Pub Date : 2025-11-11DOI: 10.1016/j.nurpra.2025.105593
Lindsey Plato-Johnson, Caroline Stowe
Migraine is a leading cause of disability and loss of productivity, yet many individuals remain undiagnosed or undertreated. Telehealth offers a powerful opportunity to expand access to timely, effective migraine care. This article presents a structured approach for nurse practitioners to evaluate primary headache disorders remotely, using targeted history-taking and a modified neurologic examination, assessed virtually. By applying these techniques, clinicians can differentiate migraine from secondary causes, initiate treatment promptly, and triage appropriately, helping more patients receive the care they need without delay.
{"title":"Primary Headache Disorders: The Virtual Neurologic Examination in Telehealth Practice","authors":"Lindsey Plato-Johnson, Caroline Stowe","doi":"10.1016/j.nurpra.2025.105593","DOIUrl":"10.1016/j.nurpra.2025.105593","url":null,"abstract":"<div><div>Migraine is a leading cause of disability and loss of productivity, yet many individuals remain undiagnosed or undertreated. Telehealth offers a powerful opportunity to expand access to timely, effective migraine care. This article presents a structured approach for nurse practitioners to evaluate primary headache disorders remotely, using targeted history-taking and a modified neurologic examination, assessed virtually. By applying these techniques, clinicians can differentiate migraine from secondary causes, initiate treatment promptly, and triage appropriately, helping more patients receive the care they need without delay.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105593"},"PeriodicalIF":0.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145529072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.nurpra.2025.105602
Jennifer J. DeVries, Holly A. Myers, Tonya M. Schmitt
Reliable and consistent measurement of height, weight, body mass index, and the use of growth curves are indispensable for the early detection, diagnosis, and management of pediatric conditions such as Crohn's disease. This case report aims to emphasize the importance of obtaining precise anthropometric measurements and interpreting them within the context of normal pediatric growth and development. Doing so allows clinicians to make informed correlations in the clinical setting, ultimately contributing to improved patient outcomes.
{"title":"Beyond Percentiles: Using Growth Curves to Uncover Pediatric Chnonic Disease","authors":"Jennifer J. DeVries, Holly A. Myers, Tonya M. Schmitt","doi":"10.1016/j.nurpra.2025.105602","DOIUrl":"10.1016/j.nurpra.2025.105602","url":null,"abstract":"<div><div>Reliable and consistent measurement of height, weight, body mass index, and the use of growth curves are indispensable for the early detection, diagnosis, and management of pediatric conditions such as Crohn's disease. This case report aims to emphasize the importance of obtaining precise anthropometric measurements and interpreting them within the context of normal pediatric growth and development. Doing so allows clinicians to make informed correlations in the clinical setting, ultimately contributing to improved patient outcomes.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105602"},"PeriodicalIF":0.0,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.nurpra.2025.105598
Margaret Perlia Bavis, Leah Burt
Diagnosis is one of the most important skills for clinicians. This project sought to develop and validate a competency-aligned simulation-based formative assessment of diagnostic reasoning in nurse practitioner students. The purpose of this project was threefold: 1) alignment of competencies among the American Association of Colleges of Nursing, National Organization of Nurse Practitioner Faculties, and interprofessional diagnostic reasoning competencies; 2) development of a formative assessment to support student progression in diagnostic reasoning competencies; and 3) content validation of the simulation scenarios to establish relevance to the intended target competencies. This project provides an evidence-based foundation to establish competency alignment across disciplines and develop a formative assessment to facilitate competency attainment.
{"title":"Moving Toward Competency: Development of a Simulation-Based Formative Assessment of Nurse Practitioner Student Diagnostic Reasoning","authors":"Margaret Perlia Bavis, Leah Burt","doi":"10.1016/j.nurpra.2025.105598","DOIUrl":"10.1016/j.nurpra.2025.105598","url":null,"abstract":"<div><div>Diagnosis is one of the most important skills for clinicians. This project sought to develop and validate a competency-aligned simulation-based formative assessment of diagnostic reasoning in nurse practitioner students. The purpose of this project was threefold: 1) alignment of competencies among the American Association of Colleges of Nursing, National Organization of Nurse Practitioner Faculties, and interprofessional diagnostic reasoning competencies; 2) development of a formative assessment to support student progression in diagnostic reasoning competencies; and 3) content validation of the simulation scenarios to establish relevance to the intended target competencies. This project provides an evidence-based foundation to establish competency alignment across disciplines and develop a formative assessment to facilitate competency attainment.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105598"},"PeriodicalIF":0.0,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1016/j.nurpra.2025.105562
Rebecca Ray, Dana R. Cruse
Endogenous hypercortisolism is a heterogeneous disease with wide-ranging clinical presentations, resulting from excess cortisol activity. Patients with hypercortisolism have increased risk of cardiometabolic morbidity and mortality, significantly impacting their quality of life and longevity. Data suggest that endogenous hypercortisolism is more prevalent than previously thought, especially in at-risk populations (eg, difficult-to-control diabetes despite standard-of-care therapy). The diagnosis of hypercortisolism is often delayed or missed, and thus it is imperative for advanced practice providers to gain a comprehensive understanding of the disease. This article reviews the disease spectrum and provides practical clinical guidance on incorporating hypercortisolism as a differential diagnosis.
