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https://t.me/med1917
CONTENTS
Vaginal Bleeding: Second and Third
Trimesters 557
Wound Infection: Episiotomy and Cesarean
Section 558
14. GYNECOLOGIC GUIDELINES 559
Rhonda Arthur
Amenorrhea 559
Bacterial Vaginosis (Gardnerella Vaginosis) 561
Bartholin Cyst or Abscess 563
Breast Pain 564
Cervical Cancer Screening Guidelines and
Interpretation 566
Cervicitis 568
Contraception 570
Dysmenorrhea 574
Emergency Contraception 576
Endometriosis 578
Female Sexual Dysfunction 580
Genito-Pelvic Pain/Penetration Disorder
(Dyspareunia) 583
Genitourinary Syndrome of Menopause 585
Impaired Fertility 588
Menopause 592
Pelvic Inammatory Disease 595
Premenstrual Syndrome and Premenstrual Dysphoric
Disorder 599
Vulvovaginal Candidiasis 601
Client Teaching Guides
Amenorrhea 605
Bacterial Vaginosis 606
Cervicitis 607
Contraception: How to Take Birth Control Pills
(For a 28-Day Cycle) 608
Dysmenorrhea (Painful Menstrual Cramps or
Periods) 609
Dyspareunia (Pain With Intercourse) 610
Emergency Contraception: Levonorgestrel 611
Emergency Contraception: Ulipristal
Acetate 612
Fibrocystic Breast Changes and Breast Pain 613
Genitourinary Syndrome (Atrophic
Vaginitis) 614
Menopause 615
Pelvic Inammatory Disease 616
Premenstrual Syndrome 617
Vaginal Yeast Infection 618
15. SEXUALLY TRANSMITTED INFECTIONS
GUIDELINES 619
Jill C. Cash and Dana N. Hughes
Chlamydia 619
Gonorrhea 620
Herpes Simplex Virus Type 2 622
Human Papillomavirus 624
Syphilis 626
Trichomoniasis 628
Client Teaching Guides
Chlamydia 631
Gonorrhea 632
Herpes Simplex Virus 633
Human Papillomavirus 634
Syphilis 635
Trichomoniasis 636
16. INFECTIOUS DISEASE GUIDELINES 637
LaDawna Goering and Jill C. Cash
Cat-Scratch Disease 637
Coronavirus Disease (COVID-19) 639
Cytomegalovirus 644
Encephalitis 648
H1N1 Inuenza A (Swine Flu) 651
Inuenza (Flu) 653
Kawasaki Disease 656
Lyme Disease 659
Meningitis 661
Mononucleosis (Epstein–Barr) 665
Mumps 667
Parvovirus B19 (Fifth Disease, Erythema
Infectiosum) 670
Rheumatic Fever 672
Rocky Mountain Spotted Fever 675
Roseola (Exanthem Subitum) 677
Rubella (German Measles) 679
Rubeola (Red Measles) 681
Scarlet Fever (Scarlatina) 684
Toxoplasmosis 686
Varicella (Chickenpox) 689
West Nile Virus 692
Zika Virus Infection 694
Client Teaching Guides
Chickenpox (Varicella) 697
Inuenza (Flu) 698
Lyme Disease and Removal of a Tick 700
Mononucleosis 702
Rocky Mountain Spotted Fever and Removal of
a Tick 703
Toxoplasmosis 705
Zika Virus Infection 706
17. SYSTEMIC DISORDERS GUIDELINES 709
Kristin K. Ownby and Dana N. Hughes
Myalgic Encephalomyelitis/Chronic Fatigue
Syndrome 709
Fevers of Unknown Origin 712
Human Immunodeciency Virus 714
Immune Thrombocytopenia 718
Iron-Deciency Anemia (Microcytic,
Hypochromic) 721
Lymphadenopathy 723
Megaloblastic Anemia 726
Client Teaching Guides
Reference Resources for Clients Regarding
HIV/AIDS 729
CONTENTS
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18. MUSCULOSKELETAL GUIDELINES 731
Carsen CashandJill C. Cash
Neck and Upper Back Disorders 731
Plantar Fasciitis 733
Sciatica 735
Sprains: Ankle and Knee 737
Client Teaching Guides
Ankle Exercises 741
Knee Exercises 742
RICE Therapy and Exercise Therapy 743
19. NEUROLOGIC GUIDELINES 745
Justin Calabrace, Jill C. Cash, and Lauren E. Kimbrell
Alzheimer Disease 745
Bell’s Palsy 747
Carpal Tunnel Syndrome 749
Guillain–Barré Syndrome 751
Headache 755
Migraine Headache 760
Mild Traumatic Brain Injury 765
