Most Popular Articles

Screening for diabetic kidney disease in primary care: A quality improvement initiative

Deem, Michelle; Rice, Jennifer; Valentine, Kathleen; More

The Nurse Practitioner. 45(4):34-41, April 2020.

Gaps in care currently exist between diabetic kidney disease (DKD) guidelines and diabetes management in primary care settings. This article explores whether a local Federally Qualified Health Center could improve rates of screening for microalbuminuria, diagnosis of DKD, and treatment of the disorder in patients with type 2 diabetes mellitus.

32nd Annual APRN Legislative Update: Improving access to high-quality, safe, and effective healthcare

Phillips, Susanne J.

The Nurse Practitioner. 45(1):28-55, January 2020.

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

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.

Pediatric hypertension: A guideline update

Benenson, Irina; Waldron, Frederick A.; Porter, Sallie

The Nurse Practitioner. 45(5):16-23, May 2020.

The prevalence of pediatric hypertension is growing. Hypertension during childhood remains a major risk factor for adverse cardiovascular events later in life. NPs should be aware of current guidelines on screening, diagnosis, and treatment of hypertension in children to improve care for this patient population.

Vesicular hand dermatitis

Sobering, Geraldine; Dika, Cheryl

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

Vesicular hand dermatitis is a type of eczema involving the fingers, hands, and sometimes the feet. It is common in primary care, requiring prompt treatment to prevent chronicity. The cause is often unknown, making the condition challenging to treat. Management consists of avoiding irritants and using emollients and topical corticosteroids.

31st Annual APRN Legislative Update: Improving state practice authority and access to care

Phillips, Susanne J.

The Nurse Practitioner. 44(1):27-55, January 2019.

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

Polycystic ovary syndrome: Diagnosis and management

Pfieffer, Mary Lauren

The Nurse Practitioner. 44(3):30-35, March 2019.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder. Patients may present with a combination of hyperandrogenism symptoms, menstrual irregularities, metabolic syndrome, infertility, acne, and obesity. PCOS diagnosis is based on three diagnostic guidelines. Treatment options include oral contraceptive pills, antiandrogens, and metformin. NPs can improve diagnosed patients' quality of life through education about this disorder.

Primary care of children with autism spectrum disorders: Developing confident healthcare leaders

Kilmer, Michele

The Nurse Practitioner. 45(5):41-47, May 2020.

This series of articles aims to equip primary care providers (PCPs) with the tools to become healthcare leaders managing patients with pediatric autism spectrum disorder (ASD). Individuals with ASD can experience optimal health outcomes when timely, evidence-based interventions are implemented in the primary care setting.

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.

Infertility management in primary care

Thable, Angela; Duff, Elsie; Dika, Cheryl

The Nurse Practitioner. 45(5):48-54, May 2020.

Infertility is a growing issue for couples. Primary care NPs can manage initial treatment as well as address the emotional and financial burdens of patients experiencing infertility. NPs can provide timely access to investigations and treatment, helping patients achieve their goal of pregnancy sooner.

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.

Substance use disorder: Screening adolescents in primary care

Mackavey, Carole; Kearney, Kelly

The Nurse Practitioner. 45(5):25-32, May 2020.

Adolescence is a time for experimentation, which can lead to impulsive decision-making and risky behavior that could cause harm. Many primary care clinicians lack training in managing positive substance use screens. Screening adolescent patients in primary care can help identify, prevent, and treat substance use disorder.

APRN transition to practice: Program development tips

Urbanowicz, Janet

The Nurse Practitioner. 44(12):50-55, December 2019.

Leaving the comfort zone of being an experienced RN for a new career as an inexperienced advanced practice registered nurse (APRN) is one of the greatest difficulties of the APRN transition to practice. To date, very few formal APRN residency or fellowship transition programs exist. Practicing APRNs can advocate for a formal transition program in their organizations.

Treatment update: Outpatient management of community-acquired pneumonia

Esden, Jana

The Nurse Practitioner. 45(3):16-25, March 2020.

