Showing posts relating to: The Rounds: Clinical Considerations

Case Study of the Week: Congestive Heart Failure

Nearly 6 million Americans have congestive heart failure (CHF) costing the healthcare system an astonishing $34.4 billion dollars each year.  About half of individuals diagnosed with heart failure die within 5 years of diagnosis.  Nurse practitioners must be prepared to diagnose and treat CHF as early diagnosis and treatment improves quality of life and increases life expectancy for people with heart failure. 

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Treating Overdose and Ingestion: A Quick Tutorial

I totally messed up my blogging schedule this month.  My self-created blogging calendar clearly states today I am to write about Poison Prevention Month.  My early morning research, however has revealed that March is the month devoted to poison safety.  Oops.  Working in the ER, overdose is one of my favorite diagnoses to treat so I'm going to review it anyway.

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Case Study of the Week: Carpal Tunnel Syndrome

I despise diagnosing cases of numbness and tingling.  Give me something I can X-Ray or visualize directly.  Numbness and tingling in the hands can be caused by many different medical issues making pinning down the patient's problem difficult.  These symptoms may signal anything from heart attack or anxiety to to cervical radiculopathy or even stroke.  Fortunately for nurse practitioners, carpal tunnel syndrome, also known as median nerve entrapment, presents with some classic symptoms helping NP's make an accurate diagnosis.

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Case Study of the Week: Bell's Palsy

Did you know celeb's such as Katie Holmes, George Clooney and Bachelorette alum Emily Maynard have suffered from Bell's Palsy?  Just one of many interesting things I uncovered while researching for this post.  Let's take a closer look at the diagnosis and treatment of this intriguing disorder.

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Case Study of the Week: Acute Cholecystitis

'Slam-dunk' diagnoses are my favorite kind.  Listening to a patient describe their symptoms and identifying their problem is gratifying.  Often these diagnoses are rashes, visual clues as to what is going on inside the body.  Other 'slam-dunk' diagnoses affect a predictable type of patient and are easily identified by their telltale symptoms.  Acute cholecystitis is one if these conditions.

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Case Study of the Week: Pseudotumor Cerebri

Don't you hate those diagnoses you cannot make with a simple physical exam or routine lab work, the diagnoses that are potentially serious but often disguise themselves as more benign conditions?  Pseudotumor cerebri is one of these tricky medical conditions- often initially misdiagnosed as a migraine headache but essential to treat properly.  To learn more about this interesting condition and hone our diagnostic skills, I have chosen pseudotumor cerebri for this week's case study.

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Case Study of the Week: Radial Head Subluxation

I love a medical problem with an immediate fix.  The patient leaves happy, I feel the satisfaction of having made someone's day just a bit better.  It is much nicer to push, pull, feel a clunk and cure the issue at hand rather than inform your patient that unfortunately they are suffering from a viral infection and should plan on a few days of feeling under the weather.  That is why I love a good case of Radial Head Subluxation (Nursemaid's Elbow). 

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Case Study of the Week: Mastoiditis

I can tell that cough, cold and sniffle season is in full force by just a quick glance at the waiting room in my workplace.  During this season it is tempting to move quickly from patient to patient trying to keep wait times low and patients happy.  But, next time you diagnose otitis media, don't miss mastoiditis, a potentially serious complication.

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Case Study of the Week: Acute Angle-Closure Glaucoma

Nothing scares me more than treating eye-related complaints.  Yes, usually the patient is dealing with a simple conjunctivitis or corneal abrasion but I am always concerned about complications.  I am less familiar with opthalmology than other areas of medicine and could use a refresher on opthalmologic conditions.  You may not know that January is Glaucoma Awareness Month.  So, in an effort to raise knowledge and awareness I have selected Acute Angle-Closure Glaucoma (AACG) as this week's case study.

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Case Study of the Week: Diverticulitis

Working in the ER, I treat a lot of abdominal pain.  It seems our population lives in fear of contracting an appendicitis and seeks emergency treatment for every twitch and pang in their tummy.  Given the large number of abdominal pain related complaints I encounter on a daily basis, I have become rather adept at sorting the serious from the benign and diagnosing them appropriately.  Among my favorite diagnoses is diverticulitis. 

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Case Study of the Week: Black Hairy Tongue

This might just be the most disgusting thing I have ever seen!  I learned about Black Hairy Tongue (Lingua Villosa) while on my CME conference a few weeks ago and decided to delve into the topic a bit further as this week's case study.  Although I have never seen or treated a severe case of black tongue thus far in my career, I will now be prepared when a patient presents with these appalling oral changes.

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Case Study of the Week: Sialolithiasis

Patients presenting with significant facial swelling strike fear in me as a medical provider.  With so many essential and complex structures and in considering proximity to the brain, dealing with facial swelling is certainly concerning and necessitates an accurate diagnosis.  Thankfully, at my continuing medical education conference last week we discussed ENT emergencies including one of my favorite diagnoses, sialolithiasis, more commonly known as the salivary stone. 

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