Showing posts relating to: The Rounds: Clinical Considerations

Real Alternatives to Opioids for Pain Management

By Healthcare Attorney Alex Scarbrough Fisher

Healthcare providers are aware of the current opioid epidemic in the United States, as well as the risks—both to the provider’s patients, and to the provider’s licensure—of prescribing opioids to patients for the management of chronic pain. So, what do we do about it? 

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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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Documenting a Respiratory Exam - Just the Basics

A physical exam of the chest includes both the heart and lungs, which can each be quite complex in themselves. So, for our purposes, we'll break the exam and documentation of the chest down into its components. Continuing our MidlevelU series on documentation basics, today we'll look at how to document an exam of the respiratory system. 

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How to Make the EpiPen Affordable for Your Patients

In recent months, drug company Mylan increased the price for its EpiPen and EpiPen Jr. 2-Paks to $600 plus; an estimated 400% increase compared to its original cost of around $100 in 2007. The skyrocketed cost has sparked outrage amongst consumers. The controversy has even made its way up to Congress and continues to unfold weekly. In the midst of the EpiPen controversy, how can nurse practitioners make sure their patients can afford the life-saving drug?

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The Nurse Practitioner's Guide to the 2016 Flu Shot

It's that time of year again, folks! The weather is crisp and leaves are beginning to fall from the trees. Yes, it's flu shot season. In the emergency department where I work, we've already seen a handful of patients test positive for influenza. So, it looks like the flu could come early this year. As a result, nurse practitioners should encourage patients to get vaccinated sooner rather than later. What do NPs need to know about the 2016-2017 flu shot?

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Documenting a Neuro Exam, Decoded

A neuro exam is one of the more complex body systems to master when it comes to assessment and documentation. Testing the cranial nerves, for example, takes practice. Omitting a small part of the process can mean missing a potentially serious diagnosis. Given the importance of the neurological exam, today as part of our documentation series, we're going to look at exactly how to record your exam findings. 

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The Essentials of Documenting an Extremity Exam

Today, we're continuing our series on documentation with the extremities. From orthopedic injuries, to infection, and symptoms of systemic illness, there's a wide range of findings you may note on an exam of the upper and/or lower extremities. Documenting these findings appropriately is important not only to the continuity of care for your patient, but also to protect yourself legally as a provider and justify your treatment plan. So, how do you document an extremity exam?

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The Skinny on Documenting an Abdominal Exam

If you're a newer nurse practitioner, chances are you may find documentation a challenge, especially if you don't have an electronic medical records system prompting the input of your physical exam findings. Documentation is key to continuity of care for your patients, as well as to protecting yourself should questions arise about the patient encounter. Given the importance of this foundational skill, we're going to spend some time covering how to document a physical exam, system-by-system (in no particular order) over the next few weeks here on MidlevelU. 

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5 Fantastic Resources for Women's Health Nurse Practitioners

If you're a women's health nurse practitioner, or an NP that sees patients for issues related to reproductive health, you're in luck. There are a number of online resources out there to make your job easier. Whether you're looking to keep up with the latest treatment guidelines, or stash a few quality handouts for your patients, there's a website to help. Here are a few of our favorites. 

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The Rules for Treating Partners of Patients with STDs

As a nurse practitioner working in the emergency department, I've become accustomed to treating patients for sexually transmitted infections. In fact, I do so nearly every shift I work. While having these sometimes awkward conversations with patients has become much easier, the waters surrounding treatment for the partners of these patients remains murky. Is it allowable to prescribe antibiotics for the partner of a patient I have never laid eyes on? What are the legal implications of doing so?

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4 Key Questions to Help Your Patients Make Lifestyle Changes

Last week at the Midlevels for the Medically Underserved kickoff, a speaker discussed the concept of motivational interviewing. In my eight years as a nurse practitioner, I had never been introduced to the topic. I wasn't quite sure what to expect. Midway through her discussion, I had an 'Aha!' moment that will make a significant difference in the way I interact with my patients. Here's what happened. 

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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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