Showing posts relating to: The Rounds: Clinical Considerations

5 Helpful Pocket Orthopedic Guides for Nurse Practitioners

Diagnosing orthopedic symptoms can be tricky. X-rays, for example, don't tell you a lot about tendons and ligaments that are often responsible for joint pain. More advanced testing, like MRI, is costly, and often requires prior authorization from insurance companies leading to a delay in treatment. While there are a number of clinical orthopedic exam maneuvers that indicate the exact type of injury and help lead nurse practitioners to a diagnosis, the specifics of these exam techniques can be difficult to recall on the spot. 

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Now, What Meds Are You Taking Again? Pill Identification Apps

By MidlevelU Intern and BSN in Progress Olivia DeFilippo

Countless times I have peered into my medicine cabinet in search of my allergy medication finding pills that have fallen out of the packaging. "I think that tablet looks like my allergy medicine" I say to myself..."But should I risk it?".

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Orthopedic Decision-Making Made Easy for the Ankle and Knee

Earlier this week, I discussed the concept of clinical prediction rules. Essentially, these rules are tools nurse practitioners can use to simplify and increase the accuracy of clinical decision making. If you've ever used Wells Criteria to rule out a DVT for example, you've used a clinical prediction rule. I frequently take advantage of such algorithms in my own nurse practitioner practice as they lend an added level of confidence to my course of diagnosis and treatment. So, today, let's talk about a few of these guidelines as they relate to orthopedics.

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Can Nurse Practitioners Text Patient Care Orders?

Have you ever texted about a patient? In the emergency department where I work, texting can be an easy way to consult with a specialist or send an image of a patient's X-ray, lab results or even chief complaint. But, is this legal? What are the implications of texting about patient care?

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Which States Allow Nurse Practitioners to Prescribe Suboxone?

Nurse practitioners are newly allowed to prescribe buprenorphine (Suboxone) as part of the Comprehensive Addiction and Recovery Act signed into law by former President Obama. While the Act augments nurse practitioners' scope of practice from a federal standpoint, some states are more limiting in the freedoms they allow NPs. In which states can nurse practitioners actually prescribe Suboxone?

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Which Flu Patients Need Antiviral Meds?

I didn't originally intend on making it viral syndrome week here on MidlevelU, but given the season it seemed appropriate. After my shift the other day in the emergency department, I felt the need for an influenza brush-up. So, I'm passing on the relevant and lesser known tidbits to other nurse practitioners who could also use a refresher. Yesterday, we looked at influenza testing and its accuracy (see 5 Lesser Known Facts to Help Make a Flu Diagnosis). Today, we'll take the next step in the patient care process and look at treatment. 

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5 Lesser-Known Facts to Help Make a Flu Diagnosis

How accurate is the flu swab? Can I just use clinical intuition? And more...

I'm still crossing my fingers that the last shift I worked in the ER won't leave me sick with the flu. It seems like every other patient I saw tested positive for influenza A. As nurse practitioners this time of year, in many settings we're bombarded by sick patients. While we can't do much for viral syndromes in most cases, there are some general guidelines we must abide by and helpful information to know that impacts diagnosis. 

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What NPs Need to Know About Treating RSV

Cold and flu season if definitely here! In addition to the seasonal flu, respiratory syncytial virus (commonly referred to as RSV) is another prevalent and highly contagious virus that can affect patients of all ages through the fall and spring months. Nurse practitioners can expect to see these patients in their practices this season. In most older children and adults who are generally healthy, RSV causes mild, cold-like symptoms which typically resolve on their own within a few weeks. But for some patients, RSV can be serious and in some cases, life threatening.

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Our Top Clinical Resource Picks for the Year

Have you started your countdown yet? Whether you're vigilantly watching the seconds tick by, or sleeping through the New Years transition, the beginning of this season is not only a time to look forward but also one to look back. When it comes to my work as a nurse practitioner, there's nothing I appreciate more than a good resource. So, in the spirit of the New Year, here's a look back at our top picks for clinical resources in 2017. Which were your favorites?

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Can Nurse Practitioners Perform Endoscopy and Colonoscopy?

I recently received a nurse practitioner scope of practice question from a surgical center practice manager. She wanted to know if nurse practitioners and physician assistants can perform endoscopy and colonoscopy. Is this in your scope of practice as an NP or PA?

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How Can NPs Learn LARC Insertion?

As a nurse practitioner, training to provide more services and procedures gives your career a major boost. Not only do these abilities serve your patients well, they also make you a more marketable provider and provide value in the workplace. In my own nurse practitioner career, I have enjoyed furthering my clinical and procedural skills as this also keeps me relevant, challenged and up to date with the latest in evidence-based practice. 

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What are PECARN Rules? Hint: They Don't Involve Nuts

Deciding when to order a CT scan in the case of a head injury can be a frustrating process. Yes, the likelihood of a serious finding is often low, but do you really want to be wrong when it comes to a head injury? Absolutely not- the stakes are too high. In kids, the CT decision becomes an even riskier process. Ordering a CT scan unnecessarily increases risk of radiation-related malignancy later in life. Enter the PECARN rules. 

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