AANP Adult gerontology primary care nurse practiotioner study guide Exam Review 2025/2026 Pheochromocytoma - ANS-small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine, leading to attacks of raised blood pressure, palpitations, and headache. Tx with Alpha blockers Rovsing's Sign - ANS-Palpation in LLQ ilicits pain in RLQ indicates appendicitis NYHA classes of Heart Failure - ANS-I No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath). II Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath). III Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea. IV Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases. Step-wise Approach to Asthma Diagnosis & Treatment - ANS-Step 1- Mild Intermitten FEV1/PEF > 80% predicted. Symptoms <2 days/week. Albuterol as needed. Step 2- Mild presistent Asthma (FEV1/PEF > 80% predicted. Symptoms > 2 days/week. Albuterol as needed. Low dose ICS ex Flovent. Alt cromolyn, montelukast, nedocromil, theophylline. Step 3- Mod presistent (FEV1 or PEF 60-80% predicted. Daily Symptoms. SABA plus low dose ICS or med dose ICS or low dose with leukotriene inhibitor (singulair, theophylline, zileuton). Step 4- Severe presistent asthma (FEV1/PEF <60% predicted. Symptoms most of day. High dose ICS plus long acting B2 agonist plus oral steroid daily (prednisone). Peak Expiratory Flow Rate (HAG): Green Yellow Red Zone: - ANS-PEF based on Height Age Gender. Blow hard using spirometer highest value recorded. 80-100% expected volume Green Zone maintain or reduce meds 50-80% expected volume Yellow Zone increase maintenance therapy. Or Having exacerbation. Below 50% expected volume Red Zone call 911 give epinephrine inj.