Most Popular Articles

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Drug updates and approvals: 2017 in review

Mospan, Geoffrey; Mospan, Cortney; Vance, Shayna; More

The Nurse Practitioner. 42(12):8-16, December 15, 2017.

In 2017, the FDA approved several new drugs for use in primary care. This article highlights the following new drugs: brodalumab (Siliq), dapagliflozin and saxagliptin (Qtern), dupilumab (Dupixent), oxymetazoline (Rhofade), safinamide (Xadago), and sarilumab (Kevzara).

The menopausal woman: The need for an individualized plan of care

Pace, Diane Todd

The Nurse Practitioner. 42(12):43-49, December 15, 2017.

With life expectancy increasing, women will spend one-third of their lives in and beyond menopause. A collaborative discussion with the clinician facilitates informed decision-making.

An update on type 2 diabetes management in primary care

Waddell, Jeffrey

The 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.

Anticoagulant options in atrial fibrillation: When new treatments become standard practice

Cole, Connie S.; Zimmerman, Richard

The Nurse Practitioner. 42(12):29-35, December 15, 2017.

Direct oral anticoagulants (DOACs) have expanded options for treating patients with atrial fibrillation. However, DOACs are not warfarin substitutes, and NPs need to be aware of the difference.

The STEADI toolkit: Incorporating a fall prevention guideline into the primary care setting

Mark, Janice A.; Loomis, Jo

The Nurse Practitioner. 42(12):50-55, December 15, 2017.

The CDC's STEADI toolkit was created to assist providers in screening and managing falls. This article introduces the toolkit and examines the process and importance of adopting it into routine clinical practice.

Delirium monitoring and management in the acute care setting

Cullen, Elizabeth; Balas, Michele C.

The Nurse Practitioner. 42(12):37-42, December 15, 2017.

Associated with substantial morbidity and mortality, delirium is a syndrome commonly experienced by hospitalized adults. This article provides 10 suggestions for improving delirium assessment, prevention, and management.

Cannabis for posttraumatic stress disorder: A neurobiological approach to treatment

Krumm, Bryan A.

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

Understanding employment contracts: What to know before you sign

Dolan, Carolyn M.

The Nurse Practitioner. 42(11):44-49, November 16, 2017.

NPs are conscientious providers, but when it comes to their own careers, they may not be as careful to apply the same prevention strategies, monitoring, and hypervigilance that they use with their patients to avoid poor outcomes. This article identifies potential risks in employment contracts and offers suggestions for avoiding disputes.

Diagnosis and treatment for chronic migraine

Moriarty, Maureen; Mallick-Searle, Theresa

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

Responding to child sexual abuse disclosure

Dolan, Carolyn M.; Raber, Micki S.

The Nurse Practitioner. 42(12):18-26, December 15, 2017.

In cases of child sexual abuse (CSA), NPs are faced with a variety of options dictated by community, agency, and individual resources. This article looks at victim-centered care from current guidelines and offers resources for clinical practice decision making when responding to CSA disclosure.

Reversal agents for oral anticoagulants

Griffiths, Carrie L.; Vestal, Mark L.; Livengood, Spencer J.; More

The Nurse Practitioner. 42(11):8-14, November 16, 2017.

For more than half a century, warfarin, a vitamin K antagonist, has been the anticoagulant of choice. However, direct oral anticoagulants are rapidly gaining in popularity, which poses the need for efficacious reversal agents. This review article summarizes the strategies and agents used to reverse oral anticoagulants.

Adult asthma: Diagnosis and treatment

Durham, Catherine O.; Fowler, Terri; Smith, Whitney; More

The Nurse Practitioner. 42(11):16-24, November 16, 2017.

Adult asthma is a prevalent chronic medical condition that is associated with high morbidity, mortality, and cost. Early identification, evidence-based diagnosis, and step-wise management can lead to improvements in patient outcomes, decrease exacerbations, and eliminate respiratory function decline as the patient ages.

Evidence-based treatment of chronic kidney disease

Smith, Cynthia Ann

The Nurse Practitioner. 41(11):42-48, November 19th, 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 Million Hearts initiative: Guidelines and best practices

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

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

Hepatitis C infection: Updates on treatment guidelines

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

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

Acne vulgaris: A review of causes and treatment options

Well, Danielle

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

Bladder cancer: Risk factors, diagnosis, and management

Farling, Kristen Burns

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

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

Bittle, Polly A.

The Nurse Practitioner. 42(6):31-38, 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.

Colorectal cancer screening: Using evidence-based guidelines

Mahon, Suzanne M.

The 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.

Pharmacologic pain management at the end of life

Davies, Pamela Stitzlein

The Nurse Practitioner. 41(5):26-37, May 19th, 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.”

Evaluation of common breast complaints in primary care

Smania, Mary Alison

The 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.

Adolescent concussions: When to return to play

Jamault, Vanessa; Duff, Elsie

The Nurse Practitioner. 38(2):16-22, February 10th, 2013.

Current recommendations for a sports concussion evaluation and management are designed for adult athletes. Recently, several states have amended legislation and now require a licensed, medical professional to assess any adolescent athlete who has a suspected concussion prior to making a return-to-play decision. The majority of the remaining states are expected to follow with similar legislation.

A new look at abnormal uterine bleeding

Twiss, Janice J.

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

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

Phillips, Susanne J.

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

Adult diabetes mellitus: Thinking beyond type 2

Giese, Karla K.

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

Pediatric portal hypertension: A review for primary care

Vogel, Clarissa Barbon

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

The rising incidence of nonalcoholic fatty liver disease

Wisocky, Jessica; Paul, Sonali

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

Recognizing type 1 diabetes mellitus in children & adolescents

Glassford, Melissa A.

The 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.

Bolstering your armamentarium with SGLT2 inhibitors

Novak, Lucia M.; Kruger, Davida F.

The 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.

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

Franklin, Mary M.; McCoy, Mary Anne

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

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

Phillips, Susanne J.

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

Red eye emergencies in primary care

Ossorio, Anthony

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

Primary care management of ulcerative colitis

Davis, Stephanie C.; Robinson, Brittani L.; Vess, Joy; More

The Nurse Practitioner. 43(1):11-19, January 15, 2018.

Ulcerative colitis (UC) is an inflammatory bowel disease marked by mucosal inflammation. UC has an impact on quality of life and places a financial burden on the healthcare system. This article focuses on the impact, presentation, diagnosis and classification, systemic manifestations, complications, management, and treatment associated with UC.

Genetic counseling for hereditary cancer: A primer for NPs

McReynolds, Kate; Lewis, Sara

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

Early identification of idiopathic sudden sensorineural hearing loss

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

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

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

Bane, Tabitha J.; Cole, Connie

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

Treating the patient with nonalcoholic fatty liver disease

Chaney, Amanda

The Nurse Practitioner. 40(11):36-42, November 15th, 2015.

Nonalcoholic fatty liver disease (NAFLD) is becoming a worldwide health crisis. Although lifestyle modifications are the first-line treatment, the NP should be aware of current and future medication management to help the patient live a healthy life.

New oral antiplatelet medications

Jeffords, Travis

The 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.

Identification and management of bipolar disorder

Scrandis, Debra A.

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

Identifying malnutrition: From acute care to discharge and beyond

Tyler, Renay D.; Guenter, Peggi

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

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