1.
Recommendations for preconception counseling and care.
Farahi, N, Zolotor, A
American family physician. 2013;(8):499-506
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Abstract
Given that nearly one-half of pregnancies are unintended, preconception care should be considered an integral part of primary care for women of reproductive age. Common issues in preconception care include family planning, achieving a healthy body weight, screening and treatment for infectious diseases, updating appropriate immunizations, and reviewing medications for teratogenic effects. Women who want to become pregnant should take folic acid supplements to reduce the risk of neural tube defects. Control of chronic diseases is essential for optimizing pregnancy outcomes. Family physicians should work with patients to control conditions such as diabetes mellitus, hypertension, and seizure disorders while simultaneously offering family planning services to avoid unintended pregnancies. Bariatric surgery is increasingly common and may improve fertility in many women with previous insulin resistance. Family physicians should counsel women undergoing bariatric surgery to prevent pregnancy during rapid weight loss and provide assistance with contraception. In addition, patients have special nutritional requirements after bariatric surgery.
2.
Health care in the first year after international adoption.
Schulte, EE, Springer, SH
Pediatric clinics of North America. 2005;(5):1331-49, vii
Abstract
After international adoption, routine screenings for infectious and nutritional diseases, lead exposure, and vision and hearing difficulties are early priorities for children's postadoptive health care. Specific health concerns raised before adoption should also be reviewed after children arrive home with their families. Once appropriate postadoptive screenings and immunizations have been initiated, the challenge for the primary care provider is to determine the intervals and content of future follow-up visits. Clinical decision making is influenced by a specific child's age, acute medical needs, and developmental assessments.
3.
A practical approach to type 2 diabetes.
Conlon, PC
The Nursing clinics of North America. 2001;(2):193-202, v
Abstract
Diabetes mellitus is among the most serious, costly, and in some cases, preventable health care problem in the United States today. Primary care providers such as nurse practitioners are ideally suited to manage chronic conditions such as diabetes and provide counseling and interventions regarding intensive management (i.e., medications, nutrition, and exercise), prevention of complications, immunizations, laboratory screenings, and physical examinations. This article provides a general overview of type 2 diabetes and the role of the nurse practitioner in the prevention and management of this disorder.
4.
Primary care in children with congenital heart disease.
Smith, P
Journal of pediatric nursing. 2001;(5):308-19
Abstract
Congenital heart defects, abnormalities in the structural development of the heart, occur in approximately 1% of live births. With improved detection, diagnosis, medical management, and surgical techniques, the number of children surviving with congenital heart disease is increasing. These children require the same comprehensive primary care as all other children; however, there are certain aspects of primary care that will be affected by the presence of a congenital heart defect. This article attempts to clarify the special considerations regarding growth and nutrition, development, physical activity, immunizations, dental care, use of over-the-counter medications, and perioperative concerns for these children. The unique needs of the cardiac transplant patient are beyond the scope of this article.