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Volume XI, Issue VI

June 2011

Take advantage of discounts and information only available

to FHEA Facebook fans!

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NP Certification Exam Review Courses

Offer of the Month 10% off Expert Exam:

Primary Care Neurologic Exam

Setting the Stage for Success in Your New NP Role

Part II By Margaret A. Fitzgerald,

DNP, FNP-BC, NP-C, FAANP, CSP

Fitzgerald Health Education Associates, Inc.

NP Certification Exam Preparation and

Continuing Education

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Adult and Family Tracks

06/13/2011 Milwaukee, WI

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Editor’s Note: The first half of this article was featured in the May 2011 edition of FHEA News, which can be found at (http://fhea.com/ezine_archive.shtml). This is the continua-tion of that article. What do I believe will be my personal contribution to NP practice? Be able to verbalize what you can add to NP practice. What will be your special contribution? What skill, pas-sion, and experience do you carry from your education, professional, and personal experience? What opportuni-ties do you plan to seek out that will further enhance your role as an NP? Where do I envision myself professionally and person-ally in 1, 5, and 10 years? Long-term professional goals may be hard to view. How-ever, by thinking futuristically about your contribution to NP practice, you can help set the stage for your prac-tice transition. Keep in mind that interviewers often ask candidates about their professional goals. Professional and personal issues, of course, intersect. Think of how your personal goals will have an impact on those you set professionally. How will holding a graduate degree influence the sal-ary I am offered? You likely needed to earn a master of science (MS), doc-tor of nursing practice (DNP), or postgraduate certificate during your NP education. You probably assume that the salary offered should reflect your educational achieve-ment; however, the marketplace often views graduate studies simply as a vehicle for NP preparation. Identify the subset of valuable skills that are acquired in gradu-ate education. These skills include the following: (Continued on page 6)

Inside this issue:

Human Milk Storage and

Use for the Healthy Term

Infant at Home, by Marie L.

Bosco, BSN, RNC, IBCLC

2

Fitzgerald Health Educa-

tion Raffle Winners! 2

Come see us in person! 2

NP News in Brief 3

Dr. Fitzgerald to be in-

ducted as a Fellow in the

American Academy of

Nursing

3

Vitamin D Deficiency: As-

sessing and Intervening in

this Common Condition

Part II

4

Dr. Fitzgerald’s Upcoming

Speaking Engagements 4

NHLBI Study, AIM-HIGH, Comes to an Early End by Jaclyn Fitzgerald, Assis-tant Editor

5

Important System Update

Information 7

New and Updated Products 8

Clinical Pharmacology for

NPs and Advanced Practice

Clinicians

9

Advanced Pathophysiology

for NPs and Advanced

Practice Clinicians

10

Pharmacology Updates 11

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Human Milk Storage and Use for the Healthy Term

Infant at Home by Marie L. Bosco, BSN, RNC, IBCLC

Breastfeeding News

Breastmilk is the optimal nutrition for infants during the first 6 months after birth. Separation during breastfeeding can occur for a variety of reasons. When this separation is inevi-table, mother’s milk may continue to be fed to the infant if milk is stored for such occasions. Human milk is fresh, living, and is full of antioxidants, antibacterial components, prebiot-ics, and probiotics. Although some of these components may be altered during storage or rewarming, breastfeeding re-mains the gold standard for infant feeding. Knowledge of how to express, store, and serve human milk to the infant is essen-tial to the breastfeeding couplet when separation occurs. The Academy of Breastfeeding Medicine Clinical Protocol for Human Milk Storage Information for Home use for Full-Term Infants was revised in 2010 after review of current research. The protocol states that when preparing to express milk, women should wash their hands with soap and water or wa-terless cleanser, and use pump equipment that is cleaned per the inserted instructions. The milk can be stored in glass or bisphenol A free plastic bottles or sturdy polypropylene bags designed for human milk storage. Containers do not need to be sterilized and the mother’s nipples do not require washing prior to expressing milk. Freshly expressed milk may be safely stored at room tem-perature (60° to 85° F) for 3 to 4 hours. It can be refrigerated for 5 to 8 days, although optimal usage is within 72 hours. Bactericidal capacity of stored refrigerated milk decreases significantly after 48 to 72 hours (Silverstre et al., 2006). Freezing breastmilk at 0° F is considered safe for at least 3 months and up to 12 months. The antibacterial activity of frozen milk is preserved for at least 6 weeks. Total protein, fat, lactose, zinc, immunoglobulins, lactoferrin, vitamins A, E, and B, are generally preserved during freezing (Marin et al., 2009). All breastmilk should be stored in the rear of the freezer to prevent exposure to warmer temperatures during opening and closing of the freezer door. It is important to leave room for expansion of milk during freezing and to label with date of expression. Typical volumes stored per con-tainer range from 2 to 3 oz, which can prevent excessive wasting of milk. Human milk may be added to previously fro-zen milk or refrigerated milk if it is cooled first. Stored hu-man milk often smells or tastes different than fresh milk be-cause of the lipase activity. This altered milk is not harmful to the infant, although some infants refuse to drink it. (Continued on page 8)

Come see us in person!

