Current Listing of Continuing Education Courses for Nurses

GOUT: DIAGNOSIS AND TREATMENT (1 CE)

Laura LaRue, DNP, FNP-BC
Ronald Alan Stein, JD, APRN, NP-C

Objectives

Upon completion of this CE learning module, participants will be able to:

•  Address the prevalence and related conditions of gout.
•  Integrate the pathophysiology of gout, its presentation and risk factors.
•  Differentiate the stages of gout and its presentation and subsequent diagnosis.
•  Describe the rationale, guidelines and sequencing of therapy for the treatment of hyperuricemia and gout.
•  Define the parameters for patient communication, education and adherence to long-term therapy.      

Abstract

Gout has long been known as the ‘disease of kings’ or the ‘rich man’s disease,” based on the idea that wealth and power lead to overindulgence of food and spirits. The disease involves precipitation of monosodium urate crystals (MSU) deposits in joint tissue, commonly the first metatarsophalangeal joint.  It is more common in men than women, usually developing in middle age (Ryan, 2015). Certain medications, for example, diuretics, play a role of in the development of gout. With gout, uric crystals are formed from purines, which are part of the chemical structure of genes of all plants, animals and humans.  There are four stages of gout with the first being an asymptomatic phase when uric acid crystals are being deposited into tissues. At this stage, the crystals damage tissue but do not cause pain. The second, or acute stage, is major inflammation of a joint or tissue.  The third, or intercritical stage, includes flares and symptom-free periods during which the deposition of gout crystals in joints continue. This deposit of monosodium crystals results in joint changes. The intercritical stage becomes shorter and shorter as the disease progresses to the fourth and last stage, which is chronic.  Gout can destroy joints and lead to disability. 

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ANTICOAGULANTS (3 CEs)

Laura LaRue DNP, FNP-BC

Objectives

Upon completion of this CE learning module, participants will be able to:

• Review the use in clinical practice of antiplatelets, anticoagulants and non-vitamin k anticoagulants.
• Review the effect of Vitamin K on clotting factors in the liver.
• Assess data from key anticoagulation stroke prevention trials, including efficacy and safety of novel oral anticoagulants (NOACs).
• Review the pharmacology of antiplatelets, anticoagulants to include NOACs and their clinical relevance in evidence-based guidelines.
• Review possible ways to reverse bleeding of non-vitamin K oral anticoagulants (NOACs).
• Evaluate reasons for underuse of oral anticoagulants for stroke prevention in patients at thromboembolic risk.
• Apply proper anticoagulation dosing to ensure greater efficacy and safety for stroke prevention in patients at thromboembolic risk.
• Discuss strategies to manage bleeding events. 
• Discuss use of these anticoagulant agents in patients with renal impairment.    

Abstract

Thrombus causes most of cardiovascular diseases and deaths. Thrombus is the most common cause of three cardiovascular disorders to including ischemic heart disease (acute coronary syndrome), stroke and venous thromboembolism (VTE) (ISTH Steering Committee, 2014).

Thromboembolism deaths in the United States are estimated at 300,000 annually. According to the CDC in 2013, there was between 60,000 to 100,000 deaths from venous thrombus (CDC, 2015).  The incidence nearly doubles in each decade of life over the age of 50. Individuals considered at high risk for blood clots include: trauma patients, surgical patients especially total knee replacement (TKR) and total hip replacement (THR), stroke patients, MI patients, spinal cord injury patients and metastatic cancer patients.

This continuing education will focus on common indicators for use of anticoagulants, antiplatelets and novel oral anticoagulants (NOACs). Another goal of this educational unit is to understand how clots are formed and how to treat clots appropriately.

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CARING FOR THE TRANSGENDER INDIVIDUAL (1.5 CEs)

Dwight D. Faught, MSN, RN, PMHNP-BC, CMSRN

Objectives

Upon completion of this CE learning module, participants will be able to:

• Identify the role and responsibilities of mental health providers working with the transgender population.
• Apply the diagnosis of gender dysphoria to the transgender individual.
• Identify four possible differential diagnoses for individuals with gender dysphoria.
• Understand the problems caused by having a 2 gender health care system.
• Identify the benefits of transition for the transgender individual.

