ENP-BC flashcards

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

Sensitivity

Proportion of people with disease who test positive: TP/(TP+FN). A highly sensitive test is useful for ruling out disease when the result is negative.

Specificity

Proportion of people without disease who test negative: TN/(TN+FP). A highly specific test is useful for ruling in disease when the result is positive.

Positive predictive value

Probability that a positive test result is correct: TP/(TP+FP). PPV rises as disease prevalence in the tested population increases.

PHQ-9 cutoff

A score of 10 or more on the nine-item Patient Health Questionnaire has about 88% sensitivity and 88% specificity for major depression.

Metformin first-line

Metformin is initial pharmacotherapy for type 2 diabetes unless contraindicated; add an SGLT2 inhibitor or GLP-1 agonist when cardiovascular or kidney disease is present.

Heart failure quadruple therapy

For reduced ejection fraction, use an ARNI or ACE inhibitor/ARB, an evidence-based beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor.

Uncomplicated cystitis treatment

Nitrofurantoin 100 mg twice daily for 5 days, trimethoprim-sulfamethoxazole for 3 days if resistance is below 20%, or fosfomycin 3 g once.

Asthma controller therapy

Inhaled corticosteroids are the preferred controller at every asthma step; short-acting beta-agonist alone is not recommended for persistent asthma.

Informed consent elements

Capacity, disclosure of risks, benefits, and alternatives, understanding, voluntariness, and documentation. A signed form alone does not prove informed consent.

Order of draw

Blood culture, light blue coagulation, red/gold serum, green heparin, lavender EDTA, gray glycolytic inhibitor. Fill tubes in this sequence to avoid additive contamination.

Lumbar puncture opening pressure

Normal cerebrospinal fluid opening pressure is 10–20 cm H2O (100–200 mm H2O) in a lateral decubitus position with knees to chest.

Capnography confirmation

Continuous waveform capnography is the preferred method to confirm endotracheal tube placement; a colorimetric detector alone is insufficient during cardiac arrest.

Warfarin INR target

Target INR is 2.0–3.0 for most indications and 2.5–3.5 for mechanical mitral valves. Vitamin K reverses warfarin; prothrombin complex concentrate for major bleeding.

Heparin-induced thrombocytopenia

Suspect when platelets fall more than 50% from baseline 5–10 days after heparin exposure; stop heparin and start argatroban, bivalirudin, or fondaparinux.

Acetaminophen daily maximum

Maximum 4 g/day in healthy adults; limit to 2 g/day or less in chronic liver disease or chronic alcohol use. Overdose causes hepatic necrosis.

Vancomycin monitoring

Target trough 15–20 mg/L for serious infections; AUC-guided dosing (AUC/MIC 400–600) is preferred. Monitor renal function and hearing with prolonged therapy.

Digoxin toxicity signs

Nausea, visual changes such as yellow-green halos, confusion, and arrhythmias. Hypokalemia and renal impairment increase toxicity risk; therapeutic level is 0.5–0.9 ng/mL.

Serotonin syndrome

Caused by serotonergic drug combinations; features include clonus, hyperthermia, agitation, and autonomic instability. Stop the offending agents and provide supportive care.

Adult CPR compression rate

Compress at 100–120 per minute to a depth of 5–6 cm, allow full chest recoil, minimize interruptions to under 10 seconds, and rotate compressors every 2 minutes.

Anaphylaxis epinephrine dose

Epinephrine 0.3–0.5 mg intramuscularly (1 mg/mL) into the anterolateral thigh; repeat every 5–15 minutes as needed. Give oxygen and IV fluids.

Septic shock resuscitation

Obtain cultures, give broad-spectrum antibiotics within 1 hour, and infuse 30 mL/kg crystalloid for hypotension or lactate of 4 mmol/L or higher.

Stroke thrombolysis window

Intravenous alteplase may be given within 4.5 hours of symptom onset if criteria are met; door-to-needle target is 60 minutes or less.

Diabetic ketoacidosis management

Isotonic saline resuscitation, insulin infusion once potassium is at least 3.3 mmol/L, add dextrose when glucose falls below 200–250 mg/dL, and monitor potassium and anion gap.

Status epilepticus sequence

Give a benzodiazepine first (lorazepam IV or midazolam IM), then a second-line antiepileptic such as levetiracetam, fosphenytoin, or valproate; intubate if refractory.

Teach-back method

Ask the patient to restate the plan in their own words. It improves recall and reveals gaps better than asking whether they understand.

Motivational interviewing OARS

Open questions, affirmations, reflections, and summaries. Elicit change talk and avoid confrontation or arguing with the patient.

Shared decision-making

Present options, discuss benefits and harms, explore patient values and preferences, and reach a decision together; document the discussion.

Health literacy plain language

Use 5th–6th grade reading level, limit to 3–5 key messages per session, and supplement with pictures or diagrams to improve understanding.

SBAR handoff

Situation, Background, Assessment, Recommendation. A structured communication tool from TeamSTEPPS that reduces omissions during handoffs.

Just culture

Distinguishes human error (console), at-risk behavior (coach), and reckless behavior (remediate or discipline); encourages reporting without fear of blame.

PDSA cycle

Plan-Do-Study-Act: a rapid improvement method for testing changes on a small scale before broader implementation, part of the Model for Improvement.

Central line bundle

Hand hygiene, maximal barrier precautions, chlorhexidine skin antisepsis, optimal site selection, and daily review of line necessity reduce bloodstream infections.

Mandatory reporting

Clinicians must report suspected child abuse, elder abuse, and certain communicable diseases to the designated authority, even without proof.

Decision-making capacity

Requires understanding, appreciation, reasoning, and expressing a choice. Capacity is task-specific and assessed by the treating clinician.