ABSTRACT:Socialization to the nurse practitioner (NP) role and professional expectations needs to begin early in NP education. The earlier and more frequently students are engaged in developing an NP professional identity, the faster they will adapt to the NP role. Innovative ideas for introducing professionalism concepts at the graduate level are introduced, along with illustrations related to how course assignments support the new AACN Essentials Professionalism domain sub-competencies. New NP students described professionalism using more internal/self-oriented values, such as integrity, respect, compassion, and accountability, which is important for NP educators to recognize.
ABSTRACT Breast cancer is the most common type of cancer affecting women. Invasive lobular carcinoma (ILC) is the second most common type of breast cancer behind invasive ductal carcinoma (IDC). Historically, breast cancer research has studied IDC and ILC together, although the pathophysiology differs. This article highlights the differences between ILC and IDC.
ABSTRACT This article supports nurse practitioners in creating a gender-inclusive clinical practice by offering up-to-date and trauma-informed interview techniques. Historical context of the care of gender-diverse patients is included to help the reader better understand the impact of past trauma and associated health disparities.
Androgen insensitivity syndrome (AIS) is a genetic disorder impacting 46,XY individuals. It occurs in a complete form, producing a 46,XY female with female genitalia but no internal female reproductive organs; a partial form, producing a 46,XY newborn with genitalia intermediate between the classic male and female types; and a mild form, producing a 46,XY male with male genitalia but oligospermia. This review examines the pathophysiology, presentation, diagnosis, and management of AIS. Its goal is to prepare the advanced practice registered nurse to recognize AIS, facilitate its diagnosis, and contribute to the multidisciplinary team needed for effective management.
Pediatric inherited disorders significantly impact morbidity, mortality, and quality of life, making timely diagnosis and management essential. Nurse practitioners (NPs) play a critical role in genetic care by guiding families through testing, providing counseling, and collaborating to provide long-term management. With knowledge of inheritance patterns, genetic testing modalities, and newborn screening, NPs can identify pathogenic variants, coordinate multidisciplinary care, and address parental concerns. Acting as the family's point person in the medical home, primary care NPs integrate education, support, and evidence-based practice to reduce diagnostic delays, improve outcomes, and empower families navigating the complexities of genetic disorders.
Bipolar major depression involves recurrent depressive episodes requiring balanced treatment. Effective options include quetiapine, lurasidone, and olanzapine-fluoxetine. Lamotrigine prevents episodes, lithium reduces suicide risk, and emerging treatments show promise. Antidepressant monotherapy is discouraged. A patient-centered approach optimizing efficacy, safety, and stability is essential.
This report traces the trajectory of education and role development of nurse practitioners (NPs) in Japan from its beginnings to the present. An overview of the qualifications of advanced practice nursing roles, including NPs, is provided. The necessity of the NP role in the setting of the country's demographics and current health care system is discussed. Considerations for the future of the role are explored.
In the first half of 2025, the US FDA approved several new drugs that have relevance for those practicing in primary care. This article highlights the following new medications and vaccinations: suzetrigine (Journavx); gepotidacin (Blujepa); meningococcal groups A, B, C, W, and Y vaccine (Penmenvy); clesrovimab-cfor (Enflonsia); and acoltremon (Tryptyr). Additionally, this article highlights the recent approval of moderately to severely active Crohn's disease as a new indication for guselkumab (Tremfya).
ABSTRACT Background: There is very limited literature specifically addressing anxiety and hypertension. This integrative review evaluated existing research on the topic of appropriate measurement of anxiety levels in adult patients with elevated blood pressure and explored implications for clinical practice. Methods: Inclusion criteria included published in English, published in medical or nursing journals, full text available, published between 2014 and 2024, and inclusion of adult participants only (ages 18 through 70 years). Exclusion criteria included only abstract available, published prior to 2014, and focused on pediatric participants. A comprehensive, systematic review of the literature was completed using PubMed, Embase, CINAHL, and Scopus databases with results uploaded to Covidence. Primary search terms were “anxiety” AND “screening” AND “hypertension” AND “intersectionality.” A hand search with Google Scholar and article citations was completed. The Johns Hopkins Nursing Evidence-Based Practice model level and quality grading criteria and the PRISMA guideline were utilized during the integrative review process>. Results: Between identifying studies from databases and the hand search, a total of 23 studies remained and were included as part of the final review. The following themes surfaced: 1) regular anxiety level screenings for patients with hypertension, 2) increased prevalence of anxiety disorder among individuals with hypertension, and 3) female sex as an independent risk factor for anxiety disorder in individuals with hypertension. Conclusion: Early identification and treatment of both anxiety and hypertension with early screenings are critically important for optimal patient outcomes. Longitudinal research, systematic reviews, and randomized controlled trials measuring the influence of anxiety on hypertension rates are needed.
