ANCC AGPCNP-BC flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Orthostatic hypotension criteria

A fall in systolic blood pressure of at least 20 mm Hg, or diastolic of at least 10 mm Hg, within three minutes of standing or head-up tilt.

Mini-Cog scoring

A three-item recall plus clock drawing; a total score of 2 or less out of 5 suggests cognitive impairment and warrants further dementia evaluation.

Timed Up and Go threshold

A completion time longer than 12 seconds on the Timed Up and Go test indicates increased fall risk and prompts gait, balance, and medication review.

Ankle-brachial index interpretation

An ABI of 0.90 or less confirms peripheral artery disease, while values above 1.40 suggest noncompressible calcified vessels common in diabetes and kidney disease.

AUDIT-C positive thresholds

Scores of 4 or more in men and 3 or more in women indicate unhealthy alcohol use and warrant a fuller assessment such as the full AUDIT.

PHQ-2 to PHQ-9

A score of 3 or more on the two-item PHQ-2 triggers administration of the nine-item PHQ-9 to grade depression severity and guide treatment.

Post-bronchodilator FEV1/FVC ratio

A post-bronchodilator FEV1/FVC ratio below 0.70 confirms persistent airflow obstruction and establishes a diagnosis of COPD in a symptomatic adult.

Delirium versus dementia

Delirium has acute onset, fluctuating course, and inattention; dementia shows insidious progressive decline in memory or another cognitive domain with arousal preserved until late.

Light's criteria

Pleural fluid is an exudate if the protein ratio exceeds 0.5, the LDH ratio exceeds 0.6, or fluid LDH exceeds two-thirds the upper normal serum limit.

Serum-ascites albumin gradient

A gradient of 1.1 g/dL or more between serum and ascitic albumin indicates portal hypertension-related ascites; lower values suggest carcinomatosis, tuberculosis, or pancreatitis.

Diabetes diagnostic A1c

An A1c of 6.5 percent or higher, fasting glucose of 126 mg/dL or higher, or two-hour OGTT of 200 mg/dL or higher confirms diabetes; asymptomatic results require confirmation.

Multiple myeloma CRAB features

HyperCalcemia, Renal insufficiency, Anemia, and Bone lesions define the CRAB criteria that separate multiple myeloma from monoclonal gammopathy of undetermined significance.

Positive likelihood ratio strength

A positive likelihood ratio above 10 substantially raises disease probability, while a negative likelihood ratio below 0.1 substantially lowers it at the bedside.

Hyponatremia initial step

Measure serum osmolality first; a low value confirms true hypotonic hyponatremia, then check urine osmolality and urine sodium to classify the cause.

High-intensity statin doses

Atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg daily lowers LDL cholesterol by 50 percent or more and is used for established atherosclerotic cardiovascular disease.

Statin primary prevention threshold

A 10-year ASCVD risk of 7.5 percent or higher by the Pooled Cohort Equations supports starting a moderate-intensity statin after clinician-patient risk discussion.

A1c goals in older adults

Target below 7 percent for most adults, but below 8 percent for those with limited life expectancy, frailty, extensive comorbidity, or high hypoglycemia risk.

Recombinant zoster vaccine schedule

Two doses of recombinant zoster vaccine are given two to six months apart for adults 50 and older, regardless of prior shingles or prior live vaccine.

Colorectal cancer screening interval

Average-risk adults begin screening at 45 and continue to 75; colonoscopy every 10 years and annual FIT are accepted primary strategies.

Aspirin primary prevention restriction

Aspirin is not initiated routinely for primary prevention in adults 60 and older because bleeding risk offsets modest benefit; decisions are individualized.

Start low go slow

Begin older adults at roughly half the usual adult dose and titrate gradually, because reduced hepatic and renal clearance increases drug accumulation and adverse effects.

Cockcroft-Gault creatinine clearance

Creatinine clearance equals (140 minus age) times weight in kg, divided by 72 times serum creatinine, multiplied by 0.85 for women; used for renal dose adjustment.

Basal insulin starting dose

Start basal insulin at 10 units daily or 0.1 to 0.2 units per kg daily, titrating by fasting glucose every three days while monitoring for hypoglycemia.

CHA2DS2-VASc anticoagulation threshold

Anticoagulation is recommended for atrial fibrillation when the score is at least 2 in men or 3 in women, and may be considered at 1 in men.

Five A's tobacco cessation

Ask, Advise, Assess, Assist, and Arrange follow-up; combine with pharmacotherapy such as varenicline, bupropion, or nicotine replacement to improve quit rates.

Naloxone co-prescribing trigger

Offer naloxone when opioid dose reaches 50 morphine milligram equivalents daily, when benzodiazepines are combined, or with prior overdose or substance use history.

Levothyroxine dose recheck timing

Wait six to eight weeks after any levothyroxine dose adjustment before rechecking TSH, because the pituitary-thyroid axis requires that interval to reach steady state.

Lipids after statin start

Recheck a lipid panel four to twelve weeks after starting or changing statin therapy to assess adherence, treatment response, and need for intensification.

A1c monitoring frequency

Check A1c every three months when therapy is changing or goals are unmet, and every six months once glycemic targets are stable and achieved.

Warfarin INR monitoring

Check INR at least weekly during initiation and after dose changes, then every four weeks once stable; target is 2 to 3 for atrial fibrillation.

Hypoglycemia risk with sulfonylureas

Sulfonylureas and insulin cause most severe hypoglycemia in older adults; deprescribe or deintensify when A1c falls below 7 percent on these agents.

Home blood pressure protocol

Take two readings morning and evening for seven days with a validated upper-arm cuff; average the second week's values and exclude the first day.