Showing posts relating to: The Rounds: Clinical Considerations

What NPs Need to Know about Signing Death Certificates

The first time a death certificate appears on your desk as a nurse practitioner is a nerve wracking moment. Are you allowed to sign death certificates as an NP? If so, what if you are unsure of the cause of death? What's the liability involved with signing a death certificate? Naturally, there's a lot of confusion and concern among nurse practitioners when it comes to signing death certificates so today we're addressing some F.A.Q. to clear up the confusion. 

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4 Written Resources for Lab Interpretation

Our last post talked apps for lab interpretation. While apps are convenient and take up only virtual storage space, we totally side with nurse practitioners who prefer more tangible clinical resources. If you're a book-loving NP, there are a number of helpful references out there to guide you in ordering and interpreting lab studies. Which pack the most punch in the clinical setting?

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The Rules for Delivering Bad News to Patients

I've talked to some colleagues recently who've been a little down about their roles as nurse practitioners. Working in family practice, they have found themselves in the position of delivering bad or upsetting news to their patients. Cancer diagnoses were fortunately made rather than missed, but letting a patient know they've got a serious, life-altering illness or condition is tough, not to mention, this is not something most of us as NPs learn to do in school. 

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3 Things You'll Learn at 'What's Up with Primary Care Emergencies?!'

It's almost mid-November and with the upcoming Thanksgiving holiday, I also get the feeling that the year is winding down. Once Thanksgiving week comes, the holiday season takes over and it's all I can do to squeeze in work, shopping, social engagements and all that comes with Christmas time. But, before holiday madness and distractions take over, I plan to get a few productive works weeks in and do some planning to get myself organized in preparation for 2018. 

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What's the Primary Care NP's Role in Managing CKD Patients?

Some of the nurse practitioners participating in Midlevels for the Medically Underserved recently let me know that they see a lot of patients with chronic kidney disease (CKD). Whether these patients are presenting for management of CKD itself or another issue, management and treatment of patients with such chronic comorbidities can be complex. Prescribing, for example, reaches a new level of complexity as the NP must decide which medications and at what doses and intervals are appropriate for the CKD patient. 

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Do Redheads Really Require More Lidocaine?

So, is it fact or fiction? Are redheads really more resistant to anesthetic compared to the rest of the population? In a recent suturing and office procedures training session I attended, the speaker mentioned that redheads may require a greater amount of subcutaneous lidocaine for these procedures than other patients. Curious as to the veracity of this claim, I decided to do a little research. 

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How Accurate are Rapid Strep Tests?

With an estimated seven million Americans seeking medical treatment for sore throats annually, it’s a safe bet that as a nurse practitioner you will treat your fair share of patients with swollen glands and tonsils. Sore throats are often the first sign of an impending illness; but sudden and severe sore throats combined with fever are the telltale sign of a more serious, yet common illness known as Group A Streptococcus or strep pharyngitis. With just one in ten cases of pharyngitis caused by strep, how do you make an accurate diagnosis?

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7 Questions to Ask about Your State Prescription Drug Monitoring Program

Do you look patients up on your state's controlled substance monitoring database before writing prescriptions for these medications? I've long been aware of this resource available to nurse practitioners and other prescribers, however I recently learned that there's a lot more to using these databases than most providers are aware of. Did you know that it may be illegal for you to print out the results of an inquiry into the system? Or, for example, that you may be legally obligated to look a patient up in your state's database before writing certain prescriptions?

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3 Apps to Help Your Patients With Medication Management

Even though I have been a nurse practitioner for a number of years, I don't think I ever fully appreciated how difficult it can be for patients to manage a medication regimen until recently. Given that a few individuals close to myself have found themselves in similar situations, prescribed numerous meds, the problem now seems closer to home. Some drugs must be taken with food, and others without. Medications may be prescribed one, two, three, or even four times a day making taking each pill at the appropriate time nearly impossible. In yet other cases, drugs must be refrigerated, which makes taking them on the go a challenge. 

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A Pharmacist's Top Drug Resource Recommendations for NPs & PAs

This week, nurse practitioners in our inaugural Midlevels for the Medically Underserved class sat in on a presentation from pharmacist Dr. Jon Pouliot about medication interactions in the primary care setting. With so many of our patients taking multiple medications, it can be tough as NPs and PAs to keep track of interaction considerations, as well as drug side effects and dosages. So, helpfully, Dr. Pouliot ended the presentation by suggesting a few practical resources nurse practitioners and physician assistants can use for prescribing. 

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The ABCs of Extremity X-Ray Interpretation for NPs

I've previously discussed the ABCDEFGHI's of chest X-ray interpretation, but today wanted to tackle a topic somewhat simpler. Fortunately for nurse practitioners, interpretation of orthopedic extremity X-rays involves fewer steps as there is generally not quite so much anatomy to consider compared with the trunk. While not all NPs interpret their own radiography, it's still essential to have a basic understanding of how the process works. What exactly should you be looking for when you interpret an extremity X-ray?

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Are You Aware of These 10 Drug-Herb Interactions?

By Guest Contributor Leondria Taty, MSN, FNP-C

Within the past 24 hours, you’ve probably consumed an herb and didn’t even know it. Think about it - almonds (Prunus Amygdalus), cinnamon (Cinnamomum verum), ginger (Zingiber officinale), cayenne (Capsicum annuum), grapes/grape seed (Vitis Vinifera), tomatoes (Lycopersicon esculentum), goji (Lycium barbarum), soy (Glycine max), and many others like it all derive from an herbal plant. Studies support the myriad of health benefits that herbs can provide, many of which have little to no side effects. 

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