Subject(s)
Emergency Nursing , Heart Diseases/diagnosis , Nursing Assessment , Panic Disorder/diagnosis , Adult , Diagnosis, Differential , Education, Nursing, Continuing , Emergency Nursing/education , Female , Humans , Hyperventilation/diagnosis , Male , Middle Aged , Panic Disorder/physiopathologyABSTRACT
Panic disorder affects approximately 1.5 percent of the general population in the United States, and individuals with this disorder are seen frequently in primary care settings. Recognition of panic disorder is complicated by the fact that patients tend to focus exclusively on the physical symptoms of the illness. Left untreated, patients with panic disorder suffer considerable impairment in functioning and are at increased risk for substance abuse, depression and suicide. This article provides clinicians with the information necessary to recognize and manage this illness. A detailed description of the disorder, including onset, course, complications, differential diagnosis and management, is presented in this article.
Subject(s)
Clinical Protocols/standards , Nurse Practitioners , Nursing Assessment/methods , Panic Disorder/nursing , Diagnosis, Differential , Humans , Nutrition Assessment , Panic Disorder/diagnosis , Panic Disorder/therapy , Patient Education as Topic , Psychotropic Drugs/administration & dosage , Psychotropic Drugs/adverse effects , Psychotropic Drugs/therapeutic useABSTRACT
The Preventive Health Examination (PHE) program was designed to screen for cancer of the lung, colon, skin, and prostate (or breast) and to detect the risk factors for coronary artery disease, i.e., arterial hypertension, hypercholesterolemia, cigarette smoking, and obesity. To investigate the cost-effectiveness of PHE performed by nurse practitioners, the first 176 subjects enrolled in the PHE program at a northeastern, suburban VA Medical Center were evaluated prospectively. The subjects were recruited through random mailing. The direct cost of PHEs was $80 per patient. PHEs were performed on 171 men and 5 women, mean age 57.2 years, divided into groups according to the date of evaluation. Nine percent of patients had findings highly suspicious of cancer (lung nodules in 7, skin lesions in 9). As a consequence, one patient underwent lobectomy for squamous carcinoma of the lung and another underwent prostatectomy for adenocarcinoma of the prostate. Fifty-five percent of patients had high cholesterol levels, 53% were obese, 30% were heavy cigarette smokers, and 19% were hypertensive. Nineteen percent of the patients had three or more coronary artery disease risk factors. We conclude that low cost PHEs performed by nurse practitioners have a high yield in detecting risk factors for coronary artery disease, and for detecting potentially treatable malignancies.
