bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment Options for Patients With the Metabolic Syndrome
Authors: Berra Kathy 
Published: May 2005

PurposeTo review clinical and laboratory findings that will enhance nurse practitioner (NP) recognition of the metabolic syndrome and to increase awareness of recent treatment guidelines and treatment options.Data SourcesProfessional association practice guidelines, government documents, original research articles, and journal articles.ConclusionsThe metabolic syndrome is a prevalent condition characterized by a cluster of lipid and nonlipid abnormalities, including atherogenic dyslipidemia, elevated fasting blood glucose, hypertension, and abdominal obesity. Many persons with this syndrome are also insulin resistant. Prompt recognition and treatment of the metabolic syndrome can prevent or delay the development of type 2 diabetes and coronary heart disease. Clinical guidelines recommend treating the metabolic syndrome as a secondary target of lipid‐lowering therapy after addressing the primary target, low‐density lipoprotein cholesterol.Implications for PracticeNPs are in an instrumental position to manage treatment for patients with the metabolic syndrome by (a) evaluating risk factors, including abdominal obesity, physical inactivity, atherogenic dyslipidemia, hypertension, and elevated fasting blood glucose; (b) assisting in the modification of lifestyle factors such as diet and exercise; (c) implementing pharmacological therapy when needed; and (d) providing psychosocial support to encourage therapeutic adherence.
Preadmission Characteristics of Advanced Practice Nursing Students
Authors: Crosby Frances E. , Dunn Joan Dolce , Fallacaro Michael D. , Jozwiak‐Shields Connie , Maclsaac Ann Marie 
Published: May 2005

PurposeTo determine the nature of prerequisite experiences of applicants to nurse practitioner (NP) and certified registered nurse anesthetist (CRNA) programs that faculty believe are necessary for success in graduate nursing programs.Data SourcesAn exploratory descriptive study based on findings from four focus groups of faculty from four different universities and a written survey mailed to program or admissions directors of a random sample of 50% of the 295 credentialed NP or CRNA programs in the United States.ConclusionsThemes from the focus groups revealed 20 personal characteristics, 14 professional character‐istics, and 9 clinical skills, all of which were used to create a survey instrument. A 33% response rate was achieved (n = 48). Personal characteristics were considered most important, professional characteristics and clinical skills moderately important, and kinds of clinical experience of lesser importance. Length of desired experience ranged from 0 to 5 years, most often 2 years. The most important characteristic under personal was “ethical;” under professional, “clinically competent;” under clin‐ical, “interpersonal communication;” and under clinical experience, “to work in a setting with MD‐RN interaction.”0
Comparison of Quality‐of‐Hypertension‐Care Indicators for Groups Treated by Physician Versus Groups Treated by Physician‐Nurse Team
Authors: Scisney‐Matlock Margaret , Makos Gail , Saunders Tracy , Jackson Frances , Steigerwalt Susan 
Published: May 2005

PurposeTo determine whether the type of health care provider (i.e., physician versus physician‐nurse team) affected the quality of hypertension care given to two groups of randomly selected adult women.Data SourcesThree indicators measured the quality of hypertension care: blood pressure control level, knowledge of hypertension, and discussion about blood pressure medications with the health care provider(s). Blood pressure readings were taken with a 24‐hr ambulatory blood pressure monitor, and demographic data from survey results taken at orientation and researchercollected data on posttreatment knowledge of hypertension and cognitive representations of hypertension were gathered. Chi‐square and t tests were used to analyze the data.ConclusionsThe group whose care was managed by a physiciannurse team demonstrated lower means for 24‐hr systolic blood pressure and diastolic blood pressure (systolic: M = 132, SD = 14.9; diastolic: M = 75, SD = 11.3) than the group whose care was managed only by one or more physicians (systolic: M = 136, SD = 13.4; diastolic: M = 79, SD = 11.24). Also, the group whose care was managed by a physician‐nurse team revealed significantly higher scores for discussion of blood pressure medication than the group whose care was managed only by one or more physicians. There were no group differences for knowledge of hypertension.Implications for PracticeNurses qualified to assist with meeting the needs of hypertension clients in primary care settings can positively affect clients’ knowledge about blood pressure medication and—perhaps as a result of this knowledge—how well the clients control their blood pressure.
Approaches to Breast Cancer Screening Among Nurse Practitioners
Authors: Lawvere Silvana , Mahoney Martin C. , Symons Andrew B. , Englert Jessica J. , Klein Susan B. , Mirand Amy L. 
Published: May 2005

