The Nurse Practitioner In Long-Term Care: Guidelines For Clinical Practice / Edition 1

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An excellent resource for new or seasoned NPs and PAs!

The Nurse Practitioner in Long-Term Care addresses the growing trend to utilize the nurse practitioner in the skilled nursing facility (SNF) to manage patients in long-term care and serves as a practical resource for managing those conditions commonly encountered in the geriatric patient. It includes an introduction to nursing homes, medication management, practical health promotion/disease prevention, and management of common clinical conditions specific to the skilled and long term care nursing home settings. It will also address important topics such as elder abuse, legal issues, reimbursement, and regulatory issues.

Subjects covered are pertinent to everyday practice and this text is useful in graduate programs for nurse practitioners and clinical nurse specialists as well as for physician’s assistant (PA) students.

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Product Details

  • ISBN-13: 9780763734299
  • Publisher: Jones & Bartlett Learning
  • Publication date: 2/6/2007
  • Edition description: 1E
  • Edition number: 1
  • Pages: 566
  • Sales rank: 1,068,207
  • Product dimensions: 7.20 (w) x 9.00 (h) x 1.40 (d)

Table of Contents

Preface     xv
Acknowledgments     xix
Contributors and Reviewers     xxi
General Principles     1
The Nurse Practitioner in the Skilled Nursing Facility   Debra Priest-Barkejian     3
Introduction     3
Understanding the Overall Environment     3
The Regulatory Environment     4
Quality of Care in the Skilled Nursing Facility     4
Understanding the Internal Nursing Home Environment     6
Nursing Functions in Nursing Homes     7
Allied Nursing Home Staff     8
Nursing Home Leadership     10
The Role of the Nurse Practitioner in Nursing Homes     11
Becoming a Skilled Nursing Facility Clinical Provider     11
Educational Preparation of Nurse Practitioners     12
Documentation and Charting in Long-Term Care     13
Confidentiality in Long-Term Care     22
References     22
Resources     23
General Principles of Patient Management   Barbara White     25
Diagnostic Challenges of Disease Presentations in the Elderly     25
Principles for Management of Multiple Disease States     26
Prescribing for the Elderly Nursing HomePopulation     27
The Beers Criteria for Prescribing Drugs for Older Adults     31
Clinical Pearls for Safe Drug Prescribing in Long-Term Care     33
Government Regulation of Medications Prescribed in Long-Term Care     34
Managing Resident Transitions and Transfers     36
References     39
Web Sites     41
Health Promotion and Disease Prevention   Barbara White     43
Health Screening     43
Chemoprophylaxis     46
Health Counseling     47
Web Sites     48
References     48
Ethical Issues   Eileen Croke   Barbara White     49
Elder Abuse     49
Advance Directives     53
Sexuality in Long-Term Care     54
Web Sites     58
References     58
Legal Considerations   Theodore O'Leary     59
Liability Overview     60
Medical Malpractice and Negligence     64
Elder Abuse Law     66
Charting and Documentation Issues     69
References     73
Management Guidelines for Common Disorders
Cardiac Disorders   Barbara White      75
Atrial Fibrillation     75
Coronary Artery Disease     81
Dyslipidemia     90
Heart Failure     95
Hypertension     106
Web Sites     113
References     113
Dermatology   Cathleen Case     117
Introduction: Skin and Aging     117
Bullous Pemphigoid     118
Cellulitis and Erysipelas     121
Cutaneous Malignancy     123
Drug Reactions     127
Eczematous Diseases     130
Superficial Fungal Infections     137
Psoriasis and Seborrheic Dermatitis     142
Scabies Infestation     147
Web Sites     151
References     151
Endocrine Disorders   Yung-In Choi   Doreen Bacon     153
Type 2 Diabetes Mellitus     153
Hyperthyroidism     161
Hypothyroidism     164
Thyroid Nodules     168
Resources     169
References     170
Gastrointestinal Disorders   Chris Butler   Eileen Simpson     173
Pancreatic Cancer     173
Colon Cancer      175
Gastrointestinal Bleeding     177
Hepatitis B     179
Hepatitis C     182
Acute Pancreatitis     183
Gastroesophageal Reflux Disease     188
Ileus     191
Diverticular Disease     195
Web Sites     199
References     199
Genitourinary and Renal   Leslie Saltzstein Wooldridge     203
Benign Prostatic Hypertrophy     203
Chronic Renal Failure     205
Acute Renal Failure     208
Prostate Cancer     210
Urinary Incontinence     214
Urinary Tract Infection     223
Web Sites     229
References     229