Multiple Sclerosis 769
Myasthenia Gravis 773
Neurocognitive Disorders (Dementia) 775
Parkinson Disease 778
Restless Legs Syndrome 781
Seizures 783
Seizure, Febrile (Child) 789
Stroke 791
Transient Ischemic Attack 796
Vertigo 799
Client Teaching Guides
Bell’s Palsy 805
Dementia 806
Febrile Seizures (Child) 808
Head Injury: Mild 809
Myasthenia Gravis 811
Parkinson Disease Management 812
Transient Ischemic Attack 814
20. ENDOCRINE GUIDELINES 815
Jill C. Cash and Hsiao-Hui “Joyce” Ju
Addison Disease 815
Cushing Syndrome 817
Diabetes Mellitus 819
Galactorrhea 827
Gynecomastia 828
Hirsutism 829
Hypogonadism 831
Metabolic Syndrome/Insulin Resistance
Syndrome 832
Polycystic Ovary Syndrome 834
Thyroid Disease: Hyperthyroidism 837
Thyroid Disease: Hypothyroidism 841
Thyrotoxicosis/Thyroid Storm 844
Client Teaching Guides
Addison Disease 847
Cushing Syndrome 848
Diabetes 849
21. RHEUMATOLOGIC GUIDELINES 853
Jill C. Cash and Hsiao-Hui “Joyce” Ju
Ankylosing Spondylitis 853
Fibromyalgia 855
Gout 857
Osteoarthritis 858
Osteoporosis/Kyphosis/Fracture 860
Polymyalgia Rheumatica 864
Pseudogout 865
Psoriatic Arthritis 866
Raynaud Phenomenon 868
Rheumatoid Arthritis 871
Systemic Lupus Erythematosus 874
Temporal Arteritis/Giant Cell Arteritis 877
Vitamin D Deciency 878
Client Teaching Guides
Fibromyalgia 881
Gout 882
Osteoarthritis 883
Osteoporosis 884
Polymyalgia Rheumatica 886
Pseudogout 887
Systemic Lupus Erythematosus 888
22. PSYCHIATRIC GUIDELINES 889
Kristina Potts
Anxiety 889
Attention Decit Disorder/Attention Decit
Hyperactivity Disorder 892
Bipolar Disorder 894
Depression 900
Failure to Thrive 905
Grief 907
Sleep Disorders/Insomnia 909
Suicide 913
Client Teaching Guides
ADHD: Coping Strategies for Teens and
Adults 917
ADHD: Tips for Caregivers of a Child With
ADHD 918
Alcohol and Drug Dependence 919
Bipolar Disorder 920
Grief 921
Nicotine Dependence 922
Sleep Disorders/Insomnia 923
23. ASSESSMENT GUIDE FOR SPORT
PARTICIPATION 925
Carsen Cash
Introduction 925
History 925
Physical Exam 926
Medical Eligibility for Sports Participation 926
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CONTENTS
SECTION II: PROCEDURES
Canalith Repositioning (Epley) Procedure
for Vertigo 929
Cervical Evaluation During Pregnancy: Bimanual
Examination 931
Clock-Draw Test 933
Cystometry 935
Foreign Body Removal From the Nose 937
Hernia Reduction (Inguinal/Groin) 938
Intrauterine Device Insertion 939
Neurologic Examination 941
Nonstress Test 942
SECTION III: APPENDICES
APPENDIX A NORMAL LABORATORY VALUES 959
APPENDIX B DIET RECOMMENDATIONS 963
Bland Diet 963
DASH Diet: Dietary Approaches to Stop
Hypertension 963
Fermentable Oligosaccharides, Disaccharides,
Monosaccharides, and Polyols Diet 965
Foods to Avoid While Taking Warfarin (Coumadin,
Jantoven) 967
Gluten-Free Diet 968
High-Fiber Diet 968
Lactose-Intolerance Diet 969
Low-Fat/Low-Cholesterol Diet 969
Oral Airway Insertion 943
Pap Smear and Maturation Index Procedure 944
Pregnancy: Estimating Date of Delivery 947
Prostatic Massage Technique: Two-Glass Test 948
Rectal Prolapse Reduction 949
Sprain Evaluation 950
Tick Removal 951
Trichloroacetic Acid/Podophyllin Therapy 952
Wet Mount/Cervical Cultures Procedure 953
Nausea and Vomiting Diet Suggestions (Children and
Adults) 971
Vitamin D and Calcium Handout 971
APPENDIX C TANNER’S SEXUAL MATURITY
STAGES 973
APPENDIX D TEETH 975
Deciduous (Baby) 975
Permanent 975
Index 977
LIST OF CLIENT TEACHING
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GUIDES