We will be exhibiting at the following locations:

Date Location

June 22 to

June 26, 2011

American Academy of Nurse

Practitioners 26th National Conference

The Venetian and The Palazzo and Sands

Expo and Convention Center

3355 Las Vegas Blvd.

South Las Vegas, NV 89109

July 14 to

July 17, 2011

National Primary Care NP Symposium

Cooper Mountain Conference Center

209 Ten Mile Cir.

Copper Mountain, CO 80443

July 30 to

July 31, 2011

Southwest Regional Nurse Practitioner

Conference

High Country Conference Center

Flagstaff, AZ 86001

September 8 to

September 11

Texas Nurse Practitioner Conference

Omni Hotel

Fort Worth, TX 76102

June 2011

Fitzgerald Health Education Raffle Winners! Fitzgerald Health Education Associates recently held a raffle drawing at the National Conference for Nurse Practitioners in Las Vegas, Nevada. We would like to congratulate Teresa Casey for winning the audio CD set Clinical Challenges in Pri-mary Care by Margaret Fitzgerald and associates. We would also like to congratulate Margaret Gehring for winning the book Nurse Practitioner Certification Examination and Prac-tice Preparation, 3rd Edition by Margaret Fitzgerald. Raffles are held at all of our exhibit locations. For a list of our upcoming exhibit locations, please see the table below.

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NP News in Brief RN Receives Army Surgeon General Nomination Maj. Gen. Patricia D. Horoho was nominated by President Barack Obama last month to be the US Army surgeon general. Horoho, a regis-tered nurse, is currently the Army deputy surgeon general and the 23rd chief of the Army Nurse Corps. If the nomination is approved by the Senate, Horoho would be the first female and the first RN appointed to the position of Army surgeon general, which would also promote her to the rank of three-star general. She has presided over more than 9,000 nurses in the Army, Army Reserve, and Army National Guard. If elected, she would become the senior officer of the US Army Medical Depart-ment and act as the commanding general of the US Army Medical Com-mand at Fort Sam Houston in San Antonio, TX. Read More

Nurses and Nurse Practitioners Improve Mental Health Care Nurses can help to change the way that mental health patients are treated by bridging the gap between primary care and psychiatric care. To improve access to mental health care, NPs and RNs in all practice settings should know how to care for patients with mental health con-cerns. NPs and RNs should openly communicate with their patients about their emotions, because mental health issues have a significant impact on overall health. The American Psychiatric Nurses Association recently received a federal grant to promote its Recovery to Practice Initiative, a resource designed to promote a recovery model to aid all healthcare professionals in treating mental health patients. Read More

June 2011

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We are pleased to announce that Dr. Fitzgerald, president of Fitzgerald Health Education Associates, Inc. will be inducted as a Fellow in the American Academy of Nursing (AAN). This exclusive designation recognizes outstanding contributions and achievements in nursing. Academy nursing Fellows are handpicked based on their contribution to nursing educa-tion, practice, and research. The 1,500 AAN Fellows are com-prised of nursing faculty members, political appointees, vice presidents, nurse consultants, and others. Fellows help to enhance the quality of healthcare by reducing health dispari-ties and inequalities, and strengthen overall healthcare deliv-ery across the globe. AAN Fellows also contribute a great deal of their time and energy to the Academy. Dr. Fitzgerald will be inducted as AAN Fellow in October of 2011 at the American Academy Induction Ceremony on Capitol Hill in Washington, DC.

Need a Speaker?

If you are interested in having Dr. Fitzgerald or one of

our other talented associates speak at your school, lo-

cal, regional or national conference, please e-mail:

services@fhea.com for more information. Conference

administrative services are also available.

