Most Popular Articles

Mind & body practices in the treatment of adolescent anxiety

Fulweiler, Bernadette; John, Rita Marie

The Nurse Practitioner. 43(8):36-43, August 2018.

Although anxiety is the most common mental health condition among adolescents in the United States, the current standards of practice for treatment are expensive, may be difficult to obtain, and potentially harmful. Even though mind and body practices show great promise in the treatment of adolescent anxiety, the associated financial constraints, lack of education, and structural barriers can hinder the integration of these practices into primary care.

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.

Recognizing and treating Lyme disease

Saccomano, Scott J.; Hrelic, Debra A.

The Nurse Practitioner. 43(8):13-21, August 2018.

Lyme disease is the most commonly reported vector-borne disease in the United States. After initial antibiotic treatment for patients with Lyme disease, ongoing symptoms that may persist have considerable long-term impact on healthcare costs. Posttreatment Lyme disease syndrome is characterized by a host of chronic symptoms that can leave patients physically and mentally disabled.

Noninfectious causes of fever in adults

Steele, Gregory M.; Franco-Paredes, Carlos; Chastain, Daniel B.

The Nurse Practitioner. 43(4):38-44, April 19, 2018.

Fever is a common clinical sign encountered in hospitalized patients and often represents the cardinal sign of infectious processes. However, a number of noninfectious etiologies causing fever should be considered prior to initiating broad-spectrum antibiotic therapy. Reducing unnecessary antibiotic use is crucial in an era of increasing resistance.

Managing sexually transmitted infections: Beyond the 2015 guidelines

Johnson-Mallard, Versie; Curry, Kim; Chandler, Rasheeta; More

The Nurse Practitioner. 43(8):28-34, August 2018.

Guidelines for the prevention and management of sexually transmitted infections (STIs) are updated periodically while new science is continuously developed. This article provides recent updates on managing STIs.

The emotional burden of diabetes: A look at diabetes distress

Giese, Karla K.

The Nurse Practitioner. 43(8):23-27, August 2018.

Patients with diabetes are sometimes overwhelmed with the burden of self-care associated with the disease. While it may seem appropriate to diagnose patients experiencing such emotional burdens with depression, the literature over the past 20 years has matured the concept of diabetes distress, which may more accurately describe the phenomenon.

Choosing Malpractice Insurance

The Nurse Practitioner. 30:21, 2005.

Price is not the only factor to consider when choosing a provider. Clinicians should also gauge the scope and quality of the protection for which they pay.

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.

Deciphering chest pain in women

Briggs, Linda A.

The Nurse Practitioner. 43(4):25-33, April 19, 2018.

The causes of chest pain range from benign sources, such as muscle strain, to life-threatening diagnoses, such as aortic dissection and myocardial infarction. The likelihood and presentations of disorders causing chest pain are different between women and men. This article highlights important features in determining the correct diagnosis.

  • Doctor of Nursing Practice

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.

Advance care planning and anticipatory decision making in patients with Alzheimer disease

Slyer, Jason T.; Archibald, Ella; Moyo, Fernea; More

The Nurse Practitioner. 43(6):23-31, June 11, 2018.

Early advance care planning and anticipatory decision making in the Alzheimer disease (AD) trajectory is a strategy NPs can incorporate to improve managing uncertainty around common decisions. This article explores decisions patients and caregivers face along the AD trajectory and provides resources for patients, caregivers, and NPs.

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.

Hypertension management options: 2017 guideline

Scordo, Kristine Anne

The Nurse Practitioner. 43(6):33-37, June 11, 2018.

The new hypertension guideline lowers the definition of high BP to 130/80 mm Hg. This means that millions of adults will now be diagnosed with hypertension and that many of those taking antihypertensive drugs are not at goal. The challenge is to communicate the change, the strength of evidence behind the change, and the options available to patients. Healthcare providers must be knowledgeable of the new guideline and ready to meet this challenge.

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.

Primary care management of obesity: Individualized treatment strategies

Hensley, Rhonda D.

The Nurse Practitioner. 43(7):41-48, July 2018.

