Showing posts relating to: The Rounds: Clinical Considerations

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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A Quick Guide to Documenting a Cardiovascular Exam

Do you struggle with documentation as a nurse practitioner? Compiling your physical exam findings into a succinct statement or two isn't always easy. You must use language appropriate to the body system to convey your exam so that your notes make sense to other providers. You must also make sure to cover the components of each system relevant to the patient's presentation. If you're a nurse practitioner who could use a documentation brush up, check out this quick guide to documenting a cardiovascular exam. 

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Six Off-Label Uses of Prescription Medications

Do you write off-label prescriptions for your patients? It’s possible that as a provider, you may be doing so without even knowing it. Although drug companies are prohibited from marketing medications for unapproved uses, off-label prescribing has become a common clinical practice amongst providers and it can be especially beneficial for patients who have exhausted all of the other treatment options.

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5 Prescription Pill Services for Your Patients

Online shopping and delivery services have transformed the way we buy goods and services. From furniture and groceries to live ladybugs and wigs for dogs, consumers can buy nearly anything their hearts desire and have it conveniently delivered right to their doorstep later that day. In similar fashion and with the evolve of telemedicine, now consumers can skip the lines at the pharmacy and have their prescription medications delivered to their homes too. This is certainly welcome news for providers who have trouble getting certain patients to adhere to taking the medications they’re prescribing them.

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Solving the CMP: Basic Lab Interpretation

When I wrapped up my nurse practitioner program, I remember thinking that I could have used more education around lab interpretation. Which abnormals did I need to worry about? When a lab value came back abnormal, what differential diagnoses could be causing the abnormality? I tell participants in MidlevelU's programs that one could get a PhD in lab interpretation - there can be a high degree of complexity in understanding how some of the physiologic systems involved work. So, we master the basics to start, then build on interpretation ability throughout our careers. 

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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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Are You Making I&D Incisions Correctly?

I’m more familiar than I would like to be with I&Ding abscesses. As a nurse practitioner working in the emergency department, it’s pretty much part of my day-to-day. Whether you’re in family practice, ER, urgent care or even some specialties, chances are you do your fair share of office procedures as well. While most nurse practitioners learn these procedures in school, I do find that many haven’t been trained in some of the finer details of performing them correctly. One such point involves I&Ding in a way that maximizes the probability of a favorable cosmetic outcome. Did you know that there’s a correct or suggested orientation by which you should make incisions?

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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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Ask These 6 Questions Before Agreeing to Call as a Nurse Practitioner

On-call responsibilities can be a major burden as a nurse practitioner (the dread!). They mean bringing work home with you and the obligation to be on duty after hours, on weekends, and even holidays. Although managing patients by phone can be an inconvenience, the way in which this responsibility is delegated within a practice is the make-or-break factor in determining if taking call is reasonable. If your employer or soon-to-be boss is asking you to accept call responsibilities, ask these six questions first. 

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Clinical Hack: Kissing Trick for Nasal Foreign Body Removal

Whenever I notice a toddler has checked into the emergency department waiting room for some sort of foreign body situation, a feeling of dread sends shivers throughout my body. Attempting to remove french fries from the noses of wiggling kids and beads from the ears of screaming infants has never been my forte. Performing procedures on children, especially those involving foreign body removal, just isn't part of my job that I enjoy. Fortunately, there are a few tricks that make removing foreign bodies a bit easier.

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6 Little Known Truths about Statins

Statins are one of the most commonly prescribed medications, consistently landing on the list of the top 10 most frequently prescribed meds (depending on the list you're looking at). Since Americans' love of pizza, burgers and fries doesn't appear to be going anywhere, as nurse practitioners we must be familiar with these medications - and most of us are. So, let's go a bit beyond the basics today and look at a handful of little known facts about the statins you're prescribing day-to-day. 

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10 Popular Clinical Posts to Ring In the New Year

Happy New Year! I hope you had a restful holiday and are ready to get back into the swing of things. With the New Year falling mid-week it seems everyone is still in vacation mode. So, here at MidlevelU HQ, while we're back in the office, we are continuing with our holiday season tradition of linking back to our most popular posts of the year. Could you use some clinical tips and tricks to integrate into your practice in 2019? If so, check out these top ten clinical posts. 

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