Dr. Margaret Fitzgerald to be inducted as a Fellow

in the American Academy of Nursing

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Editor’s Note: The first half of this article was featured in the April edition of FHEA News which can be found at: http://fhea.com/ezine_archive.shtml. This is the continuation of that article. Diagnosing Vitamin D Deficiency The preferred test for assessment of vitamin D status is a se-rum 25-hydroxyvitamin D; the results are minimally influ-enced by recent dietary intake or recent sun exposure. The alternative test, serum 1,25-dihydroxy vitamin D, typically does not become altered until vitamin D deficiency is well ad-vanced. Opinions differ on what constitutes deficiency. A physiologic deficiency is defined at a level of serum 25-hydroxyvitamin D that is sufficiently low and causes an increase in the parathy-roid hormone (PTH) levels. These hormone levels rise to cor-rect calcium levels via increased bone turnover and acceler-ated bone loss, clearly a point later in the disease process. While a measure of 25-hydroxyvitamin D <8 ng/mL (20 nmol/L) is sometimes reported as deficient per lab norms, clinical studies have revealed increased PTH levels with 25-hydroxyvitamin D levels of 20 ng/mL (50 nmol/L). As a re-sult, although most laboratories report the normal range to be 20 to 100 ng/mL (50 to 250 nmol/L), the preferred range is likely 30 to 60 ng/mL (75 to 150 nmol/L). According to Dr. Michael Holick, a recognized expert in the area of vitamin D deficiency and its clinical effects, maximum calcium trans-port, lowest parathyroid hormone levels, greatest muscle strength, and bone density occur when 25-hydroxyvitamin D levels are above 30 ng/mL (75 nmol/L). Vitamin D Deficiency—Treatment and Prevention Increasing skin exposure to the sun is helpful in avoiding and treating vitamin D deficiency, albeit with the accompanying well document risk of photoaging and skin cancer. With that in mind, a sensible compromise is exposure of the arms and legs, without sunscreen, to about 5 to 10 minutes of sunlight. Depending on the latitude, approximately 3000 IU of vitamin D3 will be synthesized by the body in a UVA dose that will seldom cause sunburn or other thermal damage. Repeating this exposure two to three times per week is a helpful method of avoiding vitamin D deficiency but is impractical for people living in more northern latitudes with weaker sun rays and (Continued on page 7)

Dr. Fitzgerald’s Upcoming Speaking Engagements

Date Location Topics

June 16, 2011

MinuteClinic Dinner Program

Radisson Hotel Columbia

2100 Bush River Road

Columbia, SC 29210

Click here

for more

information

June 24-26,

2011

American Academy of Nurse

Practitioners 26th National

Conference The Venetian and the Palazzo &

Sands Expo and Convention Ctr

Las Vegas, NV 89109

Click here

for more

information

June 29, 2011 CareOne at Evesham Maggianos Route 38, Suite 1180

Cherry Hill, NJ 08002

Click here

for more

information

July 14, 2011

National Primary Care NP Sym-

posium

Cooper Mountain Conference

Center

209 Ten Mile Cir.

Copper Mountain, CO 80443

Click here

for more

information

July 23, 2011

Fitzgerald Health Education

Advanced Pathophysiology

Course Manhattan, NY

Click here

for more

information

What Our Customers Say About us on Facebook

Took my ANCC Boards and passed them! Your CDs and live seminar helped out tremendously along with the amount of time I put into studying. I am truly blessed :) —JP, Niagara Falls, Ontario Just attended the NYC ANP review course. Thank you Dr. Fitz-gerald for the good strategies to help me prepare for my boards! —LPB, Bethpage, New York

Join the conversation today!

June 2011

Vitamin D Deficiency: Assessing and Intervening in this Common Condition

Part II By Margaret A. Fitzgerald,

DNP, FNP-BC, NP-C, FAANP, CSP

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5

Live Q&A with Dr. Fitzgerald

Have questions about the certification exam? Attend a live on-line Q&A session that covers the content presented in Dr. Fitzgerald’s NP Certification Exam Review Seminar. Listen and interact with Dr. Fitzgerald as she answers your questions and the questions of your classmates. Adult NPs will have access to two sessions and Family NPs will have access to three. Each of these sessions are 1.25-hours and include audio and visual aids as needed.

This program is available as:

A bundle package with the on-line NP Certification Exam Review Click here for more information about this program

An add on product for the live or recorded NP Certification Exam Review Click here for ANP track Click here for FNP track

June 2011

NHLBI Study, AIM-HIGH, Comes to an Early End by Jaclyn Fitzgerald, Assistant Editor

A clinical trial involving a high dosage of extended release niacin to regulate cholesterol levels has been brought to an early end because the majority of patients involved saw little to no benefits.