PurposeTo determine nurse practitioners’ (NPs’) knowledge and reported practices regarding breast cancer screening in a climate of conflicting guidelines.Data SourceA descriptive, cross‐sectional survey design was used to examine approaches to cancer screening among NPs in western New York.ConclusionsAmong the 175 NP respondents, agreement with the accepted answer for the individual breast cancer—screening items ranged from 51% to 80%; responses did not vary by age group or gender. Overall, 54% demonstrated agreement with three or more of four breast cancer—screening items.Implications for PracticeThese findings suggest the need to implement educational interventions as one means of decreasing variation in breast cancer screening among NPs. Also, the development and endorsement of a single set of evidence‐based breast cancer—screening guidelines would promote adoption of a single screening recommendation.
The Acute, Nontraumatic Scrotum: Assessment, Diagnosis, and Management
Authors: Cole Frank L. , Vogler Robert 
Published: May 2005

PurposeThis article reviews the acute, nontraumatic scrotal conditions of testicular torsion, torsion of an epididymal or testicular appendage, and epididymitis in order to assist the nurse practitioner (NP) with arriving at a diagnosis. Primary and emergency care management are presented.Data SourcesSelected published literature in refereed journals and the authors’ clinical experiences.ConclusionsSigns and symptoms of testicular pathologies can overlap, making diagnosis problematic. However, key features can raise the NP's index of suspicion for a particular diagnosis and can assist in selecting the most appropriate management strategy.Implications for PracticeAlthough these conditions are rarely fatal, they may carry a risk of morbidity in the form of testicular necrosis, infarction, or atrophy with concomitant infertility. Any patient with scrotal or testicular pain should be presumed to have testicular torsion until proven otherwise, as this condition carries a high degree of morbidity. The information gained through a thorough history and physical examination can assist in arriving at the proper diagnosis.
Bone Mineral Density in Adolescent Women Using Depot Medroxyprogesterone Acetate
Authors: Busen Nancy H. 
Published: May 2005

PurposeTo present current data on bone mineral density (BMD) in adolescent women using the long‐acting contraceptive depot medroxyprogesterone acetate (DMPA) and also to discuss the importance of developing maximal bone mass during adolescence to offset bone demineralization later in life.Data SourcesResearch‐based articles in the medical literature, review articles, and recommendations from the American Academy of Pediatrics and the National Osteoporosis Foundation.ConclusionsOsteoporosis is a preventable disease that affects millions of Americans, particularly older women. Factors influencing the attainment and maintenance of peak bone mass during childhood and adolescence affect the future risk of fractures. Although longitudinal studies conducted on adolescent women using DMPA are very limited, findings suggest that adolescents are losing bone density during a time of expected bone accretion.Implications for PracticeClinicians must consider all the risks and benefits when prescribing contraceptives to adolescents. By themselves, the findings related to BMD and DMPA use by adolescents are not sufficient to limit the use of DMPA as a contraceptive method. However, clinicians must take into account the addition of other modifying factors associated with BMD that may contribute to overall bone loss in adolescent females. More prospective data on the long‐term use of DMPA by adolescents are needed to determine DMPA's effect on bone loss and to determine if bone loss is transient in adolescents.
Acupuncture and Acupressure for the Management of Chemotherapy‐Induced Nausea and Vomiting
Authors: Collins Kimberly B. , Thomas Debera J. 
Published: May 2005

