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Nikkie the NP’s Classroom
171 members • Free
9 contributions to Nikkie the NP’s Classroom
8d •
Question of the Day 9/9
A 72-year-old female presents to establish care as a new patient. The patient is on lisinopril, hydrochlorothiazide, metoprolol, and amlodipine. Her blood pressure in the office is 172/92. What are your next steps?
1 like • 8d
Are her meds at the max doses or did previous provider just keep adding a new med each time uncontrolled? Is she actually compliant with medication? Depending on my history and physical exam & medication depends my next step. Would encourage DASH diet, monitoring BP twice daily & follow up in office in 1 week. Also if establish care grabbing labs.
0 likes • 6d
@Nikkie Miller has she taken her medication today? Maybe she came in and forgot to take it!
12d •
Question of the Day Sat 9/5
Patient reports shortness of breath. What are some things to consider when differentiating between heart failure, pneumonia, COPD, PE, or asthma?
0 likes • 8d
Physical exam & history is most important. Any recent sick contacts? History of asthma or COPD? What medications is he taking? Depending on my assessment depends on what I would be ordering!
10d •
Question of the Day 9/7
A patient on Eliquis develops weakness and shortness of breath. What is your next step?
1 like • 8d
Full assessment. Stay CXR. Vital signs. Understand when it happened, what was he doing, is it constantly, any chest pain associated? Can obtain a CBC, to check for infection. Any recent sick contacts? Hx of asthma? Obtain d-dimer, check iron Panel & ferritin. If I’m Inpatient would obtain a CTA chest
14d •
Question of the Day
A 28-year-old-female. Presents with dysuria, frequency, and urgency. UA is consistent with UTI. What are other things you need to know before treating the patient?
1 like • 14d
Is she pregnant? Could it be STI?
15d •
Question of the Day
Sorry for the delay over the last few days. It's been really busy but we are back up with a new question of the day. A patient was started on atorvastatin 3 months ago. On follow up the patient is reporting muscle pain in their legs that has been getting worse over the last 4-6 weeks. What is your next step?
1 like • 14d
Have them stop medication. Concern for rhabdo, so ask questions about that. Check liver profile& CK.
1 like • 14d
And rule out DVT! Can use well’s criteria to see if at risk. Ask about recent injury or fall.
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