The Atherothrombosis Intervention in Metabolic Syndrome with Low HDL Cholesterol/High Triglyceride and Impact on Global Health Outcomes (AIM-HIGH) study was designed for patients with cardiovascular diseases, heart diseases, coronary disease, myocar-dial infarction, atherosclerosis, and cerebrovascular accident. The 3,414 participants were treated with a combination of 40-80 mg/dL of simvastatin (Zocor) to decrease low-density lipoproteins (LDL), or “bad” cholesterol, and 1,500-2,000 mg/day of extended release niacin (Niaspan) to raise high-density lipoprotein (HDL), or “good” cholesterol. More than half of the participants (1,718) were given increasing doses of extended release niacin, while others were given a placebo. Approximately 515 participants were also given 10 mg/day of ezetimibe (Zetia), a medication intended to lower LDL choles-terol. The clinical trial, which was sponsored by the National Heart Lung and Blood Institute (NHLBI) in collaboration with Abbott Pharma-ceuticals, began in September 2005 and was originally slated to end in September 2012. Acting Director of the NHLBI, Dr. Susan B. Shurin, announced on May 26 that the study would be cut short due to the belief that participants experienced no significant benefits under this form of therapy. NHLBI investigators stated that the dosage of niacin used in the study did cause a 20% increase in HDL levels and a 25% decrease in triglycerides; however, there was little to no impact on the occur-rence of cardiovascular incidents. Overall, the treatments used in the study did not produce a notable decrease in the five-component end point (fatal or nonfatal MI, strokes, hospitalizations for acute coronary syndrome, or revascularization procedures). Of the par-ticipants taking extended release niacin, 28 strokes were reported (1.6%), whereas the control group reported 12 strokes (0.7%). NHLBI also noted that less than 1% of participants taking extended release niacin were at an increased risk for ischemic stroke. Despite the outcome of the AIM-HIGH study, the US Food and Drug Administration (FDA) does not plan to change the warning label for extended release niacin. The complete findings of the study will be published in a peer-reviewed journal at a later date.

References:

Nainggolan, Lisa. NIH Pulls Plug on AIM-HIGH Trial With Niacin. Medscape. http://www.medscape.com/viewarticle/743456?sssdmh=dm1.690720&src=nl_newsalert. Accessed on June 1, 2011. ClinicalTrials.gov. Niacin Plus Statin to Prevent Vascular Events. http://clinicaltrials.gov/ct2/show/NCT00120289. Accessed on June 1, 2011

FHEA News welcomes articles, news, comments and

ideas from its readers!

Please e-mail jaclyn@fhea.com with submissions.

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(New NP Role: Continued from page 1)

Grant writing and program proposal development skills–These were no doubt gained during the devel-opment of your thesis, scholarly project, or other capstone project.

Teaching skills– Remember all the presentations from your graduate program? Did you teach or tutor undergraduate nursing students? Did you work with families? You most likely have considerable teaching experience, even if you have never held a faculty position.

Design and development of community and patient education programs and materials.

What do I know about my state’s requirements for NP practice? The educational preparation needed for entry into ad-vanced practice nursing, as well as the nurse practitio-ner’s scope of practice and prescriptive authority, is de-termined at the state level. Prior to applying for any posi-tion, be prepared to answer questions about your state’s requirements for advanced practice act. You can find more information at https://www.ncsbn.org/boards.htm. Also, become well-versed about your ability to obtain a federal Drug Enforcement Administration (DEA) number that is needed to prescribe controlled substances. To find out the scope of NP controlled sub-stance authority, and to learn more about controlled sub-stances schedules, visit http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html. To access the appropriate application materi-als, visit http://www.deadiversion.usdoj.gov/drugreg/reg_apps/onlineforms_new.htm. Find out about Medicare, Medicaid, and other insurances and their policies on reimbursement to nurse practitio-ners, and how to obtain your National Provider Identifier (NPI). For additional information, visit http://www.cms.hhs.gov/NationalProvIdentStand/downloads/npi_fs_geninfo_010906.pdf. Have a plan in place to become nationally certified as a nurse practitioner. Many employers require this as a con-dition of hire, and most states require this as a condition of obtaining an advanced practice nursing license. Ac-quire the necessary paperwork and organize your docu-ments so that you can proceed with this in an expeditious manner.

How can I explain to others what the NP role is? By the end of these exercises, you should be able to provide a brief explanation of your view of the NP role. Having a print resource on hand can also be very helpful, particularly when dealing with a practice that has no NPs currently on staff. The American Academy of Nurse Practitioners has helpful docu-ments on its website, including the NP Scope of Practice State-ment. For more information, visit http://www.aanp.org/AANPCMS2/AboutAANP/About+NPs.htm. The American Col-lege of Nurse Practitioners also has helpful resources, includ-ing NP Fact Sheets. For more information, visit http://www.acnpweb.org/i4a/pages/index.cfm?pageID=3479. These items will be valuable if you are attempting to create the first NP position in a practice. Now that you have completed your time of reflection, it is time to launch your new career. All of us at Fitzgerald Health Educa-tion Associates, Inc., wish you great success. Welcome to the best work on Earth!

