J Am Acad Nurse Prac
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J Am Acad Nurse Prac · Sep 2006
ReviewAssessing military veterans for posttraumatic stress disorder: a guide for primary care clinicians.
To educate primary care providers on the physical effects of posttraumatic stress disorder (PTSD), explain why military veterans are at great risk, and describe how to identify PTSD in primary care clients. ⋯ Primary care clinicians, including those outside the military health system, are essential in identifying trauma histories and directing clients to appropriate care.
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To review special considerations in the management of adults 65 years of age and older with diabetes mellitus (DM) with particular attention to initiation of insulin in the management of type 2 DM (DM2), Medicare eligibility for insulin pump therapy, and intensive insulin therapy in both type 1 DM (DM1) and DM2 in older adults. ⋯ Management of diabetes in the older adult is a common clinical scenario for primary care providers (PCPs). Treatment strategies follow a continuum over time from lifestyle modification to intensive management. Intensive insulin therapy, through the use of either multiple daily injections or continuous subcutaneous insulin infusion using insulin pumps, has demonstrated benefit in both DM1 and DM2; however, there is evidence that PCPs are reluctant to initiate insulin. Moreover, in the management of older adults with diabetes, evidence-based outcomes regarding intensive management are lacking. Further studies are needed.
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J Am Acad Nurse Prac · Jun 2006
Comparative StudyPrescribing trends by nurse practitioners and physician assistants in the United States.
As an important step in analyzing the role of nurse practitioners (NPs) and physician assistants (PAs), we examined their prescribing behavior. The intent is to study the characteristics of providers and patients, and the type of prescriptions written by NPs and PAs in primary care and to compare these activities to physicians. ⋯ We suggest that NPs and PAs may provide a role that is similar to that of physicians in primary care based on prescribing behavior. The prescribing behavior of PAs and NPs parallels that of physicians by the number of medications per visit, the types of therapeutic classes, and the type of patient. However, in nonmetropolitan areas, prescribing differences emerge between the three types of providers that bear further exploration.
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To raise awareness among nurse practitioners (NPs) about the nicotine inhaler by providing clinical and practical information about the use of the nicotine inhaler as a treatment option for smoking cessation. ⋯ The nicotine inhaler is appropriate for many different smokers, including certain types of cardiac patients. NPs can include the nicotine inhaler in a group of nicotine replacement therapies to ensure that smokers are successful in tobacco cessation.