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Managing herpes zoster in older adults: Prescribing considerations

Beuscher, Linda; Reeves, Geri; Harrell, Debbie

Nurse Practitioner . 42(6):24-29, June 16, 2017.

NPs must be aware of special prescribing considerations for medication safety when managing the care of older adults with herpes zoster. Age-related physiologic changes of the body impact the pharmacokinetics and pharmacodynamics of antiviral and pain medications and can lead to potential adverse events.

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.

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.

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.

Screening tools to assess risk of opioid abuse in the Canadian primary healthcare setting

Muir, Hollie; Seymour, Fran

Nurse Practitioner . 42(6):45-50, June 16, 2017.

Opioid therapy for patients with chronic pain is increasing in frequency along with rates of opioid abuse. NPs should use screening tools that are cross-validated for use in chronic pain patients in the Canadian primary healthcare setting.

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.

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.

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.

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.

Genetic counseling for hereditary cancer: A primer for NPs

McReynolds, Kate; Lewis, Sara

Nurse Practitioner . 42(7):22-28, July 15, 2017.

Many patients have concerns regarding their family's cancer history and may be appropriate for referral to genetic counseling. This article examines indications for referral for genetic counseling for hereditary cancer, the process of genetic counseling and testing, and ways for NPs to collaborate with genetics providers.

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.

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.

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.”

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.

Caring for military families: Understanding their unique stressors

Owen, Regina; Combs, Teresa

Nurse Practitioner . 42(5):26-32, May 12, 2017.

Military families are often faced with unique stressors that civilian families do not have to deal with, such as deployment, geographic separation, and frequent relocation. When an NP is providing care for a military family, it is important that these unique stressors are discussed and understood. NPs can employ the Causal Uncertainty Model to encourage effortful cognition and support family attributes to ameliorate the negative effects of the stressors these families may face.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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