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Most Popular Articles

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.

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.

Trends in NP and RN enrollment, graduation, and practice

Fitzgerald, Margaret

The Nurse Practitioner. 43(11):53-55, November 2018.

The employment outlook for NPs is expected to continue its growth trend in the coming years. This article summarizes graduation and employment trends for nursing students and provides a synopsis of data from the Bureau of Labor Statistics about the growing demand for NPs and nurses. A brief overview of the history of recent workforce trends is also provided.

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 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.

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.

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.

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.

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.

Diabetic autonomic neuropathy resulting in sexual dysfunction

Wooton, Angela K.; Melchior, Lynne M.

The Nurse Practitioner. 43(11):39-45, November 2018.

Although diabetic autonomic neuropathy (DAN), a complication associated with diabetes, is increasing in prevalence, it is often overlooked. Knowledge regarding the development and progression of this complication is limited. NPs are in a key position to prevent complications of DAN, including sexual dysfunction, in this vulnerable population.

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.

Type 2 diabetes management: A practice guide for NPs

GC, Kajal; Cadet, Myriam Jean; Hirani, Shabeena; More

The Nurse Practitioner. 43(10):40-47, October 2018.

Type 2 diabetes mellitus (T2DM) is an endocrine and metabolic disorder that requires ongoing medical management. If T2DM is not adequately assessed and managed, a wide spectrum of clinical manifestations and complications may occur. This article provides clinical guidance to NPs on the management of T2DM in primary care settings.

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.

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.”

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.

Newest lipoglycopeptides for the management of acute bacterial skin and skin structure infections

Bell, Allison M.; King, S. Travis; Barber, Katie E.; More

The Nurse Practitioner. 43(10):31-37, October 2018.

Acute bacterial skin and skin structure infections (ABSSSIs) are some of the most commonly encountered infections worldwide. Hospitalizations as a result of ABSSSIs are associated with high mortality. This article discusses the role of oritavancin and dalbavancin, the two newest lipoglycopeptides, in the context of the other available I.V. infusion standard therapy options.

Primary care of chronic dyspnea in adults

Bull, Amy

The Nurse Practitioner. 39(8):34-40, August 16th, 2014.

Chronic dyspnea is defined as shortness of breath lasting for a minimum of 4 weeks. It is a common complaint associated with many of the cardiopulmonary diseases seen in primary care. This article provides a systematic, evidence-based, and cost-effective approach to the evaluation of this complex symptom.

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.

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.

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.

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.

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.

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.

Hypertriglyceridemia: A review of the evidence

Elkins, Casey; Friedrich, Debra

The Nurse Practitioner. 43(10):22-29, October 2018.

Elevated triglycerides are independently associated with increased atherosclerotic cardiovascular disease risk. Hypertriglyceridemia is often a polygenic condition that can be affected by numerous interventions. Primary care NPs are well positioned to appropriately evaluate and manage hypertriglyceridemia, improving overall health outcomes.

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.

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.

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.

Diagnosis and Management of Primary Aldosteronism

Thanavaro, Joanne L.

The Nurse Practitioner. 36(4):12-22, April 2011.

Primary aldosteronism is characterized by excessive production of aldosterone, which leads to hypernatremia, hypertension (HTN), hypokalemia, and alkalosis. The three crucial diagnostic steps are case detection, case confirmation, and subtype classification. Marked improvement or cure of HTN is achieved with appropriate treatment.

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.

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.

HPV, cervical cancer risks, and barriers to care for lesbian women

Waterman, Lindsay; Voss, Joachim

The Nurse Practitioner. 40(1):46-53, January 16th, 2015.

The purpose of this article is to identify Pap testing rates among lesbians and reasons for lack of recognition of cervical cancer risks in lesbians. The lesbian community requires better education, and healthcare providers should promote regular Pap smears for all women.

Caring for military families: Understanding their unique stressors

Owen, Regina; Combs, Teresa

The Nurse Practitioner. 42(5):26-32, May 12th, 2017.

Military families are often faced with unique stressors that civilian families do not have to deal with, such as deployment, geographic separation, and frequent relocation. When an NP is providing care for a military family, it is important that these unique stressors are discussed and understood. NPs can employ the Causal Uncertainty Model to encourage effortful cognition and support family attributes to ameliorate the negative effects of the stressors these families may face.

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.

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.

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.

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.

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.

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.

Screening women for intimate partner violence: Creating proper practice habits

Knox, Beth

The Nurse Practitioner. 43(5):14-20, May 17, 2018.

Intimate partner violence continues to be a challenge for advanced practice registered nurses to address and manage in their daily practice. This article reviews current healthcare concerns in heterosexual, bisexual, transgender, and lesbian women, and explores guidelines and resources for developing successful screening habits.

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.

Addressing pediatric intoeing in primary care

Davis, Lauren; Nativio, Donna G.

The Nurse Practitioner. 43(7):31-35, July 2018.

Primary care providers frequently encounter children with an intoed gait. Intoeing is most often a normal variation of development that resolves without treatment. The well informed primary care NP can identify the small subset who need referral through child and/or family history, physical exam, and by recognizing red flags.
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