Most Popular Articles

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Evaluation of common breast complaints in primary care

Smania, Mary Alison

Nurse Practitioner. 42(10):8-15, October 18, 2017.

Discovery of a breast mass, nipple discharge, or breast pain is a common, anxiety-producing occurrence for many women. Although most irregularities are benign, every woman presenting with a breast complaint should be evaluated to exclude or establish a diagnosis of cancer. The patient visit to the provider for a breast complaint can also present an opportunity for the NP to address and update any needed breast screenings.

Secondary amenorrhea: Diagnostic approach and treatment considerations

Pereira, Katherine; Brown, Ann J.

Nurse Practitioner. 42(9):34-41, September 21, 2017.

Disruptions in the menstrual cycle are a common complaint in primary care and women's health. Irregular or absent menstrual periods should trigger an evaluation to identify the root cause. This article discusses secondary amenorrhea and provides a systematic approach to its diagnostic evaluation, with referral considerations.

Early identification of idiopathic sudden sensorineural hearing loss

Jensen, Elizabeth Ann H.; Harmon, Elizabeth D.; Smith, Whitney

Nurse Practitioner. 42(9):10-16, September 21, 2017.

This article discusses the physiology of normal hearing, the pathophysiology and differential diagnoses of sudden sensorineural hearing loss, and an approach for definitive diagnosis and treatment. A focus is placed on idiopathic sudden sensorineural hearing loss in the adult population in a primary care setting.

A post-master's advanced certificate in gerontology for NPs

Greenberg, Sherry A.; Squires, Allison; Adams, Jennifer; More

Nurse Practitioner. 42(9):18-23, September 21, 2017.

This article describes an innovative post-master's advanced certificate in gerontology program developed by the Hartford Institute for Geriatric Nursing at the New York University Rory Meyers College of Nursing. The program provides content to meet eligibility criteria for the Adult-Gerontology Primary Care NP certification exam and prepares providers to care for complex older adults.

Colorectal cancer screening: Using evidence-based guidelines

Mahon, Suzanne M.

Nurse Practitioner. 42(10):18-26, October 18, 2017.

Colorectal cancer is the third most common cancer diagnosed in men and women. There are multiple options for prevention and early detection. Evidence-based guidelines are available to select the best option based on personal and family history. NPs should utilize these guidelines in clinical practice to select the appropriate screening for their patients.

Acne vulgaris: A review of causes and treatment options

Well, Danielle

Nurse Practitioner. 38(10):22-31, October 10, 2013.

Acne vulgaris is a disorder of the sebaceous follicle. The cause is multifactorial, and both adolescents and adults can be affected. Acne is associated with a significant financial burden and considerable psychological distress. Treatment options are reviewed in this article, including over-the-counter medications, prescription medications, and in-office procedures.

An update on type 2 diabetes management in primary care

Waddell, Jeffrey

Nurse Practitioner. 42(8):20-29, August 17, 2017.

Diabetes mellitus is a chronic disease impacting glucose metabolism. Type 2 diabetes mellitus (T2DM) stems from the inability of the body to utilize endogenous insulin properly. Approximately 90% to 95% of newly diagnosed cases of diabetes are T2DM. This article focuses on the initial treatment of T2DM based on the 2017 American Association of Clinical Endocrinologists and the American College of Endocrinology clinical practice guidelines. The 2017 update includes changes and additions regarding psychosocial management, physical activity, surgery, and hypoglycemia.

Cannabis for posttraumatic stress disorder: A neurobiological approach to treatment

Krumm, Bryan A.

Nurse Practitioner. 41(1):50-54, January 16, 2016.

The endocannabinoid system is intricately involved in regulation of the neurobiological processes that underlie the symptomatology of posttraumatic stress disorder (PTSD). This article discusses the neurobiological underpinnings of PTSD and the use of cannabis for treating PTSD in the New Mexico Medical Cannabis Program.

