Resistant hypertension is a common chief complaint in primary care clinics. But for new nurse practitioners, there’s a lot to sort through. 

In this video, I walk through the thought processes and approaches to managing resistant hypertension in primary care. 

✅ How to talk about medication adherence with patients

✅ The role of ongoing blood pressure checks — both in clinic and at home

✅ Considerations for current medications and dosing

✅ How to investigate the secondary causes of hypertension

Read the blog post here.

Stressed about labs? Watch our free Top Three Mistakes Even Smart NPs Make Interpreting Labs training at https://realworldnp.com/training

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Dizziness alone accounts for about 5% of all primary care office visits in the US. 

5%! That's a huge number. 

But as a chief complaint, dizziness is somewhat nebulous. The causes of dizziness can run the gamut from annoying-but-benign to yikes-let's-get-you-to-the-ER. So how do you sift through all the possibilities and uncover what’s really going on with your patient? 

In Diagnostic Approach to Dizziness, we walk NPs through the basics of assessing patients who are experiencing dizziness. We talk about:

✅ The four buckets of ideologies that your patient’s dizziness might fall into 

✅ The critical patient history questions. (And why it's important to drill down on what patients mean when they say they're CONSTANTLY dizzy.) 

✅ The diagnostic steps and key physical tests to run (and how to do them in a not-scary way for your patients!)

🚩And the red flags you absolutely need to watch out for 

Read the blog post here.

Stressed about labs? Watch our free Top Three Mistakes New NPs Make Interpreting Labs training at realworldnp.com/training

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Back pain — it’s truly one of the most common issues you come across in primary care. That’s why you need to have your diagnostic approach to it down pat as a nurse practitioner. 

And the sooner you get comfortable diagnosing back pain in primary care, the sooner you’ll feel confident helping your patients on their road to recovery. 

In this week’s episode, we talk about why you should really take a triage-based approach to back pain — among other chief complaints — plus other hot takes on assessing back pain such as:

✅ Red flags that are critical — if sometimes tricky — to uncover when taking a patient history 

✅ Key tests to consider when you're doing a physical exam 

✅ Should you order imaging or further testing?  

✅ And how to advise patients and set expectations for recovery

Read the blog post here.

Stressed about labs? Watch our free training: 3 Mistakes New NPs Make Interpreting Labs for what to avoid and do instead at realworldnp.com/training

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It’s super common for new NPs — and experienced ones — to get anxious when encountering orthopedic complaints. 

It’s a conundrum — on one hand, it seems like it should be simple. After all, you can feel all the musculoskeletal body structures right there. 

But at the same time, there are so many (SO MANY!) nuances to each body part. And there’s a lot of ortho lingo to wrap your head around. 

That’s why it’s helpful to understand exactly what an orthopedic nurse practitioner does — and what that means for working in primary care.

So sit back and enjoy — this week, orthopedic nurse practitioner, Yessica Salazar, has stopped by to talk ortho with us...and left behind so many great clinical pearls that I just know will help you in your daily practice: 

✅ How to order knee X-rays the right way

✅ Her approach to medications for orthopedic complaints

✅ Non-invasive treatment options for patients 

Read the blog post here.

Hosted on Acast. See acast.com/privacy for more information.

Do you ever find yourself spending an ENTIRE 20-minute visit just getting a history?

And even with all that time, do you still leave the room feeling like you didn't even get the info you needed?

In this episode, I'm sharing my top tips for not only a FASTER history, but also a more accurate one — so you can take great care of your patients while saving time and, quite honestly, health care dollars.

You'll learn:

• My top tip to keep your patient visits moving
• Pitfalls of where you could be missing info (and how to ask questions to get the answers you're looking for)
• The most important question to ask to save you TONS of time in each visit

Read the blog post here.

Need more support? Check out the Lab Interpretation Crash Course for Nurse Practitioners

Hosted on Acast. See acast.com/privacy for more information.

Seeing "lower leg swelling" as the chief complaint for patients as a new nurse practitioner was incredibly stressful. What’s the best course of action? Should you give diuretics for symptom control? Is this something serious...or something totally ordinary?

I had a super interesting case the other week and knew immediately that I had to share it with you — and it was one that I actually got a double-check from my colleague on!

In this episode, you'll learn:

• The top DDXs - most common and red flags
• What important history questions to ask
• Two clinical pearls of patient histories
• Differential diagnoses
• How to manage patients in this common scenario - re: testing & treatment

Read the blog post here.

Need more support? Check out the Lab Interpretation Crash Course for Nurse Practitioners

Hosted on Acast. See acast.com/privacy for more information.

Urine microalbumin: you need to check it once a year for patients with diabetes. But interpreting the results — and knowing what to do with them! — can be tricky. 

In this episode, you’ll learn:

• When to order urine microalbumin labs
• How to interpret the results and what to do with them
• How to treat abnormal levels
• 4 steps to elevated microalbumin management

Read the blog post here.

Need more support? Check out the Lab Interpretation Crash Course for Nurse Practitioners

Hosted on Acast. See acast.com/privacy for more information.

I saw a meme recently that compared hyponatremia to folding a fitted sheet— you can watch a million videos on how to do it, but in the end you'll probably just crumple it up and hope you never have to deal with it again. 🤯

Luckily in primary care low sodium is easier to deal with outpatient, and doesn't have to be super complicated. In this episode, I talk about low sodium, which is one of the top abnormal labs in primary care.

Hyponatremia involves understanding kidney function, but I've broken it down into the simplest, clearest, most digestible way to give you the most helpful insight to take into your practice. I'll bring you through the step-by-step process to implement for the vast majority of patients you'll see, and if you need to go down the rabbit hole of workup further, you'll have the tools to do so!

You'll learn:

• How to know when your patient needs to go to the ER, and when you can work them up outpatient
• The simplest way to remember low sodium
• The #1 lab you should always think of when you see low sodium
• How to know if your patient needs IV fluid (or if that'd be the worst possible thing to do for them)

Read the blog post here.

Want more lab goodies? Check out the Lab Interpretation Crash Course for Nurse Practitioners

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Feeling uncertain about referring a patient? That’s super common. You might wonder things like:  

Are there other tests you could do first?

Should you wait it out?

At what point can you be sure?

In this episode I will answer ALL of these questions. I will also walk you through my 3-step process, the pitfalls and mistakes to avoid (that I learned from experience!). Plus, I’ll give you my NUMBER ONE resource to help you:

• Feel more confident with your referrals
• Deepen and broaden your knowledge base
• Take excellent care of your patients

Read the blog post here.

Need more support? Check out the Lab Interpretation Crash Course for Nurse Practitioners

Hosted on Acast. See acast.com/privacy for more information.

You've seen high WBC counts as a nurse, but what about leukocytosis that's only 13 or 15? And it's chronic? And what about peripheral smears? How do you know if it's urgent?

In this episode we are going to talk about this super interesting case study to give you the step by step approach to interpreting these labs, and teach you how to manage a high WBC count safely and confidently.

Together, we will cover:

• Knowing when to order what labs
• Three main components of working up a high WBC
• The differential and the peripheral smear 
• Absolute lymphocyte count 
• The Flow Cytometry Test

Read the blog post here.

Check out the Lab Interpretation Crash Course for Nurse Practitioners

Hosted on Acast. See acast.com/privacy for more information.