An NP sees a patient who reports persistent seasonal symptoms of ...

[Pea0909berry]

An NP sees a patient who reports persistent seasonal symptoms of rhinorrhea, sneezing, and nasal itching every spring unrelieved with diphenhydramine (Benadryl). The NP should prescribe:
 
  a. azelastine (Astelin).
  b. triamcinolone (Nasacort AQ).
  c. phenylephrine (Neo-Synephrine).
  d. cromolyn sodium (Nasalcrom).

Question 2

A patient who will undergo surgery in implant a biosynthetic heart valve asks the primary care NP whether any medications will be necessary postoperatively. The NP should tell the patient that it will be necessary to take:
 
  a. daily low-dose aspirin for 1 year.
  b. heparin injections as needed based on activated partial thromboplastin time levels.
  c. lifelong warfarin combined with enoxaparin as needed.
  d. warfarin for 3 months postoperatively plus long-term aspirin.

[fwbard]

Answer to Question 1

B
According to randomized controlled trials in patients with allergic rhinitis, oral antihistamines are used first to help control itching, sneezing, rhinorrhea, and stuffiness in most patients. Intranasal corticosteroids are indicated for patients who do not respond to antihistamines. Azelastine is a topical antihistamine. Phenylephrine is a decongestant, and this patient does not have congestion. Cromolyn sodium is less effective than intranasal corticosteroids.

Answer to Question 2

D
Patients with biosynthetic valves should receive anticoagulation for 3 months with long-term aspirin prophylaxis. Patients with biosynthetic valves should receive anticoagulation for 3 months (INR goal, 2 to 3). Long-term prophylaxis for these patients should include aminosalicylic acid (75 to 100 mg daily), unless AF is present.

[Pea0909berry]

TY

[fwbard]

You're welcome