Most Popular Articles

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.

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.

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.

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.

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.

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.

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.

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.

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.

Peanut allergy reduction in high-risk pediatric patients

Hopper, Jaime; Hopp, Courtney; Durbin, Jessica

The Nurse Practitioner. 43(3):35-39, March 12, 2018.

The prevalence of food allergies has doubled in the past 10 years. Peanut allergies are a significant public health issue and are the primary reason for food-related anaphylactic reactions that result in death. Evidence supports that early introduction of the peanut protein (or in combination with immunotherapy) to the highly allergic may safely desensitize patients, which could lead to less adverse allergic reactions and alter allergy management overall.

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 role of race in clinical decision making

Moscou, Susan; Baker, Serena

The Nurse Practitioner. 43(3):41-46, March 12, 2018.

Is race/ethnicity useful in clinical decision making? This article uses a case example to discuss the role of race/ethnicity in clinical decision making, how racial/ethnic categories were developed, potential problems of using racial/ethnic categories, and the difference between risk factors and risk markers. The authors make the argument that using a patient's race/ethnicity in clinical decision making often results in a missed or incorrect diagnosis.

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.

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.

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.

Sodium-glucose cotransporter-2 inhibitors: Expanding oral treatment options for type 2 diabetes mellitus

Ashjian, Emily; Tingen, Jeffrey

The Nurse Practitioner. 42(4):8-15, April 16th, 2017.

Glycemic control among patients with type 2 diabetes mellitus is important to prevent future complications, including microvascular and macrovascular disease. A novel class of medications, sodium-glucose cotransporter-2 inhibitors, presents an additional oral treatment option.

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.

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 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 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.

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.

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.

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.

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).

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.

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.

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.

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.”

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.

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.

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.

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.

Integrating palliative care into primary care for patients with chronic, life-limiting conditions

Cleary, Ann Selena

The Nurse Practitioner. 41(3):42-48, March 15th, 2016.

As longevity increases, individuals with chronic, life-limiting conditions will live longer with disease burden and functional decline. Nurse practitioners can integrate symptom management, early decision-making, and supportive care into the primary care setting to improve quality of life and decrease the economic and emotional impact at the end of life.

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.

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.

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.

Approaches to male hypogonadism in primary care

Lawrence, Kristi L.; Stewart, Felicia; Larson, Brandi M.

The Nurse Practitioner. 42(2):32-37, February 12th, 2017.

Evidence suggests that providers are not adhering to current testosterone replacement therapy guidelines when treating male hypogonadism. Understanding diagnosis and management is further complicated by conflicting recommendations among available guidelines. NPs must select and follow the best guideline recommendations available to optimally treat this condition.