Showing posts relating to: The Rounds: Clinical Considerations

Charting Hacks for Nurse Practitioners

Sometimes charting makes me want to scream. When I work in the fast track area of the emergency department diagnosing ear infections, suturing lacerations and treating minor injuries, I quickly become frustrated with documentation. It seems that charting the patient interaction takes longer than the visit itself. Not to mention, documenting what seems like the same visit over and over again makes me certifiably crazy. 

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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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Auscultate It! Super Quick Lung Sounds Tutorial

It's interesting how much you can learn with a review of the most basic skills. As nurse practitioners, many of us have been listening to lung sounds for years. But, when a reader asked me to post a refresher on auscultation, even as an experienced NP I came away with a few new interesting tidbits of information. So, whether you're new to the nurse practitioner profession, or you're a seasoned NP with years of experience, check out this super quick refresher on lung sounds. 

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We Can't Stop Using These 3 Lab Interpretation Apps

As a new nurse practitioner, one of my clinical areas of weakness was that of ordering and interpreting labs tests. Matching a patient's clinical presentation up with the required diagnostic studies wasn't easy. Ordering unnecessary labs meant increasing costs for my patient. Omitting helpful lab studies could lead to a missed diagnosis or misdiagnosis. Furthermore, once the labs were complete, what was the significance of abnormal results?

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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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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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