{"title":"Should Hypercortisolism Be Part of Your Differential Diagnosis?","authors":"Rebecca Ray, Dana R. Cruse","doi":"10.1016/j.nurpra.2025.105562","DOIUrl":"10.1016/j.nurpra.2025.105562","url":null,"abstract":"<div><div>Endogenous hypercortisolism is a heterogeneous disease with wide-ranging clinical presentations, resulting from excess cortisol activity. Patients with hypercortisolism have increased risk of cardiometabolic morbidity and mortality, significantly impacting their quality of life and longevity. Data suggest that endogenous hypercortisolism is more prevalent than previously thought, especially in at-risk populations (eg, difficult-to-control diabetes despite standard-of-care therapy). The diagnosis of hypercortisolism is often delayed or missed, and thus it is imperative for advanced practice providers to gain a comprehensive understanding of the disease. This article reviews the disease spectrum and provides practical clinical guidance on incorporating hypercortisolism as a differential diagnosis.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105562"},"PeriodicalIF":0.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-05DOI: 10.1016/j.nurpra.2025.105594
Rekha Aryal, Carrie Palmer, Ashley Amorello Kellish, Marcy Williams
This quality improvement project investigated the effectiveness of integrating the evidence-based screening tool by nurse practitioners and other providers to identify patients at risk for HIV acquisition to initiate preexposure prophylaxis (PrEP) in a rural health department. Implementing Plan-Do-Study-Act (PDSA) design, 245 patients aged 15-65 years were screened over 12 weeks. The tool identified 127 patients (52%) at risk for HIV acquisition, and 93 of them (73%) agreed to PrEP. This intervention improved patient outcomes by screening for HIV risk and referring patients to PrEP, potentially reducing infectious disease expenditures. Further research is warranted to expand PrEP feasibility in rural US health care settings.
{"title":"Incorporation of an Evidence-Based HIV Risk Assessment Tool to Promote PrEP Uptake in a Rural Health Department","authors":"Rekha Aryal, Carrie Palmer, Ashley Amorello Kellish, Marcy Williams","doi":"10.1016/j.nurpra.2025.105594","DOIUrl":"10.1016/j.nurpra.2025.105594","url":null,"abstract":"<div><div>This quality improvement project investigated the effectiveness of integrating the evidence-based screening tool by nurse practitioners and other providers to identify patients at risk for HIV acquisition to initiate preexposure prophylaxis (PrEP) in a rural health department. Implementing Plan-Do-Study-Act (PDSA) design, 245 patients aged 15-65 years were screened over 12 weeks. The tool identified 127 patients (52%) at risk for HIV acquisition, and 93 of them (73%) agreed to PrEP. This intervention improved patient outcomes by screening for HIV risk and referring patients to PrEP, potentially reducing infectious disease expenditures. Further research is warranted to expand PrEP feasibility in rural US health care settings.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105594"},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-05DOI: 10.1016/j.nurpra.2025.105587
Heather M. Englund, Jessica Habeck
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is a rare autosomal dominant cancer syndrome caused by fumarate hydratase mutations, predisposing affected individuals to cutaneous and uterine leiomyomas and highly aggressive type 2 papillary renal cell carcinoma (PRCC). We report a case of a 21-year-old woman presenting with metastatic PRCC as the first manifestation of HLRCC. This case highlights the importance of early recognition, genetic testing, and surveillance for at-risk individuals. Prompt diagnosis enables risk-reducing strategies, early surgical intervention, and tailored management to improve outcomes in this aggressive hereditary cancer syndrome.
