A patient who has mild to moderate migraine headaches has severe ...

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A patient who has mild to moderate migraine headaches has severe nausea and vomiting with each episode. For the best treatment of this patient, the primary care NP should prescribe:
 
  a. triptan nasal spray.
  b. metoclopramide and aspirin.
  c. an NSAID and prochlorperazine.
  d. sumatriptan and metoclopramide.

Question 2

A patient with group A B-hemolytic streptococcal pharyngitis is treated with penicillin V. At a follow-up visit 2 weeks later, the patient presents with edema of the hands and feet, blood pressure of 140/85 mm Hg, and cola-colored urine.
 
  A urine dipstick shows proteinuria. The primary care NP should: a. perform a repeat throat culture.
  b. prescribe 10 more days of penicillin V.
  c. obtain an ASO titer and creatinine clearance.
  d. order oral amoxicillin-clavulanate for 14 days.

[missalyssa26]

Answer to Question 1

A
Administer triptan migraine medication in nasal spray or injection for patients with severe nausea and vomiting who have trouble taking oral medications. An antiemetic, such as prochlorperazine or metoclopramide, may be used, although the latter has serious side effects.

Answer to Question 2

C
A minimum of 10 days of treatment is recommended for any infection caused by group A B-hemolytic streptococcus to prevent the occurrence of rheumatic fever or acute glomerulonephritis. This patient shows signs of acute glomerulonephritis, so the NP should obtain an ASO titer and creatinine clearance to help confirm the diagnosis. It is not necessary to repeat the throat culture. Treatment involves controlling blood pressure and maintaining renal function, not giving antibiotics.

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Gracias!

[mcarey591]

TYSM