The journal for nurse practitioners : JNP
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Recent changes to guidelines for diagnosing and managing hypertension (HTN) in adults provide an opportunity for nurse practitioners to re-examine how they treat older adults with elevated blood pressure. This paper will review the revised definition of hypertension based on 2017 treatment guidelines, what age is considered "older" for adults with hypertension, what the treatment goal is for this population, and recommendations for getting blood pressure to desired goals.
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Acute compartment syndrome (ACS) of the lower leg is a time-sensitive orthopedic emergency that relies heavily on precise clinical findings. Late findings of ACS can lead to limb amputation, contractures, paralysis, multiorgan failure, and death. ⋯ The definitive treatment of ACS is timely fasciotomy. We review the pathophysiology, common causes, diagnosis, and treatment of this potentially devastating condition.
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Nurse practitioners may manage patients with coagulopathic bleeding which can lead to life-threatening hemorrhage. Routine plasma-based tests such as prothrombin time and activated partial thromboplastin time are inadequate in diagnosing hemorrhagic coagulopathy. Indiscriminate administration of fresh frozen plasma, platelets or cryoprecipitate for coagulopathic states can be extremely dangerous. The qualitative analysis that thromboelastography provides can facilitate the administration of the right blood product, at the right time, thereby permitting the application of goal-directed therapy for coagulopathic intervention application and patient survival.
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The purpose of this article is to evaluate the new Infectious Diseases Society of America and the American Thoracic Society Guideline for Community-Acquired Pneumonia in Adults for nurse practitioner (NP) practice using evidence-based practice principles. The major recommendations for diagnosis, treatment, site of care, and prevention are also summarized. In general, the guideline meets the criteria of evaluation of practice guidelines, although the methods used for the literature search are not adequately described. The guideline was not developed with the input from primary care providers; however, it is appropriate for NPs who work in a variety of settings, including primary care.