Abstract

Transgenderism has found itself in the forefront of popular media secondary to several high profile individuals who have made their gender transformation public. “Transgender individuals are those who cannot or choose not to conform to societal gender norms based on their physical or birth sex” (Xavier, et al. 2013). Kristin Beck, a former US Navy Seal and Caitlyn Jenner, former Olympic athlete, among many others have been catalysts escalating a very public debate about what it means to be transgender. This increase in visibility and public discourse provides a more open and accepted environment for transgender individuals to live as their perceived gender. As a health care provider, there is a higher probability that you may find yourself providing for the health care needs of this population.

There are many barriers to accessing health care in the United States of America. One barrier is that a treatable medical condition must exist in order to access care. It is generally accepted that being transgender is not a medical disorder requiring treatment; therefore, accessing transition care may be difficult or impossible to access. The generally accepted diagnosis for accessing transition care has been a psychiatric diagnosis based on Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association. Changes have been made in the most recent edition of the DSM fifth edition (DSM 5) to make the diagnosis less stigmatizing to the individual while providing a mechanism to allow access to medical care.

Mental health providers need to understand the diagnostic criteria for gender dysphoria. It is a provider’s responsibility to correctly diagnosis gender dysphoria and to support, advocate, and assist clients to access medical services. Assisting individuals with gender dysphoria to access transitional care has been shown to positively impact lives both short and long term.

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PAIN MANAGEMENT (2 CEs)

Phyllis Whitehead, PhD, APRN, ACHPN, RN-BC

Objectives

Upon completion of this CE learning module, participants will be able to:

• Identify the prevalence of pain in the older adult.
• Describe the pathophysiology of pain in the older adult.
• Describe the presentation of pain in the older adult and its specific symptomatology.
• Describe when and how to assess for pain in the older adult.
• Identify risk factors for pain and their inclusion in the treatment plan.
• Discuss the importance of proper assessment and identification of pain as it pertains to the older adult.
• Delineate cultural differences when treating pain in the older adult.
• Identify strategies on how to provide proper pain management education for the older adult.
• Identify appropriate medication management for pain in the older adult.
• Describe medications that should be used with caution in older adults.
• Discuss when it is appropriate to use opioids in the older adult.
• Identify three non-pharmaceutical treatments for pain management.
• Describe integrated therapy for pain management.
• Identify barriers that may arise when teaching the older adult about proper pain management.

Abstract

Pain management is an essential component of caring for the older patient. Persistent pain affects over 100 million Americans which is more than the total number of adults affected by heart disease, cancer, and diabetes combined (IASP, 2011; IOM Blueprint, 2011). Unrelieved pain has significant impact upon the functional, cognitive, emotional and social domains of the older adult (Pautex, Herrmann, Le Lous, & Gold, 2009). Tailoring pain in the older patient is a multifaceted undertaking requiring a holistic approach that addresses physical, emotional, spiritual and social domains of the person. Since the nurses are often the first clinician to hear or observe a patient’s report of pain, it is crucial for nurses to perform a comprehensive pain assessment in the older adult (MacSorley, et al., 2014; Pasero & McCaffery, 2011). Nurses are pivotal to provide effective pain management that involves a multi-modal approach to treatment including pharmacological and psychological interventions.

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RISK FACTORS AND PREVENTION OF VENOUS THROMBOEMBOLISM (1.5 CEs)

Cindy Ward, DNP, RN-BC, CMSRN, ACNS-BC

Objectives

Upon completion of this CE learning module, participants will be able to:

• Define venous thromboembolism.
• Identify 3 risk factors for venous thromboembolism (VTE) in a hospitalized patient.
• Compare pharmacologic and mechanical VTE prophylaxis.
• Recognize contraindications to pharmacologic and mechanical prophylaxis.