Abdominal Pain: Adults 423
Abdominal Pain: Children 424
Acne Rosacea 117
Acne Vulgaris 118
Acute Otitis Externa (Swimmer’s Ear) 175
Acute Otitis Media 176
Addison Disease 847
ADHD: Coping Strategies for Teens and
Adults 917
ADHD: Tips for Caregivers of a Child with
ADHD 918
Adolescent Nutrition 11
Alcohol and Drug Dependence 919
Allergic Rhinitis 191
Amenorrhea 605
Ankle Exercises 741
Aphthous Stomatitis 207
Asthma 249
Asthma: Action Plan and Peak Flow
Monitoring 250
Asthma: How to Use a Metered-Dose
Inhaler 252
Atherosclerosis and Hyperlipidemia 318
Atrial Fibrillation 317
Back Stretches 69
Bacterial Pneumonia: Adult 253
Bacterial Pneumonia: Child 254
Bacterial Vaginosis 606
Bell’s Palsy 805
Bipolar Disorder 920
Bronchiolitis: Child 255
Bronchitis, Acute 256
Bronchitis, Chronic 257
Celiac Disease 425
Cerumen Impaction (Earwax) 178
Cervicitis 607
Chickenpox (Varicella) 697
Childhood Nutrition 12
Chlamydia 631
Cholecystitis 426
Chronic Obstructive Pulmonary Disease 258
Chronic Pain 70
Chronic Venous Insufciency 319
Colic: Ways to Soothe a Fussy Baby 427
Common Cold 259
Conjunctivitis 163
Constipation Relief 429
Contraception: How to Take Birth Control Pills
(For a 28-Day Cycle) 608
Cough 260
Crohn’s Disease 430
Croup, Viral 261
Cushing Syndrome 848
Deep Vein Thrombosis 320
Dementia 806
Dermatitis 119
Diabetes 849
Diarrhea 432
Dysmenorrhea (Painful Menstrual Cramps
or Periods) 609
Dyspareunia (Pain with Intercourse) 610
Eczema 120
Emergency Contraception:
Levonorgestrel 611
Emergency Contraception:Ulipristal
Acetate 612
Emphysema 262
Endometritis 545
Epididymitis 495
Erythema Multiforme 121
Exercise 13
Eye Medication Administration 164
Febrile Seizures (Child) 808
Fibrocystic Breast Changes and Breast
Pain 613
Fibromyalgia 881
Folliculitis 122
Gastroesophageal Reux Disease
(GERD) 434
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LIST OF CLIENT TEACHING GUIDES
Genitourinary Syndrome (Atrophic
Vaginitis) 614
Gestational Diabetes 546
Gonorrhea 632
Gout 882
Grief 921
Head Injury: Mild 809
Hemorrhoids 435
Herpes Simplex Virus 633
Herpes Zoster or Shingles 123
Human Papillomavirus 634
Infant Nutrition 14
Inuenza (Flu) 698
Insect Bites and Stings 124
Insulin Therapy During Pregnancy 547
Iron-Deciency Anemia (Pregnancy) 549
Irritable Bowel Syndrome 436
Jaundice and Hepatitis 437
Kidney Disease: Chronic 496
Knee Exercises 742
Lactose Intolerance and Malabsorption 439
Lice (Pediculosis) 126
Lichen Planus 127
Lyme Disease and Removal of a Tick 700
Lymphedema 322
Mastitis 550
Menopause 615
Mononucleosis 702
Myasthenia Gravis 811
Nicotine Dependence 922
Nosebleeds 192
Oral Thrush in Children 208
Osteoarthritis 883
Osteoporosis 884
Otitis Media With Effusion 177
Parkinson Disease Management 812
Pelvic Inammatory Disease 616
Peripheral Arterial Disease 323
Pharyngitis 209
Pityriasis Rosea 128
Pneumonia, Viral: Adult 263
Pneumonia, Viral: Child 264
Polymyalgia Rheumatica 886
Postpartum: Breast Engorgement and
Sore Nipples 551
Premenstrual Syndrome 617
Preterm Labor 553
Prostatic Hypertrophy/Benign 501
Prostatitis 502
Pseudogout 887
Psoriasis 129
Pyelonephritis: Urinary Tract Infection During
Pregnancy 555
Reference Resources for Clients Regarding
HIV/AIDS 729
Respiratory Syncytial Virus 265
RICE Therapy and Exercise Therapy 743
Ringworm (Tinea) 130
Rocky Mountain Spotted Fever and
Removal of a Tick 703
Roundworms and Pinworms 440
Scabies 131
Seborrheic Dermatitis 132
