Most Popular Articles

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Non-fasting versus fasting cholesterol measurement

Dyce, Evan

The Nurse Practitioner. 43(2):16-20, February 16, 2018.

Fasting for cholesterol measurement has long been the accepted convention. Recent research expounded in clinical guidelines indicates that nonfasting cholesterol measurements predict outcomes at least as well as fasting cholesterol measurements. In most—but not all—clinical scenarios, fasting is not necessary. This article provides clinical recommendations based on the literature.

30th Annual APRN Legislative Update: Improving access to healthcare one state at a time

Phillips, Susanne J.

The Nurse Practitioner. 43(1):27-54, January 15, 2018.

The Annual Legislative Update describes recent legislative changes to practice, reimbursement, and prescriptive authority that have the most impact on NPs and other advanced practice nurses across the country.

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.

Autism spectrum disorder in primary care

Weill, Victoria A.; Zavodny, Stefanie; Souders, Margaret C.

The Nurse Practitioner. 43(2):21-28, February 16, 2018.

Nurse practitioners working in the primary care setting will commonly see children with autism spectrum disorder. It is important for clinicians to be vigilant for subtle developmental signs that can lead to early identification and diagnosis. This article presents information on assessment, screening, the responsibilities of coordinating services, and ways to support families.

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.

Adolescent use of electronic nicotine delivery systems

Vincent, Debra; Potts, Jeanne; Durbin, Jessica; More

The Nurse Practitioner. 43(3):17-21, March 12, 2018.

Use of electronic nicotine delivery systems is flourishing among adolescents. The long-term effects have not been fully determined; however, literature suggests there is potential for significant harm. Providers must be aware of usage trends, device safety, and product knowledge. Adolescents should be evaluated through routine screening, and cessation counseling should be initiated.

ADHD: From childhood to young adulthood

Wesemann, Daniel; Van Cleve, Susan N.

The Nurse Practitioner. 43(3):8-15, March 12, 2018.

Attention-deficit hyperactivity disorder (ADHD) affects approximately 11% of children between the ages of 4 and 17 years. This article discusses performing a comprehensive assessment for ADHD, the use of validated tools to make an accurate diagnosis, physical exam findings that may be suggestive of certain conditions, and ADHD treatment options.

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.

Examining changes to statewide NP practice in Connecticut

Kazer, Meredith Wallace; O'Sullivan, Cynthia K.; Leonard, Michelle

The Nurse Practitioner. 43(2):37-41, February 16, 2018.

In 2014, Connecticut legislators eliminated the need for advanced practice registered nurses with 2,000 practice hours to obtain collaborative practice agreements with physicians. This study examined resulting practice changes, barriers, and suggestions for improved implementation of independent practice. Thirteen NPs participated in focus groups to share their experiences and recommendations.

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.

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.”

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.

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.

Understanding tuberculosis in an era of global travel

Benkert, Ramona A.; Clifton, Ann

The Nurse Practitioner. 43(2):47-54, February 16, 2018.

With the resurgence of tuberculosis (TB), it is imperative that healthcare providers have the necessary skills to manage the specialized issues of prevention, recognition, and treatment of TB. The case study in this article illustrates these skills for NPs and other advanced practice providers.

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

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

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

Periodontal disease in children with type 2 diabetes mellitus

Wooton, Angela K.; Melchior, Lynne M.; Coan, Lorinda L.; More

The Nurse Practitioner. 43(2):30-35, February 16, 2018.

Collaborative efforts between health team members can advance early detection of children with elevated blood glucose levels, preventing hyperglycemia and periodontal diseases. Rates of obesity are increasing in children, impacting the prevalence of type 2 diabetes mellitus and periodontal diseases. Collaborative care between nurse practitioners and dental hygienists can detect, prevent, and treat periodontal disease in children.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

Phillips, Susanne J.

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

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.

HPV awareness and vaccination rates in college-aged male athletes

McCutcheon, Tonna; Schaar, Gina; Herline, Alan; More

The Nurse Practitioner. 42(11):27-34, November 16, 2017.

College-aged males are at high risk for human papillomavirus (HPV); however, vaccination rates remain low, suggesting minimal HPV knowledge. Therefore, an educational intervention was developed and implemented to determine if an increase in HPV knowledge, perceived HPV risk, intention and perceived self-efficacy to obtain the vaccine, and vaccination rates were observed.

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.

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.

Suicide risk assessment in high-risk adolescents

Gray, Barbara P.; Dihigo, Sharolyn K.

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

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).

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.

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.

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

Dobbins, Elizabeth H.

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

Treatment and prevention of gout

Saccomano, Scott J.; Ferrara, Lucille R.

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

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.

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