Pneumonia is a leading cause of morbidity and mortality in the US and a primary cause of hospitalization nationwide. A recent guideline update from the American Thoracic Society and Infectious Diseases Society of America provides evidence-based recommendations for managing adults with community-acquired pneumonia in the outpatient setting.

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.

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.

Cannabis for posttraumatic stress disorder: A neurobiological approach to treatment

Krumm, Bryan A.

The 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.

Pain management for patients with chronic kidney disease in the primary care setting

Lowe, Kevin M.; Robinson, Danny R. Jr.

The Nurse Practitioner. 45(1):18-26, January 2020.

Pain is routinely reported in patients with chronic kidney disease. Pain is often multifaceted, making the treatment of this complex patient population even more challenging. Understanding pain types as well as treatment options for these patients with pain is an important skillset for the primary care provider.

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.

A review of knee pain in adolescent females

Lipman, Rachel; John, Rita Marie

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

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.

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.

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.

Diagnosis and treatment for chronic migraine

Moriarty, Maureen; Mallick-Searle, Theresa

The 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.

The personal and professional responsibilities of NPs in disaster response

Zak, Concetta L.; Wood, Laura Kay; Adelman, Deborah S.; More

The Nurse Practitioner. 45(5):34-40, May 2020.

The fourth article in the Disaster Series presents the various duties that NPs may assume in a disaster. NPs possess advanced clinical knowledge and skills that position them to play key roles in all phases of a disaster.

Assessing for and managing chronic insomnia in primary care settings

Cadet, Myriam; Tucker, Lorna; Allen, Deborah H.; More

The Nurse Practitioner. 44(7):27-35, July 2019.

Chronic insomnia is the most common sleep disorder. Improper or delayed diagnosis can lead to serious health problems. Early accurate assessment is essential to guide and provide safe treatment. This article reviews assessment and management of insomnia in the primary care setting.

Pharmacologic pain management at the end of life

Davies, Pamela Stitzlein

The 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.”

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.

Managing insomnia in older adults

Hedges, Christine; Gotelli, John

The Nurse Practitioner. 44(9):16-24, September 2019.

NPs frequently care for patients with complaints of insomnia in the hospital and community settings. Because older adults with insomnia present unique challenges for successful management, NPs should understand the latest assessment and treatment options.

Acute compartment syndrome: An orthopedic emergency

Harding, Margaret Meyer

The Nurse Practitioner. 44(4):23-28, April 2019.

Acute compartment syndrome (ACS) is a true orthopedic emergency. NPs in all settings should be able to recognize ACS to ensure swift surgical intervention is not delayed. This article highlights a systematic approach to exam and diagnosis.

Primary care management of the liver transplant patient

Chaney, Amanda

The Nurse Practitioner. 39(12):26-33, December 13th, 2014.

There are over 65,000 people in the United States who have received a liver transplant. In primary care practice, nurse practitioners must be aware of the special considerations for this population.

Bladder cancer: Risk factors, diagnosis, and management

Farling, Kristen Burns

The 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.

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

Phillips, Susanne J.

The 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 ABCs of RSV

Krause, Christine I.

The Nurse Practitioner. 43(9):20-26, September 2018.

Respiratory syncytial virus (RSV) is a common viral infection affecting many children in the United States. This seasonal virus is the leading cause of hospitalization of infants and neonates. This article reviews the current recommendations for diagnostic testing, treatment options, and prevention of RSV.

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.

Pediatric metabolic syndrome

Felix, Abigail; John, Rita Marie

The Nurse Practitioner. 44(7):18-25, July 2019.

Although the prevalence of obesity and its related complications are increasing among pediatric patients, appropriate management can prevent chronic disease. This article will present an overview of metabolic syndrome, pediatric metabolic syndrome guidelines, pathophysiology, associated risk factors, and clinical practice implications.

Managing sleep disorders in the elderly

Townsend-Roccichelli, Judith; Sanford, Julie T.; VandeWaa, Elizabeth

The Nurse Practitioner. 35(5):30-37, May 2010.

Sleep disorders and sleeping difficulties are two of the most pervasive and poorly addressed problems of aging. Primary sleep disorders can be associated with significant medical, psychological, and social disturbances.

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.