Pharmacologic pain management at the end of life

Davies, Pamela Stitzlein

Nurse Practitioner. 41(5):26-37, May 19, 2016.

Escalating pain is common in the final weeks of life, requiring skilled management to assist patients with a life-limiting illness. Using a cancer model, pharmacologic approaches to treat pain in the final weeks of life are reviewed. The purpose is to improve care of the dying and contribute toward the goal of a “good death.”

Bolstering your armamentarium with SGLT2 inhibitors

Novak, Lucia M.; Kruger, Davida F.

Nurse Practitioner. 42(10):28-34, October 18, 2017.

Sodium-glucose cotransporter-2 inhibitors have a unique mechanism of action in the kidneys that causes glucosuria, which lowers plasma glucose. They are also associated with reduced body weight and BP, and a low incidence of hypoglycemia. This article reviews the pharmacologic profiles and clinical implications of canagliflozin, dapagliflozin, and empagliflozin.

Diagnosis and treatment for chronic migraine

Moriarty, Maureen; Mallick-Searle, Theresa

Nurse Practitioner. 41(6):18-32, June 19, 2016.

Migraine is a debilitating headache disorder that is underdiagnosed and undertreated worldwide, partially attributable to misdiagnosis and expectations of poor treatment outcomes. This article provides a review of chronic migraine, with special emphasis on the role of NPs.

The Million Hearts initiative: Guidelines and best practices

Melnyk, Bernadette Mazurek; Orsolini, Liana; Gawlik, Kate; More

Nurse Practitioner. 41(2):46-53, February 18, 2016.

Million Hearts® is a national initiative to improve the nation's cardiovascular health through evidence-based practices and prevention. This article reviews the ABCS of Million Hearts with an emphasis on nurse practitioner-led care models. Recommendations for clinical practice, education, research, and health policy are highlighted.

25th Annual legislative update: Evidence-based practice reforms improve access to APRN care

Phillips, Susanne J.

Nurse Practitioner. 38(1):18-42, January 10, 2013.

The Annual Legislative Update describes the legislative issues that have the most impact on nurse practitioners and other advanced practice nurses across the country.

Recognizing type 1 diabetes mellitus in children & adolescents

Glassford, Melissa A.

Nurse Practitioner. 42(6):16-22, June 16, 2017.

The common chief complaint of abdominal pain, nausea, and vomiting should prompt a broad differential diagnosis list. When a 17-year-old previously healthy male presented to a primary care clinic with these symptoms, it provoked a detailed workup and found a startling diagnosis of type 1 diabetes mellitus (T1DM). This article provides an overview of recognizing T1DM in children and adolescents with a thorough diagnostic evaluation.

Evidence-based treatment of chronic kidney disease

Smith, Cynthia Ann

Nurse Practitioner. 41(11):42-48, November 19, 2016.

To aid in diagnosis and treatment, Kidney Disease: Improving Global Outcomes 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease provides an evidence-based approach. This article reviews the major recommendations of this guideline.

The transition of care from hospital to home for patients with hypertension

Franklin, Mary M.; McCoy, Mary Anne

Nurse Practitioner. 42(2):12-18, February 12, 2017.

Approximately 50% to 75% of hospital patients have hypertension. This article describes the transition of care from the hospital to home for patients with hypertension and discusses practice implications for NPs.

28th Annual APRN Legislative Update: Advancements continue for APRN practice

Phillips, Susanne J.

Nurse Practitioner. 41(1):21-48, January 16, 2016.

This year's review and annual advanced practice registered nurse legislative update heralds significant state legislative accomplishments in the areas of APRN practice authority, reimbursement, and prescriptive authority.

The use of dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes & chronic kidney disease

Bittle, Polly A.

Nurse Practitioner. 42(6):31-37, June 16, 2017.

There is a need for treatment options in patients with type 2 diabetes mellitus and kidney disease to achieve glucose targets without risk of hypoglycemia. This article describes management options for these patients using glucose lowering therapies, in particular dipeptidyl peptidase-4 inhibitors.

