Advance for nurse practitioners
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Review
Upper respiratory symptoms in elderly patients. Hypertension complicates treatment decisions.
Approximately 6% of elderly patients present to primary care offices with hypertension and upper respiratory infection. Elderly people develop an acquired immunity to many rhinoviruses, making them less susceptible than younger people to the common cold. ⋯ Upper respiratory infections require close monitoring in elderly patients to detect secondary infections and other complications. Most published research on respiratory symptom treatment is not limited to elderly subjects.
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Multiple sclerosis is a chronic disease of the central nervous system that affects young adults most often. The course of MS is unpredictable and variable on a day-to-day basis. ⋯ A diagnosis of multiple sclerosis is a clinical one based on a thorough history and neurologic examination findings and supported by magnetic resonance imaging of the brain and evoked potential studies. Management strategies fall into three general categories: treatment of relapses caused by underlying disease; prevention of progression or reduction of the frequency of relapses; and control of specific symptoms.
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The challenges of pediatric laceration repair include the probability of an uncooperative participant, tense or frantic parents and a busy setting. Linear lacerations of the scalp, trunk and extremities are excellent sites for staples. ⋯ The most common methods of anesthesia for laceration repair include topical agents, direct infiltration and blocks. All wounds that are deep, dirty or may contain a foreign body should be locally cleansed with antimicrobial agents and irrigated vigorously.