Uncommon causes of noncardiogenic pulmonary edema

Simko, Lynn Coletta; Culleiton, Alicia L.

The Nurse Practitioner. 45(4):26-32, April 2020.

NPs should be familiar with less common causes of noncardiogenic pulmonary edema, including transfusion-related acute lung injury, neurogenic pulmonary edema, preeclampsia/eclampsia, opioid overdose, high-altitude pulmonary edema, and pulmonary embolism. This article addresses nursing considerations associated with each uncommon cause of noncardiogenic pulmonary edema.

Adverse childhood experiences and implementing trauma-informed primary care

Esden, Jana L.

The Nurse Practitioner. 43(12):10-21, December 2018.

Adverse childhood experiences (ACEs) include exposures such as abuse and household dysfunction. These exposures are associated with long-term sequelae and unfavorable health outcomes in adulthood. NPs working in primary care can help to reduce the impact of ACEs in adulthood by identifying individuals with these experiences and implementing trauma-informed care strategies.

Tremors: Learning to stop the shakes

Struble, Laura M.

The Nurse Practitioner. 35(6):18-25, June 2010.

A tremor is a common, abnormal, involuntary movement of muscles that may be noted during a routine physical examination. Identifying the type of tremor is necessary to determine underlying neurological disorders. This article offers a practical approach to assessment and diagnosis of the most common tremors seen in practice.

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.

Advocating for Washington state ARNP payment parity

Kaplan, Louise; Gill, Justin

The Nurse Practitioner. 45(2):38-47, February 2020.

Workforce and reimbursement data were collected from a 2018 survey of Washington state advanced registered nurse practitioners (ARNPs). Survey results will be used to improve workforce planning and advocate for payment parity legislation requiring health plans to pay ARNPs the same as physicians for the same service.

How NPs can help expand telehealth services

Rincon, Teresa A.

The Nurse Practitioner. 44(11):30-35, November 2019.

Consumers of healthcare services are demanding more convenient and accessible options to care. Technologic advancements can support this demand, but telehealth knowledge is lacking. This article will describe the current state of telehealth and examine the role that NPs can play in furthering its adoption.

Gout diagnosis and management: What NPs need to know

Hardy, Eva

The Nurse Practitioner. 36(6):14-19, June 2011.

Gout is the result of hyperuricemia, either from the body's overproduction or underexcretion. It can result in joint deterioration and destruction when improperly managed. Because primary care providers diagnose and treat the vast majority of patients with gout, it is important that they understand current guidelines and evidence-based practice.

Evidence-based treatment of chronic kidney disease

Smith, Cynthia Ann

The 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.

Loneliness in adults: Evidence-based research and interventions for NPs

Pearson, Tamera

The Nurse Practitioner. 44(9):26-34, September 2019.

Loneliness is a complex psychophysiologic concept, a health risk factor, and a worrisome trend across the globe. This article reviews the latest research on the negative health effects associated with loneliness. Evidence-based NP interventions aimed at improving patients' perceived social connections are also explored.

The therapeutic versatility of antihistamines: A comprehensive review

Shirley, David W.; Sterrett, James; Haga, Neal; More

The Nurse Practitioner. 45(2):8-21, February 2020.

Antihistamines are common and readily available medications for primary care patients and those seeking over-the-counter treatments. This article provides an overview of available antihistamines, their mechanisms of action, safety concerns in specific populations, and their therapeutic uses in several common conditions.

Heart disease prevention in women: The NP's role

Wood, Jennie; Gordon, Patricia

The Nurse Practitioner. 44(10):10-17, October 2019.

More women die from heart disease than any other illness. This article focuses on risk factors and their prevalence in women along with strategies for preventing this disease. Armed with this information, the NP can play a major role in preventing cardiovascular deaths in women.

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.

Syphilis: A growing concern

Harmon, Elizabeth D.; Robertson, Eric Wayne

The Nurse Practitioner. 44(8):21-28, August 2019.

Since a brief low in 1998, reported cases of syphilis have continued to grow in the US. As primary care providers, NPs are at the forefront of the battle to eliminate syphilis. This article reviews the stages of this infection, diagnosis nuances, and treatment guidelines.