Dyspareunia: Etiology, presentation, and management.

ABSTRACT: Dyspareunia in women is a recurrent pain in the genital and/or pelvic area associated with sexual intercourse. Dyspareunia is associated with increased risk of sexual dysfunction and relationship distress, and it may impact an individual's confidence, self-image, and self-esteem. Pain resulting from dyspareunia can be superficial or deep; it can range from intermittent to continuous and dull to sharp. Regardless of presentation, many women are reluctant to report symptoms to providers, making it an underreported yet common condition. The onus lies with practitioners to form trusting and safe relationships with patients in which such discussions are possible. A knowledgeable practitioner can encourage disclosure and improve outcomes for patients with dyspareunia.

Menopause: A primary care perspective.

ABSTRACT: Menopause signifies permanent cessation of ovarian function and the end of a woman's reproductive potential. Menopausal transition plays a major role in many symptoms common in middle age and may contribute to chronic conditions and disorders of aging. An evidence-based plan of care improves outcomes, enhancing quality of life.

Recurrent bacterial vaginosis.

ABSTRACT: Bacterial vaginosis increases the risk of sexually transmitted infections, including HIV, and treatment is crucial to avoid complications. This article reviews the evidence-based options for treating bacterial vaginosis to improve patient outcomes.

Recurrent bacterial vaginosis.

Bacterial vaginosis recurrence is common but can lead to frequent bothersome symptoms associated with infection. This article reviews evidence-based options for practicing providers to improve patient outcomes. Bacterial vaginosis increases the risk of acquiring sexually transmitted infections, including HIV. Adequate treatment is essential to help avoid adverse patient outcomes.

Acute acetaminophen toxicity in adults.

When taken in the recommended dosage, acetaminophen is a safe and effective analgesic and antipyretic agent. Its wide availability and easy accessibility make accidental or intentional overdose, leading to hepatotoxicity, a common occurrence. To prevent morbidity and mortality, prompt recognition of acetaminophen toxicity is essential. This article covers the stages of acetaminophen toxicity, recommended treatments, and NP considerations, including patient education recommendations.

Osteoarthritis treatment: Decreasing pain, improving mobility.

Osteoarthritis (OA) is the most common articular disease. The condition results in bone-on-bone contact, stiffness, pain, and decreased mobility. By the year 2050, 40 million individuals will be severely disabled because of OA, and there will be over 130 million individuals suffering from OA worldwide.

Recognizing and treating Lyme disease.

Lyme disease is the most commonly reported vector-borne disease in the United States. After initial antibiotic treatment for patients with Lyme disease, ongoing symptoms that may persist have considerable long-term impact on healthcare costs. Posttreatment Lyme disease syndrome is characterized by a host of chronic symptoms that can leave patients physically and mentally disabled.

Constipation in children: Diagnosis, treatment, and prevention.

Deviation from normal bowel function in the pediatric population is often a cause for concern for parents and caregivers, prompting numerous visits to a primary care provider. Constipation is a common and challenging issue in children that can have an adverse impact on their psychosocial and emotional well-being as well as quality of life. This article provides practical strategies for diagnosing, treating, and preventing constipation in children.

Treatment and prevention of gout.

Gout is a disorder of purine metabolism that primarily occurs in adult males. Elevated plasma uric acid concentrations (hyperuricemia) cause deposits of urate crystals in joint spaces causing severe, repeated attacks of arthritis.

Fall prevention in older adults.

Falls in older adults are a major public health concern and can often have fatal results. Practitioners need to be aware of assessment and diagnostic techniques to prevent falls in older adults.

Managing corneal abrasions in primary care.

Corneal abrasion is a common eye injury that occurs in all age-groups. A focused history and physical exam can identify patients with corneal abrasions and improve intervention time. Minor corneal abrasions usually heal within 48 hours without complications or eye damage.

Integrating delegation into the undergraduate curriculum.

One of the essential practice skills for registered nurses (RNs) is the delegation of tasks. However, few experiences in RN educational programs directly address the development of delegation skills. Many RNs report not feeling confident in their ability to delegate appropriately upon completing their educational programs. Nurse educators must respond to the need to address delegation in undergraduate nursing curricula. This article describes research evaluating levels of knowledge of and confidence in the delegation process among newly graduated RNs, and explores options for teachable moments about delegation.

Cultural considerations at the end of life.

It is important for nurse practitioners to understand their patients' cultural backgrounds to provide competent care at the end of life. Understanding the concepts of various cultures can keep the lines of communication open and help providers elicit the necessary information to make the end-of-life experience as comfortable as possible.

Sleep disorders in older adults.

Sleep pattern changes are considered normal as individuals age. However, changes in sleep patterns can ultimately affect the quality of life of many older adults. In addition, many sleep conditions are associated with an increase in morbidity and mortality. It is essential for clinicians to recognize sleep changes to lead to appropriate treatment. This article will focus on the assessment and interventions of sleep disorders in older adults.

Evaluation of acute abdominal pain.

Abdominal pain is a common complaint encountered in primary care and in the ED. Varying levels of pain dictate the immediacy of the intervention. Time is vital when making the decision to initiate therapeutic interventions. A comprehensive assessment with physical exam and diagnostic studies is required.

Dizziness, vertigo, and presyncope: what's the difference?

Dizziness is a general term used to express subjective patient complaints related to changes in sensation, movement, perception, or consciousness. There are four types of dizziness: vertigo, disequilibrium, presyncope/syncope, and dizziness as a result of psychological disturbances. Differentiating the type of dizziness will assist in the course of the evaluation.

Crohn disease: recognition is key.

Crohn disease (CD) is an autoimmune disease that affects people across the lifespan. Patients with CD are predisposed to other autoimmune illnesses, such as psoriasis or arthritis, and suffer from complications including infection and malnutrition. This article will focus on the diagnosis and treatment of CD.

Ischemic stroke: the first 24 hours.

Patients who have suffered a stroke are often left with a high incidence of physical and psychosocial impairments. Institutions must develop and implement clinical protocols and pathways to quickly and efficiently initiate evidence-based stroke therapies.