PurposeTo examine the formal and informal health care beliefs, behaviors, and practices of nurse practitioners (NPs).Data SourcesA self‐administered questionnaire with primarily closed‐ended format was distributed over a 3‐day period to a convenience sample of 321 NPs attending a national NP conference.ConclusionsThe overall health status and health practices of NPs were found to be fairly good, but there was room for improvement, particularly with regard to nutrition, health responsibility, physical activity, and stress management.Implications for PracticeRespondents were more likely to self‐diagnose and self‐treat minor illnesses and largely received their primary health care from physicians. The majority of NPs indicated a willingness to receive health care from an NP; however, the nonavailability of NPs restricted this option.
A Proposal for a Code of Ethics for Nurse Practitioners
Authors: Peterson Moya , Potter Robert Lyman 
Published: May 2005

PurposeTo review established codes for health care professionals and standards of practice for the nurse practitioner (NP) and to utilize these codes and standards, general ethical themes, and a new ethical triangle to propose an ethical code for NPs.Data SourcesReviews of three generally accepted ethical themes (deontological, teleological, and areteological), the ethical triangle by Potter, the American Academy of Nurse Practitioners (AANP) standards of practice for NPs, and codes of ethics from the American Nurses Association (ANA) and the American Medical Association (AMA).ConclusionsA proposal for a code of ethics for NPs is presented. This code was determined by basic ethical themes and established codes for nursing, formulated by the ANA, and for physicians, formulated by the AMA. The proposal was also developed in consideration of the AANP standards of practice for NPs.Implications for PracticeThe role of the NP is unique in its ethical demands. The authors believe that the expanded practice of NPs presents ethical concerns that are not addressed by the ANA code and yet are relevant to nursing and therefore different than the ethical concerns of physicians. This proposal attempts to broaden NPs’ perspective of the role that ethics should hold in their professional lives.
Health Promotion Attitudes and Practices of Texas Nurse Practitioners
Authors: Reeve Kathleen , Byrd Theresa , Quill Beth E. 
Published: May 2005

PurposeThe Purpose of this descriptive cross‐sectional survey was to examine the health promotion attitudes and practices of Texas nurse practitioners (NPs).Data SourcesOriginal research utilizing the Health Promotion Practices of Nurse Practitioners Instrument developed by the researcher and completed 442 Texas NPs.ConclusionsOverall, Texas NPs have positive attitudes toward health promotion and are supportive of health promotion practices. However, the findings this study indicate that improvement can made in the adoption of certain health promotion practices.Implications for PracticeThe growing number of NPs providing care patients can significantly impact public health through consistent health promotion in clinical practice.
Prospective Analysis of Presenting Symptoms Among 265 Patients With Radiographie Evidence of Chiari Malformation Type I With or Without Syringomyelia
Authors: Mueller Diane M. , Oro’ John J. 
Published: May 2005

ObjectiveTo characterize the presenting symptoms among persons with radiographic evidence of Chiari malformation (CM) type I in an effort to help the primary care provider determine accurate diagnosis and treatment.MethodsThe symptoms of CM can often be vague and ambiguous, leading to misdiagnosis. Patients who had radiographic evidence of CM with or without syringomyelia were prospectively studied. The detailed symptom data were collected from patient reports at initial examination to determine if there was a pattern of symptoms typically attributable to the CM.ResultsAnalysis of presenting symptoms among 265 patients demonstrated a distinct pattern of symptom constellation. This study reports a prospective analysis of presenting symptoms among 265 patients with radiographic evidence of CM with or without syringomyelia and defines a common presentation pattern. Recognition of typical symptoms attributable to CM can result in appropriate diagnostic workup, accurate diagnosis, and timely treatment, leading to improved patient outcomes.
Caught in the Middle: Experiences of Tobacco‐Dependent Nurse Practitioners
Authors: Heath Janie , Andrews Jeannette , Kelley Frances J. , Sorrell Jeanne 
Published: May 2005

