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I found pt education very satisfying. Being able to articulate clinical findings, lab results and explain them in lay people term as well as help them work towards health within their means is quite satisfying. For example, pt with low vit. D, I helped them towards modifying their diet with lactaid or the like. I love it when pt asks you for more info. Love how attentive they are. It makes me feel like I'm a true provider. Able to provide health promotion to them. 

Whenever I look at the paramount amount of info. we have digest for our didactic class, I remind myself that such info. would be very essential for my clinical practice and pt education that I'll be able to provide. It serves as a good motivating factor for me to study harder so that I can do better and provide better care. 
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Source: http://www.prorepatin.com/images/grafik_fissur.jpg

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Characteristics: red pinkish with clear dermacation around the anus. Pt may bleed/irritated/itching.

Tx: Nystatin cream AAA  (apply to affected area) x 7days




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Notes from Merck: http://www.merckmanuals.com/home/skin-disorders/fungal-skin-infections/candidiasis
Candidiasis (yeast infection, moniliasis) is infection with the yeast Candida.
  • Candidiasis tends to occur in moist areas of the skin.
  • Candidiasis may cause rashes, scaling, itching, and swelling.
  • Doctors examine the affected areas and view skin samples under a microscope or in a culture.
  • Antifungal creams or antifungal drugs given by mouth usually cure candidiasis.
Candida yeast is a normal resident of the mouth, digestive tract, and vagina that usually causes no harm. Under certain conditions, however, Candida can overgrow on mucous membranes and moist areas of the skin. Typical areas affected are the lining of the mouth, the groin, the armpits, the spaces between fingers and toes, on an uncircumcised penis, the skinfold under the breasts, the nails, and the skinfolds of the stomach. Conditions that enable Candida to infect the skin include the following:
  • Hot, humid weather
  • Tight, synthetic underclothing
  • Poor hygiene
  • Infrequent diaper or undergarment changes, particularly in children and older people
  • A weakened immune system resulting from diabetes, disorders, or use of corticosteroids and other drugs that suppress the immune system
  • Pregnancy, obesity, or use of antibiotics
People taking antibiotics may develop candidiasis because the antibiotics kill the bacteria that normally reside on the body, allowing Candida to grow unchecked. Corticosteroids or immunosuppressive therapy after organ transplantation can also lower the body’s defenses against candidiasis. Inhaled corticosteroids, often used by people with asthma, sometimes cause candidiasis of the mouth. Pregnant women, people receiving cancer therapy drugs, obese people, and people with diabetes also are more likely to be infected by Candida.
In some people (usually people with a weakened immune system), Candida may invade deeper tissues as well as the blood, causing life-threatening systemic candidiasis (see Candidiasis).


Symptoms


Symptoms vary, depending on the location of the infection.

Infections in skinfolds (intertriginous infections) or in the navel usually cause a bright red rash, sometimes with breakdown of skin. Small pustules may appear, especially at the edges of the rash, and the rash may itch intensely or burn. A candidal rash around the anus may be raw, white or red, and itchy. Infants may develop a candidal rash in the diaper area (see Rashes in Children).

Diaper Rash (Candidiasis)
Diaper Rash (Candidiasis)
Image provided by Thomas Habif, MD.

Vaginal candidiasis (vulvovaginitis, yeast infection—see see Overview of Vaginal Infections) is common, especially among women who are pregnant, have diabetes, or are taking antibiotics. Symptoms of these infections include a white or yellow cheeselike discharge from the vagina and burning, itching, and redness along the walls and external area of the vagina.

Penile candidiasis most often affects men with diabetes, uncircumcised men, or men whose female sex partners have vaginal candidiasis. Sometimes the rash may not cause any symptoms, but usually the infection causes a red, raw, itching, burning, or sometimes painful rash on the head of the penis.

Thrush is candidiasis inside the mouth (see Gingivitis Due to Infections). The creamy white patches typical of thrush cling to the tongue and sides of the mouth and may be painful. The patches can be scraped off with a finger or blunt object and may bleed when scraped. Thrush in otherwise healthy children is not unusual, but in adults it may signal a weakened immune system, possibly caused by cancer, diabetes, or human immunodeficiency virus (HIV) infection. The use of antibiotics that kill off competing bacteria increases the risk of developing thrush.

Thrush
Thrush
Image provided by Thomas Habif, MD.

Perlèche is candidiasis at the corners of the mouth, which causes cracks and tiny fissures. It may stem from chronic lip licking, thumb sucking, ill-fitting dentures, or other conditions that make the corners of the mouth moist enough that yeast can grow.

Candidal paronychia is candidiasis in the nail folds or cuticles, which causes painful redness and swelling (see Onychomycosis) around the nail. In longstanding infection, the area underneath the nail may turn white or yellow, and the nail plate may separate from the nail bed (onycholysis). This disorder typically occurs in people with diabetes or a weakened immune system or in otherwise healthy people whose hands are subjected to frequent wetting or washing.

Chronic mucocutaneous candidiasis is a condition that develops when a person's immune system is less able to react to candida. It causes red, pus-filled, crusted, and thickened areas that resemble psoriasis (see Psoriasis), especially on the nose and forehead. People who have this condition are also prone to thrush.

