from sleep. Appendicitis in children may also present with vomiting accompanied by pain; often, however, children with appendicitis will have anorexia. Initially a low-grade fever may be present, escalating if perforation ocCOACH curs. The onset of pain before vomiting is a CONSULT key to differentiation between appendicitis and infectious enteritis. Obtain a CBC and uriIf you suspect FAP, nalysis, and consider an abdominal ultrasound investigate the examination to aid in the diagnosis.
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Qxd Table 2–9 11/24/09 12:04 PM Page 39 Stepped Approach to Management of Adult Asthma LUNG FUNCTION INDICATORS STEP SYMPTOMS TREATMENT Step 4 Severe persistent Continual symptoms Limited physical activity Frequent exacerbations Frequent nighttime symptoms FEV1 <60% predicted PEF (peak expiratory flow) variability >30% High-dose inhaled corticosteroid and long-acting inhaled beta2 agonist and if needed: Corticosteroid tablets Step 3 Moderate persistent Daily symptoms Daily use of inhaled short-acting beta-2 agonist Exacerbations affect activity Exacerbations more than twice a week Nighttime symptoms >1 time/week FEV1 60%–80% predicted PEF variability >30% Low- to mediumdose inhaled corticosteroid and long-acting inhaled beta 2 agonist Alternative: Low- to medium-dose inhaled corticosteroid and leukotriene modifier or theophylline Step 2 Mild persistent Symptoms >2 times/week, but <1 time/day Exacerbations may affect activity Nighttime symptoms >2 times/month FEV1 >80% predicted PEF variability 20%–30% Low-dose inhaled corticosteroid Alternative: Cromolyn, leukotriene modifier, or sustainedrelease theophylline Step 1 Mild intermittent Symptoms <2 times/ week Asymptomatic and normal PEF between exacerbations Exacerbations brief (few hours–few days) Nighttime symptoms <2 times a month FEV1 >80% predicted PEF variability <20% No daily medications needed Quick relief 2–4 puffs short-acting beta-2 agonist May respond to short course of systemic corticosteroids Adapted from Nurse Practitioner Prescribing Reference Winter 2008–2009.