Showing posts relating to: The Rounds: Clinical Considerations

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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Nurse Practitioners, Are You Complying with This Reporting Law?

By Leondria Taty, MSN, FNP-C

Every state has a reportable disease list, and health care providers including nurse practitioners are required by law to report these diseases. Yes, that’s right by law. That’s because when these diseases are not reported, delayed, or incomplete, new incidences of the disease can occur and spread in your community. Here’s how it works and why it’s important.

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Are Pharmaceutical Companies Targeting Kids?

As nurse practitioners, we're far too familiar with the influence that drug companies have on our patients. Asking for medications by name, patients often come to us knowing exactly what they want. They are influenced by friends, family, or marketing campaigns. While marketing efforts by pharmaceutical companies aren't inherently a bad thing, drugs help billions of people, the tactics of these companies have been called into question. Recently, the issue has taken on new light given it's effect on increasingly younger populations. 

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Are You Following These 4 Practical Prescribing Principles?

Most often, when I read research articles, I find them interesting, but not directly applicable to my practice. Or, the article presents an interesting perspective, however the research is young and not widely tested. Recently, however, a journal article was recommended to me that proved to be practical and directly applicable to my work as a nurse practitioner. The article? Principles of Conservative Prescribing published in the Archives of Internal Medicine

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Beer's List- Medications You Shouldn't Give to Old People

Do you ever get stumped when it comes to prescribing medications for the elderly? Or, maybe you just don't know what you don't know concerning drugs and old people. It seems like some of the most common feedback my colleagues and I working in the emergency department receive from primary care providers relates to prescribing in the elderly population. 

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Clinical Hack: The Ring String Trick

Working in the emergency department, one of my favorite cases to treat is rings stuck on swollen fingers. While it doesn't happen everyday, there's something gratifying about the opportunity to grind through a ring on a finger that is steadily turning bluer and bluer.

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