Journal of the American Academy of Nurse Practitioners
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To provide nurse practitioners (NPs) information about sickle-cell disease (SCD) and pulmonary hypertension (PHTN) as a complication. A case study is presented to illustrate the diagnosis of PHTN in a patient with SCD. Clinical manifestations, diagnosis, and interventions for both SCD and PHTN are also discussed. ⋯ Many patients with SCD are seen in primary care practices. Such is the situation for the patient in this case study. Familiarity with pulmonary hypertension secondary to SCD can increase the awareness of NPs of this potential consequence and initiate early diagnostic evaluation.
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J Am Acad Nurse Pract · Mar 2010
Comparative StudyVeterans' perceptions of care by nurse practitioners, physician assistants, and physicians: a comparison from satisfaction surveys.
To examine the differences in patient satisfaction with care provided by nurse practitioners (NPs), physician assistants (PAs), and physicians in the Veterans Health Administration (VHA) system. ⋯ The VHA is the largest healthcare system and the single largest employer of NPs and PAs in the country. This study shows that a majority of the primary care clinic patients prefer to see NPs as compared with PAs and physicians. Besides clinical care, NPs focus on health promotion, disease prevention, health education, attentiveness, and counseling. Physicians and PAs should be educated on these characteristics to promote patient satisfaction and expected outcomes.
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J Am Acad Nurse Pract · Feb 2010
Diagnosis and management of endometriosis: the role of the advanced practice nurse in primary care.
To discuss the etiology, clinical presentation, diagnosis, and management of endometriosis for the advanced practice nurse (APN) in primary care. ⋯ The APN in primary care plays an essential role in health promotion through disease management and infertility prevention by providing support and much needed information to the patient with endometriosis. APNs can also facilitate quality of care and manage treatments effectively to improve quality of life, reduce pain, and prevent further progression of disease. Practice recommendations include timely diagnosis, pain management, infertility counseling, patient education, and support for quality of life issues.
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To review the risks, diagnosis, management, and prevention of aspiration pneumonia in adults over age 65, and discuss the major role of dysphagia as a risk factor in this population. ⋯ Numerous physical, cognitive, or environmental factors have been identified as predictors of aspiration pneumonia. Knowledge of clinical features, treatments, and prevention will help NPs improve outcomes in older adults with aspiration pneumonia; especially those in long-term care.
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J Am Acad Nurse Pract · Dec 2009
How family practice physicians, nurse practitioners, and physician assistants incorporate spiritual care in practice.
To investigate how primary care family practice providers incorporate spirituality into their practices in spite of documented barriers. ⋯ Findings support that patients' spiritual needs can be addressed in spite of documented barriers. Techniques to assist providers in providing spiritual care are discussed and directions for future research are suggested.