Related Articles

Dr. Fitzgerald has written many articles concerning NP Certifi-cation. Click the link below to read dozens of articles she has written sharing exclusive insights she has gained over 20 years of helping nurse practitioners prepare for the certification ex-ams. NP Certification Information: http://fhea.com/certificationcols/certfaqfhea.shtml

Related Products

Fitzgerald Health offers nurse practitioner certification pro-grams in a variety of formats. You can complete our NP prepa-

ration course from home with the on-line or CD recording, or you can attend a live course. Be even more prepared with Dr. Fitzgerald’s Nurse Practitioner Certification Examination and Practice Preparation, 3rd Edition. This updated book based on the AJN Book of the Year 2nd edition gives clinical pointers of-fering practice pearls and words of advice,

in-depth discussions of disorders and their diagnosis and treat-ment, with questions and answers to test your knowledge base, and much more!

Order these products here

June 2011

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(Vitamin D Deficiency: Continued from page 4) long, cold, often overcast winters. Dietary intake of vitamin D-rich foods is somewhat helpful, keeping in mind that few foods are naturally abundant in this important micronutrient. Orange juice, milk, and many other dairy products are vitamin D forti-fied, usually with vitamin D3 100 IU per serving. Food with naturally occurring high levels of vitamin D3 include salmon, tuna, and sundried shitake mushrooms. Since sufficient vitamin D intake is difficult to achieve via die-tary means and sun exposure, supplements are usually re-quired. The typical adult dose long recommended is vitamin D3 400 to 800 IU daily; due to its ability to be stored in fat and long T ½, this low supplementation is not sufficient to correct a defi-ciency. Vitamin D3 (cholecalciferol) is the preferred supple-ment, as this form is less likely toxic in megadoses, more potent, has a longer half-life, and is better able to raise levels in defi-ciency. When compared to vitamin D2 (ergocalciferol), vitamin D3 form is approximately 80% more potent. According to Hol-ick’s recommendations, a dose of 50,000 IU of vitamin D2 (as vitamin D3 is usually not available in a megadose) once a week for 8 weeks will likely be needed. A follow up for long-term pre-vention accomplished by giving 50,000 IU of vitamin D2 every 2 to 4 weeks will be needed thereafter. If megadose supplementa-tion is not desirable or practical, vitamin D deficiency can be treated with a daily use of the micronutrient. Daily use of vita-min D3 1000 IU for 3 months will result in a 10 ng/mL (25 nmol/L) increase in vitamin D levels, while 2000 IU (50 mcg) per day will increase the level by 20 ng/ml (50 nmol/L). Opinions differ on the hazards of excessive vitamin D supple-mentation, though not excessive sun exposure. Vitamin D intoxi-cation is usually only noted with protracted supplementation with doses of 50,000 IU per day; the usual clinical consequence is hypercalcemia and hyperphosphatemia. Prudent practice dic-tates that healthcare providers be aware of the patient’s overall health status and the select conditions, such as chronic renal failure and chronic granulomatous disorders, where vitamin D supplement requirements usually vary. On a personal note, I have treated numerous patients for vita-min D deficiency with many achieving great health benefits.

Maintaining a high index of suspicion for this common clinical problem is the first step in successful diagnosis and treat-ment.

References Holick MF. Strategies to Prevent and Treat Vitamin D Deficiency, N Engl J Med 2007;357:266-281. Holick, M., Vitamin D Deficiency: What a Pain It Is, Mayo Clin Proc. 2003;78:1457-1459 Available at http://www.mayoclinicproceedings.com, accessed 6.1.11 Linus Pauling Institute: Micronutrient Information Center: Vitamin D, available at http://lpi.oregonstate.edu/infocenter/vitamins/vitaminD/, accessed 6.1.11. Moyad, M., Vitamin D: A Rapid Review, available at http://www.medscape.com/viewarticle/589256, accessed 5.20.11. Plotnikoff, G., Quigley, J. Prevalence of Severe Hypovitaminosis D in Patients With Persistent, Nonspecific Musculoskeletal Pain. Mayo Clin Proc. 2003;78:1463-1470, available at http://www.ncbi.nlm.nih.gov/pubmed/14661675, accessed 6.1.11. Tangpricha, V., eMedicine: Vitamin D Deficiency and Related Disor-ders, available at http://www.emedicine.com/med/topic3729.htm,

Important System Update Information

Routine maintenance is scheduled for June 18, 2011. FHEA is com-mitted to providing our customers maximum uptime, reliability, and security for our On-line Testing and Learning Site, www.npexpert.com. Regular system maintenance is critical to achieving this goal. System maintenance is normally performed the third Saturday of each month.