Abstract

Venous thromboembolism (VTE) is the leading cause of preventable hospital deaths in the United States. The true incidence of VTE is unknown; but it is estimated that 300,000 to 600,000 people are affected annually (Beckman, Hooper, Critchley & Ortel, 2010; Office of the Surgeon General, 2008). Is it estimated that 50 – 75% of hospital-acquired VTE would be potentially preventable if the patient received appropriate prophylaxis (Maynard & Stein, 2008). Individuals with a deep vein thrombosis (DVT) who are untreated have a 37% incidence of a pulmonary embolus (PE) that is fatal (Stein & Mata, 2010). As many as 1 in 20 hospitalized patients will suffer a fatal PE if they have not received adequate VTE prophylaxis. For 25% of individuals with a PE, the first symptom is sudden death (Beckman et al., 2010; Cardiovascular Disease Educational and Research Trust (UK), European Venous Forum, North American Thrombosis Forum, International Union of Angiology & Union Internationale du Phlebologie, 2013; Heit, 2005).

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CURRENT DIAGNOSIS AND THERAPEUTIC STRATEGIES FOR VAGINITIS

Marjorie Young, DNP, RN, IBCLC, FNP-BC

Objectives

At the completion of this continuing education module, the participant will be able to:

1.            Discuss the pathophysiology of vaginitis.

2.            Discuss the negative impact of vaginitis on health and quality of life.

3.            Identify risk factors for developing vaginitis.

4.            Describe the diagnostic techniques for vaginitis.

5.            Identify and differentiate the most common types of vaginitis.

6.            Describe the diagnostic strategies to differentiate between the different types of vaginitis.

7.            Discuss current medication, complementary, and alternative therapies for vaginitis.

Abstract

Vaginal symptoms are one of the leading reasons that women seek medical care via their primary care provider, gynecologist, urgent care center, or emergency department. Self-diagnosis and treatment lead to inappropriate and under treatment of vaginal infections. The four most common causes of vaginitis consists of atopic vaginitis, bacterial vaginosis, candida vulvovaginitis, and trichomoniasis. The purpose of this module is to provide nurse practitioners with the current information on vaginitis consisting of the pathophysiology, symptomology, risk factors, negative health impacts, and diagnostic techniques along with strategies for treatment including medication, complementary and alternative therapies.

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Caring for Patients with Acne Vulgaris in Primary Care

Deborah Quinn, MSN, FNP, DCNP

Objectives

Upon completion of this CE learning module, participants will be able to:

·         Describe psychosocial impact of acne

·         Describe pathophysiology of acne

·         Identify types of acne

·         Explain principles of treatments

·         Determine when to refer to dermatology

Abstract

Acne Vulgaris is the most common dermatological complaint across the life span in the United States that primarily affects adolescents and peri-menopausal woman.  The management of acne by primary care providers is expected to increase due to changes in the health care system including the increase of insured persons through the Affordable Care Act (ACA) and the push towards patient centered medical homes (Collins, Piper & Owens, 2013).  Acne can have a profound effect on quality of life causing both emotional and physical scarring.  Acne is a multifactorial disease that can be effectively treated with standard and novel medications that includes both topical and systemic treatment choices. 

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COMPLEMENTARY HEALTH APPROACHES FOR WOMEN

Virginia Weisz, PhD, WHNP-C

Objectives

At the completion of this continuing education module, the participant will be able to:

1.      Describe the differences between women and men in their use of Complementary health approaches (CHA).

2.      Describe what motivates women to use CHA in pregnancy and childbearing and in menopause.

3.      Describe current evidence related to the use of CHA for pregnant and childbearing women and those in menopause.

4.      Be able to describe implications for nursing practice related to the use of CHA for pregnant and childbearing women and those in menopause.

Abstract

Complementary health approaches (CHA) are combined often with conventional health care practices and are referred to as complementary and integrative care (CAI). The practice approach is gaining momentum as a holistic way to treat patients and research has shown positive effects on improving health and wellness. The purpose of this module is to review evidence-based current literature of complementary health approaches specifically for women with a focus on pregnant, childbearing and menopausal women. Implications for practice are discussed. It is written for RNs and APNs.