Shortness of Breath 266
Sinusitis 193
Skin Care Assessment 133
Sleep Apnea 267
Sleep Disorders/Insomnia 923
Supercial Thrombophlebitis 324
Syphilis 635
Systemic Lupus Erythematosus 888
Testicular Self-Examination 503
Tinea Versicolor 135
Tinnitus 179
Toxoplasmosis 705
Transient Ischemic Attack 814
Trichomoniasis 636
Ulcer Management 441
Urinary Incontinence: Females 504
Urinary Tract Infection (Acute Cystitis) 505
Vaginal Bleeding: First Trimester 556
Vaginal Bleeding: Second and Third
Trimesters 557
Vaginal Yeast Infection 618
Varicose Veins 325
Warts 136
Wound Care: Lower Extremity Ulcers 137
Wound Care: Pressure Injuries/Ulcers 138
Wound Care: Wounds 139
Wound Infection: Episiotomy and Cesarean
Section 558
Xerosis (Winter Itch) 140
Zika Virus Infection 706
CONTRIBUTORS
https://t.me/med1917
Rhonda Arthur, DNP, LNP, CNM,
WHNP-BC, FNP-BC, CNE
Associate Professor
Frontier Nursing University
Floyd, Virginia
Emily Y. Brignola, DNP, APRN, FNP-C
Division of Otology
Department of Otolaryngology—Head and
Neck Surgery
Vanderbilt University Medical Center
Nashville, Tennessee
Amy C. Bruggemann, MS, APRN-BC, CWS
Director of Clinical Operations
Specialized Wound Management
Chestereld, Missouri
Justin Calabrace, RN, MSN, ACNP-BC
Lead Neurocritical Care Nurse Practitioner
Assistant in Anesthesiology
Department of Anesthesiology
Division of Critical Care
Vanderbilt University Medical Center
Nashville, Tennessee
Jill C. Cash, MSN, APRN, FNP-BC
Nurse Practitioner
Department of Medicine
Vanderbilt Medical Group
Westhaven Family Practice
Franklin, Tennessee
Vanderbilt University Medical Center
Nashville, Tennessee
Carsen Cash, MD
Resident Physician
Department of Physical Medicine and
Rehabilitation
Vanderbilt University Medical Center
Nashville, Tennessee
Audra Malone Cave, DNP, FNP-BC
Assistant Professor
Department of Family Nursing
Frontier Nursing University
Versailles, Kentucky
Doncy J. Eapen, PhD, MSN, APRN, FNP-BC
Assistant Professor, Clinical, AVA Scholar
Department of Undergraduate Studies
Cizik School of Nursing
UTHealth Houston
Houston, Texas
LaDawna Goering, DNP, APRN, ANP-BC,
BC-ADM
Cizik School of Nursing
The University of Texas Houston Health
Science Center
Houston, Texas
Debbie A. Gunter, APRN, FNP-BC, ACHPN
Nurse Practitioner
Neurology and Palliative Care
Emory University
Atlanta, Georgia
Dana N. Hughes, MPH, MSN
Assistant in Medicine
NP Ambulatory
Department of Medicine
Division of Infectious Diseases
Vanderbilt University Medical Center
Nashville, Tennessee
Hsiao-Hui “Joyce” Ju, DNP, APRN,
FNP-BC, CNE
Cizik School of Nursing at UTHealth
Houston, Texas
Lauren E. Kimbrell, BS, MSN
Critical Care Nurse Practitioner
HCA Physician Services Group
Intensive Care Consortium
Centennial Medical Center
Nashville, Tennessee
Kristin K. Ownby, PhD, RN, ACHPN,
AOCN, ANP-BC
Associate Professor of Clinical Nursing
Department of Undergraduate Studies
Cizik School of Nursing
UTHealth Houston
Houston, Texas
Laura Petty, MSN, GNP-BC
Gerontological Nurse Practitioner
Lebanon, Tennessee
Kristina Potts, MSN, FNP-BC
Nurse Practitioner
St. Luke’s Fenton Family Physician
Fenton, Missouri
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CONTRIBUTORS
Kathleen Siders, DNP, APRN, FNP-C
Co-Director, DNP Program
Assistant Professor
Department of Graduate Studies
Cizik School of Nursing
UT Health Houston
Houston, Texas
Sarah Hendershott Taylor, MSN, FNP-C
Otolaryngology Nurse Practitioner
Vanderbilt University Medical Center
Nashville, Tennessee