Obesity is a growing epidemic in the United States. This article explores the popular diet trends in the country and analyzes their potential for use among patients with comorbid conditions. The American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for obesity management are used as a framework for comparing obesity management options.

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.

The human papilloma vaccine: A time for NP leadership

Hardwicke, Robin L.; Benjamins, Laura J.; Grimes, Richard M.

The Nurse Practitioner. 43(7):49-55, July 2018.

The human papilloma virus (HPV) causes approximately 30,700 annual cancer cases of the cervix, vulva, vagina, penis, oral cavity, and anus. Nurse practitioners can use their unique relationships with patients to advocate for the HPV vaccine. The purpose of this article is to update NPs on current knowledge regarding the HPV vaccine while providing appropriate information necessary for counseling patients and parents.

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.

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.

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.

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.

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.

The essential SOAP note in an EHR age

Pearce, Patricia F.; Ferguson, Laurie Anne; George, Gwen S.; More

The Nurse Practitioner. 41(2):29-36, February 18th, 2016.

This article reviews the traditional Subjective, Objective, Assessment, and Plan (SOAP) documentation format. The information is useful for both providers and students for integrating history-taking and physical exam and highlights the importance of attending to critical documentation details with or without the use of an electronic health record.

Managing the airway in acute care patients

Meissen, Heather; Johnson, Laura

The Nurse Practitioner. 43(7):23-29, July 2018.

Understanding how to assess, secure, and manage an airway can save a patient's life in an emergent situation. The NP must assess patients in respiratory distress quickly and in an organized manner to implement life-saving treatment and stabilize the patient before further decline occurs. This article will briefly describe the basics of airway management.

Idiopathic pulmonary fibrosis: A guide for nurse practitioners

Vega-Olivo, Michelle; Criner, Gerard J.

The Nurse Practitioner. 43(5):48-54, May 17, 2018.

Idiopathic pulmonary fibrosis (IPF) is a rare disease characterized by decline in lung function, dyspnea, and cough. The clinical course of IPF is variable and unpredictable. Early referral to specialists is key to ensure timely and accurate diagnosis. Two antifibrotic drugs (nintedanib and pirfenidone) have been approved for the treatment of IPF.

Urinary tract infections and asymptomatic bacteriuria in older adults

Nelson, Joan M.; Good, Elliot

The Nurse Practitioner. 40(8):43-48, August 15th, 2015.

Overuse of urinalysis in older adults to investigate vague changes in condition, such as confusion, lethargy, and anorexia, has led to overtreatment of asymptomatic bacteriuria and associated antibiotic resistance. Implementation of UTI-surveillance criteria can help decrease inappropriate use of antibiotics by at least 30%.

Secondary amenorrhea: Diagnostic approach and treatment considerations

Pereira, Katherine; Brown, Ann J.

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

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.

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.

Acute bronchitis: Evaluation and management

Blush, Raymond R. III

The Nurse Practitioner. 38(10):14-20, October 10th, 2013.

Acute bronchitis affects millions of individuals, significantly impacting patient health and the healthcare industry. Understanding evaluation and treatment guidelines for acute bronchitis allows the nurse practitioner to practice comprehensive care for patients. This article reviews evidence-based practices when caring for the patient with acute bronchitis to promote healthy outcomes.

Low health literacy: Implications for managing cardiac patients in practice

Hickey, Kathleen T.; Masterson Creber, Ruth M.; Reading, Meghan; More

The Nurse Practitioner. 43(8):49-55, August 2018.

There are limited data on racial and ethnic disparities related to quality of life (QoL) and health literacy in adults with multiple cardiac conditions. This article evaluates the relationship between health literacy and QoL among patients with cardiac conditions in a multiethnic community in New York City.

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.

Understanding health policy to improve primary care management of obesity

Bowen, Pamela G.; Lee, Loretta T.; McCaskill, Gina M.; More

The Nurse Practitioner. 43(4):46-52, April 19, 2018.

NPs are ideal candidates for implementing positive health changes for obese patients. Providers have medical expertise and can promote obesity reduction strategies to their patients. Increased awareness of the influence of health policy and clinical implications for obesity management are needed. Obesity management for most primary care providers is difficult, but they are ideal candidates for making positive health changes for obese patients.