June 2011

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Click here for more information about these products

New and Updated Products

(Human Milk Shortage: Continued from page 2) Milk can be served cold or at room temperature, but it should not be heated above 104°F (40°C) as it alters enzyme activity. Generally, fresh milk is better than frozen milk and the oldest milk should be used first to prevent waste and optimize bene-fits. Frozen milk should be defrosted overnight in the refrigera-tor or thawed in warm tap water. A microwave is not recom-mended as it heats unevenly and decreases anti-infectives in the milk (Quan et al., 1992). Once thawed milk is defrosted and brought to room temperature, it should not be left out more than a few hours because once the baby begins drinking the prepared milk, some contamination occurs from the infant’s mouth; as a result, milk should be discarded within 1 to 2 hours. Mothers can continue to feed and store human milk even if there is evidence of bacteria or yeast on the nipple. However, if the human milk appears purulent, foul, or has an altered tex-ture, the milk should not be fed to the baby.

June 2011

Human milk remains the gold standard for infant nutrition. With appropriate milk expression, storage, and handling, breastmilk can be given to the infant even when separation oc-curs. Support from the healthcare professional, the workplace, and the community continue to be an integral piece of breast-feeding longevity. References

ABM Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants. Breastfeeding Medicine. 2010, 5:3, 127-130. Silvestre D, Lopez MC, March L, et al. Bactericidal Activity of Human Milk: Stability during Storage. Br J Biomed Sci 2006; 63:59-62. Marin ML, Arroy R, Jimenez E, et al. Cold storage of human milk: effects on its bacterial composition. J Pediatr Gastroenterol Nutr 2009; 49:343-348. Quan R, Yang C, Ruginstein S, et al. Effects of microwave radiation on anti-infective factors in human milk. Pediatrics 1992; 89:667-669.

This revised edition has 300 additional problem-oriented, multiple-choice questions divided accord-ing to content area and includes answers, ration-ales, and bibliographic references. Prepared by board certified nurse practitioners, the questions are representative of those found on the American Midwifery Certification Board (AMCB) exam or women's health nurse practitioner exam from the National Certification Corporation (NCC).

Midwifery & Women's Health Nurse Practitioner Certification Study Question Book, Second Edition

This comprehensive review is designed specifi-cally for those preparing to take the American Midwifery Certification Board (AMCB) or the National Certification Corporation (NCC) women's health nurse practitioner certification exams. Completely revised and updated, the Second Edition has new questions in each chap-ter and contains more than 600 sample test questions representative of questions found on the examinations.

Midwifery & Women's Health Nurse Practitioner Certification Review Guide, Second Edition

Pediatric Nurse Practitioner Certification Study Question Book, Third Edition

Clinical Consult for Psychiatric Mental Health Care

This quick reference serves as an authoritative clinical guide to diagnos-tic treatment and moni-toring recommendations for patients with mental disorders in the primary care setting. It offers fast and efficient access to evidence-based diagnos-tic and therapeutic guide-

lines for managing psychiatric and mental health conditions.

Pediatric Nurse Practitioner Certification Review Guide: Primary Care, Fifth Edition

This book has been developed especially for pediatric nurse practi-tioners and family nurse practitioners preparing to take certification ex-aminations and as a reference in the practice setting. The text is di-vided into systems with an in-depth coverage of

growth and development and health promotion and maintenance.

This book is the ideal review guide for pediat-ric nurse practitioners and family nurse practi-tioners preparing to take certification exams and as a reference in the practice setting. The content of this book is divided into systems with an in-depth cover-

age of growth and development and health promotion and maintenance.

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Can’t attend a live course?

This program is also available on-line

Visit: https://store.fhea.com for more information.

This 5 ¾ day course addresses the growing need for a thorough

course in the principles of pharmacotherapeutics. Prescribing

has become a major part of the role of advanced practice

nurses while at the same time, prescribing has become more

complex and polypharmacy is more prevalent with the possi-

bility of adverse interactions. Thus, a course of this caliber is

critical to the preparation of advanced practice nurses.

The course is taught in an intensive format by 2 of the nation’s

most respected NP educators. In addition, recorded lectures of

this course form the basis for other university NP pharmacol-

ogy courses including Pennsylvania State, Pace University, Neu-

mann College, Georgia College and State University. The mate-

rial constitutes the equivalent of a three credit university

course in pharmacology.

Pharmacology contact hours: 45.0**

Code: PCON — standard $799; advance: $7501;

early bird: $6992

Note 1: Registrations received or postmarked between 2 months and 2

weeks prior to the start of the course qualify for this rate.

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Upon receipt of your enrollment and full payment, you will receive a con-

firmation of registration and directions to the course. A fee of $50.00 will

be charged for cancellation. No refunds will be granted within 2 weeks of

the starting date. All cancellations and changes must be received in writ-

ing.