PurposeTo explore how tobacco‐dependent nurse practitioners (NPs) describe their experiences with health promotion and disease prevention practices with patients who smoke.Data SourcesTwelve NPs who completed a graduate level NP program of study participated in face‐to‐face interviews and/or online chat room interviews.ConclusionsParticipants’ responses revealed three themes relevant to their experience as tobacco‐dependent clinicians with health promotion responsibilities. These themes centered around (a) living as an insider in the world of tobacco addiction, (b) having the outside‐in view of living with a tobacco addiction, and (c) being caught in the middle of a tobacco addiction.Implications for PracticeAll of the tobacco‐dependent participants described limited smoking‐cessation interventions with their patients. A barrier to implementation of more aggressive interventions, perhaps, is the provider's own tobacco addiction. With increasing evidence that tobacco‐dependent health care professionals are not adequately intervening with tobacco‐dependent patients, effective strategies are needed to assist and/or support not only tobaccodependent patients but providers as well.
Atopic Dermatitis: An Overview for the Nurse Practitioner
Authors: Mack Susan 
Published: May 2005

PurposeTo provide the primary care provider (PCP) with a review of the clinical presentation, aggravating factors, and basic options for treatment of atopic dermatitis (AD).Data SourcesSelected scientific literature and clinical experiences of the author.ConclusionsAD is a common, chronic skin condition that is frequently seen in both children and adults. Although AD can be challenging to treat, a number of therapeutic options exist to help alleviate the pruritus and rash that accompany the disorder.Implications for PracticeThe PCP can manage AD in most patients by prescribing avoidance measures, good skin care, antihistamines, and conservative topical medications. Patients with more severe disease may require aggressive therapies such as phototherapy, balneo‐phototherapy, or systemic agents.
Evidence for Practice: Oral Contraception and Risk of Cervical Cancer
Authors: Bertram Cathy Cramer 
Published: May 2005

PurposeThe issue of continued oral contraceptive use among women with abnormal Pap smears may be controversial due to reported evidence of an increased risk of cervical cancer among long term oral contraceptive users. This article reviews the evidence concerning oral contraception and cervical cancer risk. The role of Human Papilloma virus (HPV)and proposed mechanisms for the development of cervical cancer are explained.Evidence from World Health Organization (WHO) studies and additional research evidence are discussed.Implications for clinical practice are included.Data SourcesWHO commissioned studies, additional relevant studies searchable from an EBSCO database, and texts that describe the natural history of HPV.ConclusionsEpidemiological studies and biomedical research suggest a role for steroid hormones, such as oral contraceptives, in facilitating the action of HPV. However, a majority of HPV infections resolve spontaneously, despite widespread use of oral contraception. Oral contraception does not appear to increase incident HPV infection or persistence of HPV infection. The benefits of oral contraceptives appear to outweigh the risks associated with HPV facilitation.Implications for PracticeNPs inform patients of abnormal Pap smears, manage the clinical care of women at risk of cervical cancer, and provide educational counseling regarding contraceptive choices. Ethical considerations include clear disclosure of potential risk. However, a risk‐benefit analysis supports continued use of oral contraception among women who have abnormal Pap smears but also have access to clinical surveillance.
Adolescent Obesity: Current Trends in Identification and Management
Authors: Hagarty M. Anette , Schmidt Cynthia , Bernaix Laura , Clement Jacquelyn M. 
Published: May 2005

PurposeTo discuss the prevalence, identification, and clinical manifestations of adolescent obesity for the advanced practice nurse in primary care.Data SourcesSelected research and clinical articles.ConclusionsAdolescent obesity has been historically attributed to inappropriate diet and exercise; however, recent research also attributes adolescent obesity to genetic factors and metabolic dysfunction. If left untreated, adolescent obesity may result in the metabolic complications of dyslipidemia, hypertension, cardiovascular disease, and early onset of type 2 diabetes.Implications for PracticePractitioners should focus on using the new body mass index (BMI) national guidelines for early identification of obesity. Essential to the management of this condition are education, parental involvement, behavior modification, and psychological support.
Testicular Complaints and the Young Man
Authors: Mullen Barbara Ann 
Published: May 2005