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.

Using essential oils to enhance nursing practice and for self-care

Allard, Melissa E.; Katseres, Julie

The Nurse Practitioner. 43(5):39-46, May 17, 2018.

With the growing popularity of integrative medicine, essential oils have found their way back into healthcare. Essential oils provide a simple way to alleviate certain physical symptoms, promote emotional well-being, and provide comfort. This article discusses the administration and common uses of essential oils; their reported benefits, potential risks, and contraindications; and the current state of associated research.

Implications of vitamin D toxicity & deficiency

Waterbury, Susan

The Nurse Practitioner. 43(5):22-30, May 17, 2018.

Vitamin D deficiency is an increasing problem affecting all ages. Patients should be assessed for risk factors as part of preventive health maintenance, and serum 25-hydroxyvitamin D level testing should be done for those at risk.

Managing chronic pain in primary care

Kawi, Jennifer

The Nurse Practitioner. 41(3):14-32, March 15th, 2016.

Chronic pain affects at least 100 million adults in the United States, which is greater than the combined total of adults affected by heart disease, cancer, and diabetes. The complexity of chronic pain management can be challenging, and this article discusses systematic strategies to facilitate safe, efficient, satisfactory, and quality care of patients with chronic pain in primary care.

Family history of substance use disorder and chronic pain management

Pestka, Elizabeth L.; Evans, Michele

The Nurse Practitioner. 43(6):43-48, June 11, 2018.

The use of family history of substance use disorder information as part of a comprehensive assessment of chronic pain can provide important data for treatment. This case example illustrates assessment, patient education, and brief motivational interviewing with referral to appropriate resources.

Graves’ Disease: The Importance of Early Diagnosis

Weeks, Bridget H.

The Nurse Practitioner. 30(11):34-45, November 2005.

Graves’ disease is the most common form of hyperthyroidism. Because Graves’ disease is an autoimmune disorder that also affects other organ systems, taking a careful patient history is essential to establish the diagnosis. In some cases, the history might suggest a triggering factor such as trauma to the thyroid, including surgery of the thyroid gland, percutaneous injection of ethanol, and infarction of a thyroid adenoma. Other factors might include interferon or interleukin therapy.

Assessing DNP impact Using program evaluations to capture healthcare system change

Pritham, Ursula A.; White, Patricia

The Nurse Practitioner. 41(4):44-53, April 17th, 2016.

The doctor of nursing practice (DNP) degree was formalized in 2004. Data evaluating the impact of DNP-prepared nurses on individual patient care, population health, and healthcare system outcomes are limited. This article demonstrates how the Essentials of Doctoral Education for Advanced Nursing Practice can be used to frame DNP program evaluation data.

Assessment and Differential Diagnosis of Abdominal Pain

Miller, Sally K.; Alpert, Patricia T.

The Nurse Practitioner. 31(7):38-47, July 2006.

Abdominal pain as a chief complaint can present a significant diagnostic challenge in the primary care setting. While a variety of diagnostic imaging tests can rule in or out a particular diagnosis, the clinician must make several judgment calls before getting to that point.

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.

Allergic rhinitis: Diagnosis through management

Krouse, Helene J.; Krouse, John H.

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

Menopause Assessment, Treatment, and Patient Education

Smith, Patricia E.

The Nurse Practitioner. 30(2):32-43, February 2005.

In the years following menopause, women should strive to live in good health, and make normal adjustments and modifications throughout the aging process. An individualized discussion with the primary care provider is an important part of achieving this goal.

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.

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.

Evidence-based pain management for endometrial biopsies and IUD insertions

Kass-Wolff, Jane H.; Fisher, Jennifer E.

The Nurse Practitioner. 39(3):43-50, March 13th, 2014.

Intrauterine device (IUD) insertions and endometrial biopsies (EMB) are common outpatient office procedures performed by advanced practice nurses. There are currently no guidelines for pain management with either IUD insertions or EMB procedures. Combination modalities are the most likely to impact pain perceptions, but more research is required in this area.