Topics covered in this course:

National legal and practice issues

Principles of safe prescribing: Pharmacokinetics, pharmacody-

namics, pharmacogenomics, drug interactions

Prescribing in special populations: Pregnancy, lactation, chil-

dren, older adults

Hormonal contraception and post menopausal hormone therapy

Pharmacologic management in type 1 and type 2 DM: Oral

agents, insulin and non-insulin preparations

Principles of antimicrobial therapy: Intervention in bacterial

infection

Drugs that affect the respiratory system: Beta2 agonists, me-

thylxanthines, anticholinergics, mast cell stabilizers, inhaled and

systemic corticosteroids, leukotriene modifiers, over-the-

counter cough and cold medications

Evaluation and intervention in common thyroid disorders

Assessment and intervention in common anemias

Drugs that affect the cardiovascular systems: Antihypertensives,

antianginals, dysrhythmics, medications used in the manage-

ment of heart failure

Pharmacologic treatment of lipid abnormalities and drugs that

affect clotting

Drugs that affect the GI system: H2 receptor antagonists, proton

pump inhibitors, antacids, prokinetics, antidiarrheals, including

over-the-counter medications

Management of viral, fungal and protozoal infection

Management of pain; opioids, NSAIDs and others including over-

the-counter medications

Management of eye, ear, and skin disorders

Visit: https://store.fhea.com for more information.

Earn 45 Contact Hours!

Clinical Pharmacology for NPs and Advanced Practice Clinicians

Dallas, TX

October 25 to 30, 2011

Presented by:

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, and

Sally K. Miller, PhD, ACNP-BC, ANP-BC, FNP-BC, GNP-BC, CNE, FAANP

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June 2011

10

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Click here for more information about these products

June 2011

Advanced Pathophysiology for NPs and Advanced Practice Clinicians

New York, NY

July 18 to 23, 2011

Presented by:

Sally K. Miller, PhD, ACNP-BC, ANP-BC, FNP-BC, GNP-BC, CNE, FAANP

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP

Earn 45 Contact Hours!

This 5 ¾ day course is presented by highly acclaimed clinician-educators who currently maintain clinical practice, thus bringing clinical rele-vance to the classroom in addition to their knowledge and teaching skills in pathophysiology. FHEA instructors consistently rank at the top of speaker ratings at national conferences. Both the course material and testing material are kept up-to-date on subject matter. The electronic com-ponents of this program are updated as needed to reflect the current state of practice. This course will be available on-line this fall.

Topics Presented by Sally K. Miller

Unit I Cellular Pathophysiology

I. Cell structure and function

II. Mechanisms of cellular transport

III. Membrane and action potentials

Unit III Mechanisms of Cell Trauma

I. Reversible injury

II. Irreversible injury

III. Hypoxia

IV. Physical trauma

V. Infectious trauma

VI. Chemical trauma

Unit IV Cellular Response to Injury

I. Adaptation

II. Inflammation

Unit V Pathophysiology of the Hematologic System

I. Hematopoiesis

II. Microcytic anemias

III. Macrocytic anemias

IV. Hemoglobinopathies

V. Primary hemostasis

VI. Secondary hemostasis

Unit VI Pathophysiology of the Nervous System

I. Synaptic transmission

II. Neurotransmitter

III. Post-synaptic processes

IV. Selected disorders

Unit VIII Pathophysiology of the Cardiovascular System

I. Cardiac action potential

II. Contractile tissue

III. Non-contractile tissue

IV. Cardiac conduction

V. Contractile fibers and the sarcomere

VI. Electromechanical coupling

VII. Cardiac muscle tasks

VIII. Selected disorders

IX. Lipid synthesis and transport

X. Selected dyslipidemias

Unit IX Pathophysiology of Endocrine Disease

I. Types of hormones

II. Hormone receptors

III. Feedback mechanisms of secretion

IV. Maintenance of plasma glucose concentra-tion

V. Maintenance of thyroid hormone concentra-tion

VI. Maintenance of adrenal cortex/medullary hormone concentration

VII. Selected disorders

Unit X Pathophysiology of Pulmonary Disease

I. Anatomy and physiology of airways

II. Vascular and lymphatic anatomy

III. Autonomic nervous system regulation

IV. Compliance and recoil

V. Airflow and resistance

VI. Ventilation and perfusion

VII. Selected obstructive/restrictive diseases

Unit XI - Pathophysiology of Renal Disease

I. Anatomy and physiology of the nephron

II. Regulation of blood pressure, calcium, and erythropoietin

III. Regulation of renal function; tub glomerular feedback

IV. Cortical and medullary flow

V. Acute renal failure

VI. Chronic kidney disease

VII. Electrolyte imbalance

VIII. Regulation of acid/base balance

Unit XII - Pathophysiology of Digestive System Disease

I. Anatomy and musculature of the gastrointes-tinal track

II. Neural control systems

III. Chemical control systems

IV. Myogenic control systems

V. Oropharyngeal/esophageal motility

VI. Gastric motility and control

VII. Gastric acid secretion

VIII. Selected disease states

Topics Presented by Margaret A. Fitzgerald Unit VII - Pathophysiology in Reproduction

