Journal of the American Academy of Nurse Practitioners
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To provide an overview of the pathophysiology, steps in making a diagnosis, differential diagnosis, and treatment methods for vocal cord dysfunction (VCD) in young athletes. ⋯ The ability to correctly differentiate VCD from other causes of respiratory distress can lead to accurate interventions, save precious time in an acute situation, and promote long-term control of this condition.
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J Am Acad Nurse Pract · Nov 2008
ReviewPostpartum management for gestational diabetes mellitus: policy and practice implications.
The pathogenesis of gestational diabetes mellitus (GDM) and insulin resistance, risk factors, links to diabetes following the pregnancy, and clinical practice recommendations for this population are reviewed. Economic implications and future research needs are included. ⋯ Nurse practitioners need to be cognizant of the risks for diabetes and should follow clinical practice recommendations for routine screening and implementing preventive strategies for women who experience GDM. Office reminder systems such as standardized documentation flow sheets and electronic medical records may assist with provider adherence to practice recommendations. Strict postpartum screening and management may help reduce risks for developing diabetes in this vulnerable population.
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J Am Acad Nurse Pract · Oct 2008
ReviewImproving patient outlook in rheumatoid arthritis: experience with abatacept.
To examine the importance of improving patient outlook in rheumatoid arthritis (RA) and to discuss the role of the nurse practitioner (NP) who, through the assessment of patient-reported outcomes and in acting as an advocate for the patient with the wider healthcare team, has a crucial part to play in managing the overall well-being of the patient. This article will draw on the clinical experience to date with abatacept, a first-in-class therapy that has been approved for the treatment of RA in patients with an inadequate response to either traditional disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, or biological DMARDs, such as tumor necrosis factor-alpha antagonists. ⋯ The use of more patient-centered measures of response are gaining increasing importance both in clinical trials and in clinical practice, and as such the NP has an important role in ensuring that both the physical and the psychological needs of patients are met. Clinical trials to date have shown that abatacept provides significant and clinically meaningful improvements in patient-reported outcomes, as well as demonstrating significant clinical benefits and a consistent safety profile, thus representing a valuable treatment option within the RA treatment armamentarium.
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J Am Acad Nurse Pract · Sep 2008
A challenge in academia: meeting the healthcare needs of the growing number of older adults.
The purposes of this study were to survey nurse practitioners (NPs) to determine their comfort level with knowledge about caring for individuals aged 65 years and older and to obtain their input on enhancing geriatric content in the educational preparation of advanced practice nurses who provide care to older adults but are not specialists in gerontology. ⋯ Based on the results of this study, an online, four-credit geriatric-focused course "Issues in Geriatric Management" was developed. The course is required in the acute care and adult NP programs. Eventually, this course will be offered as continuing education credit for practicing NPs. The offering of a course focused on geriatrics will help to better prepare NPs to care for the growing number of elderly in this country.