Nancy Pesta Walsh, DNP, MSN, FNP
Assistant Professor
Frontier Nursing University
Versailles, Kentucky
Family Nurse Practitioner
Glacial Ridge Health System
Glenwood, Minnesota
Penny Wortman, DNP, CNM, CNE
Assistant Professor
Department of Midwifery and Women's Health
Frontier Nursing University
Cedar Falls, Iowa
PREFACE
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We are excited to collaborate on this sixth edition of Family Practice Guidelines. The guidelines
have been written and updated by experienced nurse practitioners. This valuable resource is
designed to assist nurse practitioners in organizing and using the content in a quick-reference
format. Emphasis is placed on history taking, physical examination, and key elements of the diagnosis. Useful website links have also been incorporated, along with updated client teaching guides.
This book is organized into chapters using a body-system format. The disorders included within
each chapter are organized in alphabetical sequence for easy access. Disorders that are more commonly seen in the primary care setting are included. Clinical pearls and bold and italic text alert the
practitioner to key information throughout the chapters. Client teaching guides are also available for
many topics and appear at the end of their respective chapters. These guides are also available as
downloadable PDFs
ORGANIZATION
The book is organized into two main sections:
■
Section I: Guidelines: Chapters containing the individual disorder guidelines.
■
Section II: Procedures: Procedures that are commonly conducted within the ofce or clinic setting.
NOTABLE UPDATES
■
The sixth edition has been updated and features new disease topics, tables, algorithms, and
updated clinical content for each system.
■
Health Maintenance: Centers for Disease Control and Prevention (CDC) guidelines on health
maintenance and immunization schedules for adults and children.
■
Dermatology Guidelines: Dermatology guidelines include color photos of skin rashes/disorders and the newest treatment guidelines.
■
Respiratory Guidelines: Focused guidelines for the management of asthma and more.
■
Cardiovascular Guidelines: Updated guidelines for heart failure and hypertension.
■
Genitourinary Guidelines: Updated management of urinary tract infections, erectile dysfunction, and premature ejaculation.
■
Neurologic Guidelines: Key updates for stroke management.
■
Infectious Diseases: Current CDC guidelines on the management of coronavirus (COVID-19).
We hope you are able to use the sixth edition of Family Practice Guidelines in education and practice and nd it a valuable resource to guide your clinical decision-making for your clients.
—Jill C. Cash
https://t.me/med1917
ACKNOWLEDGMENTS
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It has been a pleasure to work with the editorial staff and production team at Springer Publishing
Company.
To Joe Morita, Executive Acquisitions Editor: Thank you for being a steadfast proponent of this
work.
To Taylor Ball, Director, Content Development: Thank you for your energy, enthusiasm, and
support that you always shared on our Friday afternoon Zoom calls when planning the development of this textbook.
To Kris Parrish, Production Manager, andJoanne Jay, Vice President, Production: Thank you
for your talent and support in nalizing the material and guiding this book toward publication.
—Jill
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