I. Factors influencing impaired female fertility

II. Factors influencing impaired male infertility

III. Pathophysiologic problems encountered in pregnancy: Recurrent pregnancy loss, preg-nancy induced hypertension, placental disor-ders, others

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Pharmacology Updates

Cape Cod, Massachusetts July 27–28, 2011

Coonamessett Inn

311 Gifford St.

Falmouth, MA 02540

Earn 9 Pharmacology Contact Hours!

Enjoy beautiful Cape Cod at the Coonamessett

Inn in the seaside village of Falmouth. This tradi-

tional New England inn is located close to sandy

Cape Cod beaches, galleries, and antique shops.

The meticulously groomed grounds and histori-

cal architecture make the Coonamessett Inn a

picturesque vacation spot. So

bring your beach towels and

earn contact hours while ex-

periencing all that Cape Cod

has to offer!

Click here for more information about these pharmacology updates

Take a mid-winter break at the Sheraton Maui

Resort and Spa in Lahaina, Hawaii, in February

2012. Spend your mornings honing your pharma-

cology knowledge base with internationally rec-

ognized presenter, Dr. Fitzgerald. Spend your

afternoons sitting on the beach and listening to

the waves crash against the surf. A perfect and

practical getaway for the NP, family, and friends.

Maui, Hawaii February 16-17, 2012

Sheraton Maui Resort & Spa

2605 Ka'anapali Pkwy

Lahaina, HI 96761

Earn 9 Pharmacology Contact Hours!

Rome, Italy March 13-14, 2012

Rome, Italy

Hotel information - see website

Earn 9 Pharmacology Contact Hours!

Topics include a timely

pharmacology update.

Join us in Rome, Italy, in March 2012. Hone your

pharmacology skills in this beautiful ancient city.

Visit some of the most significant landmarks and

museums in the world. From the Vatican, to the

Colosseum, Rome offers a wealth of historical and

modern delights for everyone. Don’t miss this

opportunity to explore all that Rome has to offer

while building your professional repertoire!

This seminar leads up to Presidents’ week

school vacation, so accommodations need to be

arranged as soon as possible!

North Andover, Massachusetts October 5–6, 2011

Fitzgerald Conference Center

85 Flagship Dr.

North Andover, MA 01845

Earn 12 Pharmacology Contact Hours!

Sharpen your prescribing skills! Learn about the

latest in drug therapy in a clinically useful format.

This practical knowledge is presented in an infor-

mation packed seminar.

Featuring:

The latest in treatment

options

In-depth pharma-

cologic information on

clinical conditions you

encounter in practice

Much more!

June 2011

Fitzgerald Health Education

Associates, Inc.

85 Flagship Dr

North Andover, MA

01845-6154

Phone: 978.794.8366

Fax: 978.794.2455

E-mail: cs@fhea.com

Interested in advertising in

this newsletter? E-mail

june@fhea.com

Editorial Staff

Publisher:

Margaret A. Fitzgerald,

DNP, FNP-BC, NP-C, FAANP, CSP

Managing Editor:

Marc Comstock

Editor:

Emily Paquin

Assistant Editors:

June Kuznicki

Jaclyn Fitzgerald

Technical Assistant:

Bernice Flete

Contributors

Margaret A. Fitzgerald,

DNP, FNP-BC, NP-C, FAANP, CSP

Marie L. Bosco, BSN, RNC, IBCLC

Jaclyn Fitzgerald, Assistant Editor

Open Forum

FHEA welcomes articles, news, com-

ments and ideas from its readers!

Please e-mail emily@fhea.com

If you would like to contact

customer service please e-mail

cs@fhea.com. We have sent this e-

mail newsletter in the hope that you

will find it useful. If you prefer not to

receive future issues, please e-mail:

stopnews@fhea.com. Please include

"Stop" as the subject of your e-mail

and your full name and the mail ad-

dress you wish to cancel in the body.

If you received a copy of this

newsletter from a friend, you can

subscribe by sending an e-mail to:

newsletter@fhea.com. Be sure to

include your full name, mailing ad-

dress, and daytime phone number so

that we can confirm and authenticate

your subscription.

Topics include a timely

pharmacology update.

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