Hematology/Oncology   Julia Eggert     233
Acute Leukemia     233
Chronic Leukemias     235
Multiple Myeloma     237
Myelodysplastic Syndromes     239
Hodgkin's Lymphoma     240
Non-Hodgkin's Lymphoma     241
Web Sites     242
References     243
Infectious Disease   Bethsheba Johnson     245
Diarrhea     245
Herpes Zoster Virus (HZV; Shingles)      252
Web Sites     259
References     259
Musculoskeletal Disorders   David Casey   Deborah Truax     263
Gout and Pseudogout     263
Low Back Pain     266
Osteoarthritis     270
Osteoporosis     274
Polymyalgia Rheumatica and Giant Cell Arteritis     280
Rheumatoid Arthritis     283
Web Sites     288
References     288
Neurological Disorders   Marianne McCarthy     291
Parkinson's Disease     291
Multiple Sclerosis     301
Spinal Stenosis     308
Seizures     313
Stroke     320
Subdural Hematoma     329
Web Sites     332
References     332
Psychological Disorders   Valisa Saunders     337
Generalized Anxiety Disorder in the Elderly     337
Dementia     342
Late-Life Delirium     353
Late-Life Depression     357
Web Sites     362
References     363
Respiratory Disorders   Deborah Cox     373
Asthma      373
Bronchitis     376
Chronic Obstructive Pulmonary Disease     379
Influenza     384
Lung Cancer     387
Pleural Effusion     390
Pneumonia     393
Pulmonary Embolism     397
Web Sites     400
References     400
Vascular Disorders   Deborah Caswell   Michelle Eslami     403
Abdominal Aortic Aneurysm     403
Carotid Disease     405
Deep Vein Thrombosis     407
Peripheral Arterial Disease     410
Venous Insufficiency     414
Web Sites     417
References     417
Special Considerations
Wound Care   Evonne Fowler     419
Introduction     419
Pressure Ulcer Quality Improvement and Risk Management     420
Prevention of Pressure Ulcers     421
Definition of Wounds and Healing     422
Types of Wounds     423
Skin Tears     423
Neuropathic Foot Ulcers     424
Vascular Ulcers     424
Postoperative Wounds     426
Radiation-Related Skin Changes     426
Pressure Ulcers      427
Patient Assessment     427
Management of Wound     428
Wound Bed Preparation and Time     428
Selecting a Dressing     437
Web Sites     439
References     439
Nutrition   Mary Jacob   Barbara White     443
Management Plan     448
Pressure Ulcers     456
Cardiovascular Disease     456
Hypertension     457
Diabetes     457
Web Sites     458
References     458
Rehabilitation   Aquilina Saw   Deborah Truax     461
Principles of Rehabilitation     461
Stroke Rehabilitation     467
Rehabilitation of the Lower Extremity Amputee in the Skilled Nursing Facility     478
Rehabilitation of Acute Low Back Pain in the Skilled Nursing Facility     482
Total Joint Arthroplasty of Hip and Knee     485
Total Knee Replacement     486
Total Hip Replacement     487
Hip Fracture     488
Deconditioning     490
Web Sites     491
References     491
Podiatry   Guy Danon     495
Introduction      495
Establishing a Foot Care Regimen     495
Medicare and Health Care Coverage     496
Diabetic Foot Care, Prevention, and Education     496
The Nail and Aging     497
The Immune System and Aging     498
Pediatric Dermatology     499
Vascular Insufficiency     499
Skin Cancer     500
Diagnostic Considerations     501
Essential Tests     501
Malignant Melanoma     501
Basal Cell Carcinoma     502
Squamous Cell Carcinoma     502
Kaposi's Carcinoma     503
Infectious Disease in Geriatrics     503
Common Podiatric Conditions Seen in Long-Term Care     503
Athlete's Foot     503
Onychomychosis     505
Inflammation and Infection in the Toenail Unit (Paronychia)     507
Distal Diabetic Polyneuropathy     508
Pressure-Induced Hyperkeratosis     510
Plantar Neurotrophic Ulcer     511
Web Sites     513
References     513
Pain Management   Pegi Black     515
Epidemiology Prevalence, and Incidence     515
Definition      515
Barriers to the Recognition of Pain     516
Consequences of Pain     518
Process to Diagnosis and Treatment     518
Acute Pain     527
Chronic Pain     528
Cancer Pain     529
Pain at End of Life     530
Summary     531
Web Sites     531
References     531
End-of-Life Care   Pegi Black     533
The Evolution of Hospice and Palliative Care in the United States     534
Barriers and Benefits to Appropriate End-of-Life Care     534
Establishing Goals of Care     538
Pain and Symptom Management     541
The Dying Process When Time Is Near     543
Grief and Bereavement     544
Ethical Issues     545
Competency     546
Withholding or Withdrawing Treatment     546
Assisted Suicide     546
Web Sites     547
References     547
Index     551
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