Diagnosis


Usually, doctors can identify candidiasis by observing its distinctive rash or the thick, white, pasty residue it generates. To confirm the diagnosis, doctors may scrape off some of the skin or residue with a scalpel or tongue depressor. The sample is then examined under a microscope or placed in a culture medium (a substance that allows microorganisms to grow) to identify the specific fungus (see Culture).

Treatment


Treatment typically depends on the location of the infection.

Infections in skinfolds are treated with antifungal creams, powders, solutions, or other products that are applied directly to the skin (topical). Examples include miconazoleclotrimazoleoxiconazoleketoconazoleeconazoleciclopirox, and nystatin. In healthy people, skinfold infections are usually easily cured. Keeping the skin dry helps clear up the infection and prevents it from returning. Solutions that dry out the skin (such as Burow solution) or talcum powder helps keep the surface area dry. Keeping the area dry may also help prevent a recurrence. People who have many infected skinfolds may be given drugs by mouth (such as fluconazole).

Vaginal candidiasis is treated with antifungal drugs that may be applied as a cream to the affected area, inserted into the vagina as a suppository, or taken by mouth (such as fluconazole).

Diaper rash is treated with more frequent changes of diapers, use of super-absorbent or ultra-absorbent disposable diapers, and a cream that contains an antifungal drug (for example, butoconazoleclotrimazolefluconazoleketoconazole, or miconazole).

Candidal paronychia is treated by protecting the area from wetness. Doctors give antifungal drugs that are taken by mouth or applied to the skin. These infections are often difficult to treat.

Thrush in adults is treated with drugs that go directly in the mouth. An antifungal drug (such as clotrimazole) may be given as a tablet or lozenge that dissolves in the mouth. Doctors may also have people gargle with liquid nystatin for as long as possible and then spit it out or swallow it. Doctors may also give drugs in pill form that are swallowed (such as fluconazole).

Thrush in infants may be treated with liquid nystatin. The liquid can be applied with a finger or cotton swab to the cheek pouches inside the mouth.

Chronic mucocutaneous candidiasis is treated with antifungal drugs taken by mouth (such as ketoconazole or itraconazole). These drugs are taken for a long time.


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Electrocardiograms are recorded based on the input from leads connected to the body at specific points. Einthoven proposed that the heart is an electric generator that acts approximately as a dipole; that is, as a pair of electrodes (electrical terminals) separated by a short distance. He regarded the electrical actions of the heart as quantifiable vectors consisting of a magnitude and a direction, and proposed an analytic scheme in which three vectors form a triangle, called today the Einthoven triangle.

The term “lead” has two meanings here. It can refer to an actual electrode and cable connected to the electrocardiograph. It also refers specifically in electrocardiography to the voltage difference between two or more of these electrodes. In the simplest case a lead involves two electrodes attached to the skin. The leads used by Einthoven, called limb leads, were obtained from pairs of electrodes attached at the left leg (Lead 1), the left arm (Lead 2), and the right arm (Lead 3). Einthoven recognized that these voltages were not independent, but that Lead I + Lead III = Lead II, a relationship known today as Einthoven’s law.
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They discovered that the heart electrical activities can be recorded from the skin surfaces. Pretty cool - their apparatus has water levels that go up and down according to the heart pumping

  • 1887, A.D. Waller records a human electrocardiogram (ECG)
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They found out that the heart beats with electrical rhythm

  • 1856, R.A. von Kölliker and Heinrich Müller discover that a frog's heart generates electric currents

http://ethw.org/Electrocardiography
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Galvani experiment - Electrodes attached to frog legs resulting in frog leg dancing =>  muscles have electrical action potentials.

1791, Luigi Galvani reports that an electric spark can cause muscle to twitch 

Source: http://ethw.org/Electrocardiography 
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Links:
http://midlevelu.com/blog/ancc-vs-aanp-comparing-nurse-practitioner-certification-exams#comments

http://allnurses.com/nurse-practitioners-np/which-certification-aanp-528112.html

https://np2be.com/ancc-vs-aanp-your-certification-exam-questions-answered/

http://npodyssey.blogspot.com/2014/01/ancc-or-aanp-np-certification-exam.html

https://fhea.com/content.aspx?p=certificationcols/common_questions.htm

http://www.differencebetween.net/miscellaneous/difference-between-aanp-and-ancc/

http://jessicafarrone.weebly.com/1/post/2010/05/first-post.html
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http://nursecredentialing.org/AdultGeroPrimaryCareNP-SampleQuestions

http://www.aanpcert.org/resource/documents/2016%20Certificant_Candidate_Handbook%20(Final)%2001%2004%2016.pdf   (p.36-39)
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http://www.rn.ca.gov/pdfs/applicants/np-app.pdf


The national organizations/associations listed below have met the certification requirements that are equivalent to the Board’s standards for nurse practitioner certification:

 • American Academy of Nurse Practitioners (AANP) P. O. Box 12846, Austin, TX 78711 (512) 442-4262

www.aanp.org

• American Nurses Association - American Nurses Credentialing Center (ANCC) 8515 Georgia Ave., Suite 400, Silver Spring, MD 20910-3402 (800) 284-2378

www.nursecredentialing.org