PurposeTo review the common causes, diagnostic procedures, treatment options, education, and follow‐up care for testicular complaints in the young man between the ages of 15 and 40 and to provide a case study that illustrates diagnostic concerns.Data SourcesCurrent literature published in journals and textbooks.ConclusionsA testicular mass has multiple possible etiologies. The mnemonic “TESTICLE” can help the practitioner to remember all the differential diagnoses. Treatment is based upon history and diagnostic findings.Implications for PracticeAn untreated testicular mass can lead to many adverse outcomes, including infertility and death. It is imperative that the nurse practitioner be up‐to‐date on differential diagnoses, evaluation, and treatment of a testicular complaint.
Transformation in Family Nurse Practitioner Students’ Attitudes Toward Homeless Individuals After Participation in a Homeless Outreach Clinic
Authors: Dela Cruz Felicitas A. , Brehm Constance , Harris Jeanne 
Published: May 2005

PurposeTo use a retrospective pre/post self‐assessment survey to determine the attitudes of family nurse practitioner (FNP) students toward homeless individuals before and after partici‐pating in a homeless outreach clinic (HOC) and to elicit, through focus groups, their per‐spectives on the homeless population after their HOC participation.Data SourcesA mixed‐methods study using focus group tapes and transcripts of 15 FNP students who were divided into two separate focus groups as well as three completed survey measures: Demographic Data Form, Attitudes Toward Homelessness Inventory, and HOC Attendance Form.ConclusionsOverall, the FNP students revealed no stigma‐tizing attitudes toward homeless people prior to their HOC participation, but a significant positive change in their attitudes occurred after the experience. There were significant mean differences in 6 out of the 11 scale items and in the overall total mean scores after the HOC experience (p=. 013). The focus groups revealed the transformation of the students' attitudes toward homeless individuals after their HOC participation, supporting and illu‐minating the survey findings.Implications for PracticeThe study findings underscore the importance of including the care of homeless patients in FNP educational programs. Such exposure provides FNP students with an opportunity to develop the social responsibility to care for all segments of society, especially homeless people, in keeping with nursing's social contract as a helping profession.
Perception and Use of Herbals Among Students and Their Practitioners in a University Setting
Authors: Ambrose Evelyn T. , Samuels Sandra 
Published: May 2005

PurposeTo determine the extent of herbal use among students at Rutgers, the State University of New Jersey, and to examine the campus health services practitioners' attitudes toward herbals.Data SourcesAn exploratory study of a nonrandom sampling of 1,754 students and 40 practitioners. The student t test and chi‐square comparisons were used to analyze the data.ConclusionsOver half of the students surveyed were using herbals, primarily for relief of physical symptoms, prevention of illness, and improvement of general well‐being. Many students lacked accurate or sufficient information about herbals and were not seeking medical guidance. Although the practitioners asked students about herbal use and sometimes even encouraged it, 75% noted the need for additional professional education about herbals.Implications for PracticePractitioners in the college health setting need to be cognizant of students' self‐medication with herbals and need to have the knowledge to guide students appropriately.
Stress Urinary Incontinence in Women
Authors: Gray Mikel 
Published: May 2005

PurposeTo review and synthesize existing knowledge about the epidemiology, pathophysiology, evaluation, and management of stress urinary incontinence in women.Data SourceSelected scientific literature.ConclusionsStress urinary incontinence is more than merely a symptom. Instead, it is a clinically relevant disease with adverse psychosocial and physical consequences. Evaluation begins with active screening and is followed by individualized assessment when urinary leakage is detected.Implications for PracticeTraditional treatment modalities, including pelvic muscle rehabilitation, focus on behavioral strategies to reduce urine loss, and surgical correction of anatomic defects is completed in selected cases. Pharmacotherapeutic options have been limited, but one compound is undergoing clinical trials to determine whether it is a safe and effective alternative for the treatment of stress urinary incontinence.