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.

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 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.

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.

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.

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.

Bladder cancer: Risk factors, diagnosis, and management

Farling, Kristen Burns

Nurse Practitioner . 42(3):26-33, March 7, 2017.

Bladder cancer is the most common genitourinary cancer in the United States. Symptoms of bladder cancer mimic those of a urinary tract infection, which can delay timely diagnosis. This article reviews the signs and symptoms of bladder cancer along with management options to safely care for this patient population.

Managing type 2 diabetes in Black patients

Akindana, Adeola; Ogunedo, Chioma

Nurse Practitioner . 40(9):20-27, September 13, 2015.

Despite the many available treatments for managing type 2 diabetes, Black patients continue to disproportionately suffer complications associated with poor glycemic control. This article describes a comprehensive approach to managing diabetes mellitus in Black patients and addresses cultural nuances that may be barriers to positive outcomes.

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.

Improving end-of-life care: Recommendations from the IOM

Dobbins, Elizabeth H.

Nurse Practitioner . 41(9):26-34, September 22, 2016.

A 2014 consensus report by the Institute of Medicine offers recommendations for healthcare providers to decrease unwanted care and improve the quality of life at the end of life. This article discusses the recommendations of interest to advanced practice registered nurses and applies them to a common patient and family experience.

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.

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.

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.

A review of knee pain in adolescent females

Lipman, Rachel; John, Rita Marie

Nurse Practitioner . 40(7):28-36, July 15, 2015.

Primary care practitioners are in a position to educate patients and parents of the risk factors that may increase the incidence of knee pain in adolescent females. This article highlights patellofemoral pain syndrome, Sinding-Larsen-Johansson syndrome, Osgood-Schlatter disease, and meniscal tears. This review encourages nurse practitioners to identify potential risk factors for injury.

Adult diabetes mellitus: Thinking beyond type 2

Giese, Karla K.

Nurse Practitioner . 41(5):40-45, May 19, 2016.

Not all adults presenting with diabetes mellitus have type 2. NPs must become familiar with atypical presentations of type 1 and type 2 diabetes mellitus, as burgeoning diabetes caseloads, coupled with a shortage of endocrinologists, have created a critical need for expert-level diabetes care among NPs. Two case studies illustrate variations of adult-onset diabetes along with discussion and diagnostic clues.

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.”

Prevention of Alzheimer disease: The roles of nutrition and primary care

Bane, Tabitha J.; Cole, Connie

Nurse Practitioner . 40(5):30-35, May 15, 2015.

Risk factors for developing Alzheimer disease include hypercholesterolemia, hypertension, obesity, and diabetes. Due to a lack of effective treatments for Alzheimer disease, nutrition and primary prevention become important.

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.

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.

Treating dyslipidemia in patients with type 2 diabetes mellitus

Frank, Michelle L.; Gerhardt, Annie M.

Nurse Practitioner . 40(8):18-22, August 15, 2015.

Diabetic dyslipidemia is a major cause of cardiovascular complication and a key area for intervention. Blood cholesterol treatment guidelines and strategies to reduce cardiovascular risk are outlined and addressed in this article.

Suicide risk assessment in high-risk adolescents

Gray, Barbara P.; Dihigo, Sharolyn K.

Nurse Practitioner . 40(9):30-37, September 13, 2015.

A significant number of adolescents experience depression and other mental health disorders that may put them at risk for suicide. Depression and suicide risk screening can help healthcare providers prevent suicides in this population.

The CMS Annual Wellness Visit: Bridging the gap

Hain, Debra J.

Nurse Practitioner . 39(7):18-26, July 13, 2014.

In 2011, Medicare beneficiaries became eligible for an Annual Wellness Visit, which includes a health risk assessment and a customized wellness or personal prevention plan. This article discusses strategies for performing the exam in a primary care setting.

An update on gout for primary care providers

Harding, Mariann

Nurse Practitioner . 41(4):14-21, April 17, 2016.

This article discusses the current beliefs regarding the pathogenesis of gout and reviews the 2012 guidelines from the American College of Rheumatology regarding diagnostic testing, optimal treatments, and lifestyle modifications. Implementing these guidelines will help clinicians resolve acute episodes and manage gout, improving outcomes and quality of life.

HPV, cervical cancer risks, and barriers to care for lesbian women

Waterman, Lindsay; Voss, Joachim

Nurse Practitioner . 40(1):46-53, January 16, 2015.

The purpose of this article is to identify Pap testing rates among lesbians and reasons for lack of recognition of cervical cancer risks in lesbians. The lesbian community requires better education, and healthcare providers should promote regular Pap smears for all women.