Showing posts relating to: The Rounds: Clinical Considerations

5 ECG Interpretation Courses for Nurse Practitioners

Mastering the art of ECG interpretation is tough. Reading ECGs proficiently is a skill that takes practice and fine tuning over time. Nurse practitioners working in some environments may not see ECGs everyday making it even more difficult to hone these skills. Fortunately for NPs, there are several organizations offering ECG interpretation focused courses and conferences. If your ECG interpretation skills leave room for improvement, check out these continuing medical education courses to get you up to speed. 

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Laceration Repair Round Up: Best Posts for Learning to Suture

Mastering procedures was one of the more difficult parts of life as a new grad nurse practitioner. Procedures take practice. Not to mention, there are additional factors to consider compared with less involved patient interactions. The risk of complications, for example, is much higher with procedures. So, these interventions must be approached with careful consideration. If you could use a brush up on your laceration repair skills, the following blog posts will help. 

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Let's Talk About Urine! Microalbuminuria Q&A

I recently gave a presentation on chronic kidney disease to a group of NPs and PAs in our latest Midlevels for the Medically Underserved cohort. They asked a number of excellent questions on the topic which led to some discussion about screening for proteinuria. It seems there's a need to clear up some confusion around microalbuminuria. So, today, let's get back to primary care basics with some Q&A on the topic. 

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Understanding Opioid Strengths and Other Prescribing Pearls

Whether or not you prescribe opioids, a lot of your patients are taking them. So, it's important for nurse practitioners and physician assistants to get familiar with how they work to guide your treatment and prescribing plans. Today, let's talk opioid strengths. When we talk about the 'strength' of opioid medications, there are two aspects to consider. First, we look at the drug potency. Second, we can look at the drug's duration of action. For the purposes of today's post, we will discuss potency. 

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Your Mind Is Not a Microwave

So don't treat your clinical education like it is one

I see a number of posts from nurse practitioners requesting quick fixes. Inquiries like "I accepted a new position in neurology - do you know of any quick brush-up courses?" and "I'm trying to learn medical Spanish - does anyone know of any conferences to attend?". While conferences and other short learning experiences certainly have merit, mastering the various aspects of clinical practice takes much more time and involvement than a one-week continuing education bootcamp. 

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The Lucky 7: Classes of Meds for Pain Management

Pain management is basically a dirty word among nurse practitioners and physician assistants today. We shun patients on long-term pain medications and grow weary of requests for "that medicine that I had that one time - it starts with a 'D'...". The opioid problem and our resulting hesitancy to prescribe pain medications has become so bad that a patient comes to see us with something like an acute femur fracture and we pause before prescribing ten tablets of Percocet upon discharge from the hospital. 

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5 Must-Read Pharmacy Blogs for NPs & PAs

The nerd in me really loves pharmacology. The subject pairs my clinical career with my undergrad studies in biology and chemistry. It hits home with my academic and professional interests. Not to mention, as nurse practitioners and physician assistants, we prescribe a lot of medications. Pharmacology is complex leaving us with questions about what and how to prescribe. As part of this month's series on prescribing for pain, I thought it would be a good idea to share some resources that relate to prescribing in general. 

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The First Step to Appropriate Pain Management

I have to admit that I kind of hate talking about pain management. Pain is one of those things that your patients can't show you visibly (at least most of the time). It doesn't show up in lab results. Treatment of pain is based on subjective report. So, as a nurse practitioner it can be difficult for me to make decisions about managing pain for my patients. Then, toss into the mix that our nation is facing an opioid crisis, the fact that I've been duped a few times into writing narcotic prescriptions for addicts and I'm not sure what to do next or where to draw the line. 

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New Series! Approaching Pain Management

From pharmacology to putting your foot down

Raise you hand if you struggle with setting boundaries in treating pain for your patients. Pain management is a huge topic these days for nurse practitioners and physician assistants. As one who has personally broken ribs in the past and felt the relief a Lortab provides and as one who suffered from a nasty case of influenza as a child and was comforted by codeine-containing cough syrup, I understand that opioids have a valid place in medicine. But, as a nurse practitioner practicing amidst an opioid crisis, I also feel immense pressure to stray from prescribing these drugs. 

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Which Patients Actually Need Preventative Low Dose Aspirin?

The answer, simplified.

Keeping up with preventative care guidelines can be pretty confusing. It seems like every professional society related to each specialty publishes their own recommendations. From kidney and liver disease prevention to cardiac and osteoporosis screenings, where do you even begin? One particular preventative measure often recommended by nurse practitioners, taking low dose aspirin to prevent cardiovascular disease, is particularly nebulous. 

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Can Essential Oils Interfere With the Prescriptions You're Writing?

When you take a patient’s history, are you asking what essential oils they may be using in addition to any medications they’re taking? Patients are often under the impression that because essential oils are derived from natural, plant-based substances, they’re a safe alternative to traditional pharmaceuticals and pose little to no health risk. As such they may not feel it’s relevant to disclose it to their healthcare provider unless asked. 

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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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