26th Annual Legislative Update: Progress for APRN authority to practice

Phillips, Susanne J.

Nurse Practitioner. 39(1):29-52, January 11, 2014.

The Annual Legislative Update describes the legislative issues that have the most impact on nurse practitioners and other advanced practice nurses across the country.

Integrating palliative care into primary care for patients with chronic, life-limiting conditions

Cleary, Ann Selena

Nurse Practitioner. 41(3):42-48, March 15, 2016.

As longevity increases, individuals with chronic, life-limiting conditions will live longer with disease burden and functional decline. Nurse practitioners can integrate symptom management, early decision-making, and supportive care into the primary care setting to improve quality of life and decrease the economic and emotional impact at the end of life.

Approaches to male hypogonadism in primary care

Lawrence, Kristi L.; Stewart, Felicia; Larson, Brandi M.

Nurse Practitioner. 42(2):32-37, February 12, 2017.

Evidence suggests that providers are not adhering to current testosterone replacement therapy guidelines when treating male hypogonadism. Understanding diagnosis and management is further complicated by conflicting recommendations among available guidelines. NPs must select and follow the best guideline recommendations available to optimally treat this condition.

New oral antiplatelet medications

Jeffords, Travis

Nurse Practitioner. 42(8):32-39, August 17, 2017.

New and more potent oral antiplatelet agents have shown better clinical outcomes over the last few years. This article discusses four of the newest FDA-approved oral antiplatelet agents and simplifies the latest research and guidelines to provide a better understanding of the current oral antiplatelet therapy available, indications and contraindications, genetic considerations in relation to resistance, and major drug interactions.

Identifying malnutrition: From acute care to discharge and beyond

Tyler, Renay D.; Guenter, Peggi

Nurse Practitioner. 42(4):18-24, April 16, 2017.

Nutrition assessment and intervention significantly contribute to the well-being of patients. NPs should advocate that patients be appropriately evaluated and implement recommendations as part of a comprehensive care plan to avoid malnutrition in patients while they are in the hospital and when they return home.

Pediatric rheumatologic diseases: A review for primary care NPs

Teague, Malinda

Nurse Practitioner. 42(9):43-47, September 21, 2017.

Rheumatologic diseases are uncommon in children but have the potential for significant morbidity, mortality, and disability. This article reviews the most common rheumatologic diseases in children, their diagnostic evaluations, and the NP's role in the management and coordination of these conditions.

Sodium-glucose cotransporter-2 inhibitors: Expanding oral treatment options for type 2 diabetes mellitus

Ashjian, Emily; Tingen, Jeffrey

Nurse Practitioner. 42(4):8-15, April 16, 2017.

Glycemic control among patients with type 2 diabetes mellitus is important to prevent future complications, including microvascular and macrovascular disease. A novel class of medications, sodium-glucose cotransporter-2 inhibitors, presents an additional oral treatment option.

The rising incidence of nonalcoholic fatty liver disease

Wisocky, Jessica; Paul, Sonali

Nurse Practitioner. 42(7):14-20, July 15, 2017.

Nonalcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in the United States and will soon be the leading indication for liver transplantation. NAFLD can lead to cirrhosis of the liver and is usually asymptomatic. Prompt referral to a hepatologist may halt the morbidity and mortality associated with NAFLD.

Hypertension in 2014: Making sense of the guidelines

Scordo, Kristine Anne; Pickett, Kim Anne

Nurse Practitioner. 39(6):18-23, June 15, 2014.

If not appropriately treated, hypertension can lead to stroke, kidney failure, myocardial infarction, and death. Substantial evidence from multiple randomized clinical trials demonstrates the benefit of antihypertensive therapy. The purpose of this article is to discuss current hypertension guidelines.

Pediatric portal hypertension: A review for primary care

Vogel, Clarissa Barbon

Nurse Practitioner. 42(5):35-42, May 12, 2017.

Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. This article reviews the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests available, and treatment and management options.

A new look at abnormal uterine bleeding

Twiss, Janice J.

Nurse Practitioner. 38(12):22-30, December 10, 2013.

This article presents new universal terminology, classifications, and definitions recommended by the International Federation of Gynecology and Obstetrics and supported by the American College of Obstetricians and Gynecologists to describe abnormal uterine bleeding abnormalities in reproductive women. Identification and management of anovulatory and ovulatory uterine bleeding are explored.

Recognizing depression in late life

Edlund, Barbara J.; Lauerer, Joy; Drayton, Shannon J.

Nurse Practitioner. 40(2):36-42, February 15, 2015.

Depression is not a normal part of aging, presents differently in older adults than in younger adults, and frequently occurs with many chronic illnesses in later life. The astute practitioner will screen for depression in this population and appropriately treat to improve chronic illness management and quality of life in older adults.

Hepatitis C infection: Updates on treatment guidelines

Pozza, Renee; Hill, Catherine; Hefner, Anna Marie; More

Nurse Practitioner. 42(5):14-23, May 12, 2017.

Hepatitis C virus (HCV) is a major cause of chronic liver disease worldwide. Due to the asymptomatic nature of the infection, many acute cases of HCV infection are left undiagnosed, so screening individuals at risk is an important public health priority. New medications offer sustained virologic response rates of over 95%, fewer adverse reactions, and shorter durations of therapy. This article reviews the new treatment guidelines for the evaluation and management of patients with HCV infection.

Managing hyperlipidemia The updated cholesterol treatment guidelines

Scordo, Kristine Anne

Nurse Practitioner. 39(7):28-32, July 13, 2014.

The ACC/AHA 2013 cholesterol treatment guidelines focus on lowering the risk of heart disease and stroke and not on targeted treatment goals in adult patients. This article offers a synopsis of the new guidelines and how to apply them in clinical practice.

Identification and management of bipolar disorder

Scrandis, Debra A.

Nurse Practitioner. 39(10):30-37, October 15, 2014.

Bipolar disorder is a complex and chronic mental illness. Individuals with this disorder usually have medical comorbidities needing management in primary care. This article focuses on bipolar identification and medication management concerns for primary care nurse providers.

Treatment and prevention of gout

Saccomano, Scott J.; Ferrara, Lucille R.

Nurse Practitioner. 40(8):24-30, August 15, 2015.

Gout is a disorder of purine metabolism that primarily occurs in adult males. Patient cooperation with the treatment plan is essential for gout management.

Red eye emergencies in primary care

Ossorio, Anthony

Nurse Practitioner. 40(12):46-53, December 12, 2015.

Severe red eye conditions can be the result of intraocular inflammation, corneal insults or inflammation, and acute glaucoma. These pathologies require the knowledge and assessment tools of an ophthalmologist. NPs should maintain a high level of suspicion during the history and physical exam and ask key questions that can lead to the correct diagnosis and management of these ocular pathologies. This article will discuss red eye emergencies that the NP should promptly recognize and refer to ophthalmology.

Allergic rhinitis: Diagnosis through management

Krouse, Helene J.; Krouse, John H.

Nurse Practitioner. 39(4):20-28, April 13, 2014.

Allegic rhinitis (AR) is an immune hypersensitivity response of the nasal mucosa affecting children and adults. Patients with a genetic predisposition become sensitized to certain allergens over time with repeated exposures. This article discusses AR from diagnosis through treatment.

Type 1 diabetes & cardiovascular disease

Kreider, Kathryn Evans; Padilla, Blanca I.

Nurse Practitioner. 41(10):18-25, October 20, 2016.

Individuals with type 1 diabetes mellitus (T1DM) have a high risk of developing cardiovascular disease (CVD), but some risk factors can be mediated by lifestyle modification and medication. NPs should understand evidence-based management approaches to counsel patients with T1DM about appropriate self-management interventions to reduce the likelihood of CVD.

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