ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Today, primary care providers are managing clinical problems that were frequently addressed by a “specialist.” Consequently, they must keep current with myriad state-of-the-art diagnostic modalities. In the case of coronary artery disease, knowledge about the reversibility of left ventricular dysfunction conceptualized as “hibernating” and “stunned” myocardium has resulted In an increased utilization of nonlnvasive cardiac Imaging techniques to facilitate clinical decision making. These procedures provide diagnostic and prognostic information about coronary artery disease and left ventricular function beyond that provided by the conventional exercise stress test. The most commonly employed of these are the stress echocardiogram and stress myocardial nuclear perfusion procedures. Both modalities can be performed in conjunction with physical or pharmacologically Induced stress, and may be performed on an outpatient basis. Knowledge of how these procedures are performed and the clinical data they provide will facilitate primary care providers as they care for this growing population.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

In spite of the well-documented evidence that physical activity is beneficial, only 30% of individuals over the age of 65 report exercising regularly. Regular physical activity can minimize and prevent chronic problems and increase functional ability in the elderly. Designing physical activity for the elderly requires initial assessment of functional ability, exercise tolerance, physical limitations, and psycho logic and social support of the individual. The exercise prescription should address the intensity, frequency, and duration of the exercise. Several factors affect the elderly's initiation and adherence to a physical activity program. These include the elder's perception of factors preventing physical activity, individual goal setting, and personal and therapist support in the effort.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The pediatric health care provider is often faced with myriad decisions related to the use of infant formula. This article compares human milk to cow's milk. It addresses the composition, classification, and use of some of the most common infant formulas manufactured for use with the term infant in the outpatient setting. Common clinical situations are discussed, including the role for low-iron, goat's milk, and follow-up formulas, and formula use for the Infant with diarrhea, colic, and atopic disease. The article highlights the poor quality of research and the lack of definitive answers available to the clinician when managing the Infant with atopic disease. It concludes with a review of practical aspects of infant formula feeding for use in client education and management, including guidelines for formula preparation, calculating necessary formula intake, frequency, and quantity of Infant feedings, and provisions of the WIC program.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Patients with Bell's palsy, or Idiopathic facial paralysis, present sporadically in the primary care setting. New evidence implicates reactivated herpes simplex virus (HSV) as the etiologic agent in greater than 70% of cases diagnosed as Bell's palsy. Careful evaluation of the patient with facial paralysis, including history, physical examination, and diagnostic assessment, may mandate the expeditious treatment of facial paralysis to prevent faulty nerve regeneration during the recovery period. Using the results of an objective tool for grading resting facial symmetry, symmetry of voluntary movement, and synkinesis can provide a quantitative measurement for decision making. These data are also useful in documenting progression or regression of the patient's facial paralysis. Administration of acyclovir with prednisone improves the recovery of complete facial functioning following an episode of Bell's palsy. During the acute and convalescent stages, the eye on the affected side must be protected until function Is restored to the facial nerve. Residual effects of Bell's palsy lasting more than 6 months may Indicate another diagnosis and the need to refer the patient to a specialist.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

An employment agreement is a legal contract that spells out the conditions of a working relationship between an employer and employee. Nurse practitioners (NPs) are being offered employment agreements. These documents are complex, lengthy, and require careful analysis. Three clauses commonly found in employment agreements are especially difficult to interpret and can have profound effects on an NP's life. These clauses are restrictive covenants, bonus formulas, and termination clauses. Restrictive covenants require an NP to promise—up front—not to compete with an employer when the present employment ends. Bonus formulas specify conditions under which an employer rewards an NP for superior performance. Termination clauses specify that an employer may end the agreement, without cause, with 30 days' notice. This article gives examples of each type of clause and advises NPs about how to negotiate reasonable terms.

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1997

数据来源: OVID