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.
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.
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.
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.
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).
OPIOID PRESCRIBING: UNDERSTANDING THE CDC GUIDELINES (1.5 CEs)
Sabrina Johnson, MSN, FNP-BC, RN-BC
Objectives
Upon completion of this CE learning module, participants will be able to:
- Explain the use of a risk assessment tool.
- Understand the use of the Prescription Monitoring Program.
- Understand when to use an opioid agreement and its purpose.
- Explain when to use short-acting versus long-acting opioids.
- Explain when to refer to the pain specialist.
- Verbalize when to discontinue opioids.
Abstract
On March 18, 2016, the Centers for Disease Control and Prevention (CDC) issued new guidelines for prescribers wishing to write opioid prescription for patients experiencing pain. These guidelines are to be utilized as a tool to aid prescribers while helping to fight the United States uphill battle against prescription drug abuse. Over 18,000 deaths in 2014 were directly linked to prescription drug abuse ("Drug Poisoning Fact Sheet," 2016). In the last year, more than 26% of those who initiated abusing drugs started with prescription medications, 17% of which were opiates ("Summary of Drug Use," 2013). Because this abuse has gotten so out of control, the CDC felt compelled to provide safer and more effective treatment recommendations and attempt to reduce the occurrence of opioid use disorder and overdose (CDC Guidelines, 2016). The purpose of this continuing education module is to assist clinicians to identify and use the new guidelines and apply them in clinical practice.
MEDITATION AND MINDFULNESS IN NURSING
Ellen Birx, PhD, RN
Objectives
Upon completion of this CE learning module, participants will be able to:
- Define meditation and mindfulness.
- Identify uses of meditation and mindfulness to promote the holistic health of patients.
- Identify the uses of meditation and mindfulness as self-care strategies for nurses.
- Summarize recent nursing research regarding meditation and mindfulness in healthcare.
- Distinguish the physiological, psychological, and spiritual effects of mindfulness meditation.
- Share their personal experience of practicing several meditation and mindfulness exercises.
- Appreciate the relationship between self-compassion and compassion for patients.
- Select at least one goal for integrating meditation or mindfulness into daily self-care or nursing practice
Abstract
In response to the rapidly expanding body of research regarding meditation and mindfulness and its current uses in healthcare settings, this continuing education offering is aimed at providing nurses the up-to-date information they need about these practices. The uses of meditation and mindfulness to reduce the stress, anxiety, and depression of patients, as well as their uses by nurses for self-care and the cultivation of presence and compassion, are discussed. Recent nursing research related to the use of meditation and mindfulness to promote the well-being of both patients and nurses is reviewed. Audio and video guidance is provided to help nurses gain first-hand experience of meditation and mindfulness practices.