ABSTRACT Idiopathic anaphylaxis (IA) is a diagnosis of exclusion, and the etiology remains elusive. Research on immunoglobulin E (IgE)-mediated anaphylaxis has identified histamine as the immune system mediator, but dietary histamine's potential role in IA is often overlooked. For some individuals, excessive histamine may cause IA and mimic signs and symptoms of IgE-mediated anaphylaxis.1 This review provides an overview of IA and the potential role of histamine in symptom manifestation. It aims to enhance awareness and provide nurse practitioners with insights into the complexities of managing IA, emphasizing the importance of considering dietary factors in patient care and treatment strategies.
ABSTRACT:Idiopathic anaphylaxis (IA) is a diagnosis of exclusion, and the etiology remains elusive. Research on immunoglobulin E (IgE)-mediated anaphylaxis has identified histamine as the immune system mediator, but dietary histamine's potential role in IA is often overlooked. For some individuals, excessive histamine may cause IA and mimic signs and symptoms of IgE-mediated anaphylaxis.1 This review provides an overview of IA and the potential role of histamine in symptom manifestation. It aims to enhance awareness and provide nurse practitioners with insights into the complexities of managing IA, emphasizing the importance of considering dietary factors in patient care and treatment strategies.
BACKGROUND:There is very limited literature specifically addressing anxiety and hypertension. This integrative review evaluated existing research on the topic of appropriate measurement of anxiety levels in adult patients with elevated blood pressure and explored implications for clinical practice. METHODS:Inclusion criteria included published in English, published in medical or nursing journals, full text available, published between 2014 and 2024, and inclusion of adult participants only (ages 18 through 70 years). Exclusion criteria included only abstract available, published prior to 2014, and focused on pediatric participants. A comprehensive, systematic review of the literature was completed using PubMed, Embase, CINAHL, and Scopus databases with results uploaded to Covidence. Primary search terms were "anxiety" AND "screening" AND "hypertension" AND "intersectionality." A hand search with Google Scholar and article citations was completed. The Johns Hopkins Nursing Evidence-Based Practice model level and quality grading criteria and the PRISMA guideline were utilized during the integrative review process>. RESULTS:Between identifying studies from databases and the hand search, a total of 23 studies remained and were included as part of the final review. The following themes surfaced: 1) regular anxiety level screenings for patients with hypertension, 2) increased prevalence of anxiety disorder among individuals with hypertension, and 3) female sex as an independent risk factor for anxiety disorder in individuals with hypertension. CONCLUSION:Early identification and treatment of both anxiety and hypertension with early screenings are critically important for optimal patient outcomes. Longitudinal research, systematic reviews, and randomized controlled trials measuring the influence of anxiety on hypertension rates are needed.
ABSTRACT:Genitourinary syndrome of menopause, or GSM, is a highly prevalent condition in postmenopausal women, but many do not discuss their symptoms with health care providers. The American Urological Society, alongside the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction and the American Urogynecologic Society, published an updated guideline on GSM in May of 2025. This article will examine the pathophysiology, clinical assessment, and diagnosis of GSM and will review updated research on the recommended treatments to guide nurse practitioners on the latest evidence-based practice approach to GSM management.
ABSTRACT The term standard of care is a legal concept in health care representing the duty a practitioner owes to each patient, and this duty is the same for telehealth encounters, whether video based or audio only, as it is for in-person encounters. This article presents an anonymized case analysis of a fatal peritonsillar abscess misdiagnosed during an audio-only telehealth encounter, highlighting the telehealth regulatory variations across states and emphasizing professional liability considerations for nurse practitioners (NPs) delivering remote care. Through the PEP and AUDIO telehealth frameworks, NPs can implement the telehealth modality that is most clinically appropriate and best safeguards diagnostic accuracy and patient safety for each patient encounter. Understanding evolving regulatory landscapes and maintaining proper documentation allow NPs to leverage telehealth advantages while fulfilling their professional duty and preventing potentially fatal diagnostic and management errors.
ABSTRACT Neck pain among adults is a common issue seen by the advanced practice registered nurse (APRN). It is important to carefully evaluate and classify neck pain. APRNs must evaluate patients with neck pain for the presence of red flags potentially signifying serious underlying pathology and refer as appropriate. Most cases of neck pain in the absence of red flags can be managed in a conservative manner. The APRN should be able to care for the patient in holistic manner as a part of an interprofessional team.