{"title":"Metastatic Papillary Renal Cell Carcinoma From Hereditary Leiomyomatosis Syndrome","authors":"Heather M. Englund, Jessica Habeck","doi":"10.1016/j.nurpra.2025.105587","DOIUrl":"10.1016/j.nurpra.2025.105587","url":null,"abstract":"<div><div>Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is a rare autosomal dominant cancer syndrome caused by fumarate hydratase mutations, predisposing affected individuals to cutaneous and uterine leiomyomas and highly aggressive type 2 papillary renal cell carcinoma (PRCC). We report a case of a 21-year-old woman presenting with metastatic PRCC as the first manifestation of HLRCC. This case highlights the importance of early recognition, genetic testing, and surveillance for at-risk individuals. Prompt diagnosis enables risk-reducing strategies, early surgical intervention, and tailored management to improve outcomes in this aggressive hereditary cancer syndrome.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105587"},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-05DOI: 10.1016/j.nurpra.2025.105595
Denise G. Link
{"title":"Follow Your (Well Informed) Gut","authors":"Denise G. Link","doi":"10.1016/j.nurpra.2025.105595","DOIUrl":"10.1016/j.nurpra.2025.105595","url":null,"abstract":"","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105595"},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-04DOI: 10.1016/j.nurpra.2025.105563
Anna Sciortino, Brigit VanGraafeiland, Shawna S. Mudd
Pediatric concussions are common sports-related injuries with potential for long-term cognitive and psychosocial effects. Timely follow-up improves recovery outcomes, yet adherence remains inconsistent. This integrative review evaluated whether standardized provider education enhances follow-up rates for patients aged 11–17 years. A systematic search of PubMed, Embase, and CINAHL identified 9 U.S.-based studies published from 2019 to 2024. Four themes emerged: consequences of delayed follow-up, variability in timing, sociodemographic disparities, and caregiver-related barriers. Evidence supports structured discharge instructions and early specialist evaluation to improve adherence. Future research should focus on prospective, multisite evaluations of standardized follow-up models to enhance pediatric concussion management.
{"title":"Barriers and Recommendations for Concussion Follow-Up in Pediatric Athletes: An Integrative Review","authors":"Anna Sciortino, Brigit VanGraafeiland, Shawna S. Mudd","doi":"10.1016/j.nurpra.2025.105563","DOIUrl":"10.1016/j.nurpra.2025.105563","url":null,"abstract":"<div><div>Pediatric concussions are common sports-related injuries with potential for long-term cognitive and psychosocial effects. Timely follow-up improves recovery outcomes, yet adherence remains inconsistent. This integrative review evaluated whether standardized provider education enhances follow-up rates for patients aged 11–17 years. A systematic search of PubMed, Embase, and CINAHL identified 9 U.S.-based studies published from 2019 to 2024. Four themes emerged: consequences of delayed follow-up, variability in timing, sociodemographic disparities, and caregiver-related barriers. Evidence supports structured discharge instructions and early specialist evaluation to improve adherence. Future research should focus on prospective, multisite evaluations of standardized follow-up models to enhance pediatric concussion management.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105563"},"PeriodicalIF":0.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-04DOI: 10.1016/j.nurpra.2025.105589
Heather Allstrom, Kenneth Mueller, Jocelyn Zavala-Garcia, Erin Ferranti, Cathleen Hewlett-Masser, Daniel Jackson Smith
Pregnant people face increased risks from climate change, especially from heat and air pollution linked to adverse birth outcomes. This narrative review explores the relationship between climate change and reproductive health, focusing on maternal outcomes. Twelve studies from 2020 onward were reviewed, assessing how rising temperatures and air pollution affect pregnancy through epidemiologic and environmental health methods. Climate stressors were linked to adverse maternal outcomes, with disproportionate impact on structurally marginalized groups. Providers play a key role in education and advocacy. Climate literacy and policy change help to safeguard maternal health.
{"title":"Reproductive Health in a Changing Climate: A Review for Providers","authors":"Heather Allstrom, Kenneth Mueller, Jocelyn Zavala-Garcia, Erin Ferranti, Cathleen Hewlett-Masser, Daniel Jackson Smith","doi":"10.1016/j.nurpra.2025.105589","DOIUrl":"10.1016/j.nurpra.2025.105589","url":null,"abstract":"<div><div>Pregnant people face increased risks from climate change, especially from heat and air pollution linked to adverse birth outcomes. This narrative review explores the relationship between climate change and reproductive health, focusing on maternal outcomes. Twelve studies from 2020 onward were reviewed, assessing how rising temperatures and air pollution affect pregnancy through epidemiologic and environmental health methods. Climate stressors were linked to adverse maternal outcomes, with disproportionate impact on structurally marginalized groups. Providers play a key role in education and advocacy. Climate literacy and policy change help to safeguard maternal health.</div></div>","PeriodicalId":101233,"journal":{"name":"The Journal for Nurse Practitioners","volume":"22 1","pages":"Article 105589"},"PeriodicalIF":0.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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