Donna Hallas, PhD, PPCNP-BC, CPNP, PMHS, FAANP, FAAN

Jane Mendle, PhD’s research at Cornell University in Ithaca, New York, investigating the long-term psychological effects of early puberty has significant implications for our practices as pediatric nurse practitioners-and for all healthcare providers.

There are two articles in the March 2018 issue of Contemporary Pediatrics that merit your attention: Dr. Bass’ article on “Is it the flu?” and Ms. Zimlich’s article on “Major vaccines addressed in updated ACIP guidelines.”

Is the overwhelming problem of too many opioid and narcotic pain prescriptions related to the identification of ‘pain’ as the ‘fifth vital sign’?  Was the intention for the designation, the ‘fifth vital sign’, an expectation that individuals would be pain free during hospital stays, eg, after a surgical procedure, or after visiting ambulatory centers for an injury?

Pediatric providers need to help patients and their parents develop critical thinking about their personal healthcare and the long-term outcomes from their decisions.

Ms. Hester presents a heartwarming story describing the puppy brigade program’s design and its process for helping children to heal at Akron Children’s Hospital in Ohio while receiving both inpatient and outpatient care.

Dr. Bass’ recent article in Contemporary Pediatrics, “Personalized medicine, right drug, right patient, right time,” provides a miniature but profound view of what may be the future of pediatric healthcare: focusing on healthcare that is truly individualized through precision science in the areas of diagnosis and treatment, rather than generalized, population-based treatment guidelines.

I highly recommend reading his article, and then reflecting on your current office- and hospital-based practices surrounding prescribing medications for children to determine areas to apply these best practice initiatives in your personal work settings.

Opioids have impacted every population served by all healthcare providers in the United States and by now every nurse practitioner (NP) has been exposed to the opioid scourge. Perhaps it’s time to reassess the role for NPs in caring for their individual populations confronting an opioid crisis.

Every nurse practitioner should review the AAP guidelines and include an action plan in each of their practice settings. All providers should communicate information to all school, camp, and field nurses who are often the first to assess a child presenting with symptoms of anaphylaxis outside a medical facility.

While reading Dr. Hall’s article “Persistent agitation in children with neurologic impairments,” the differences between the medical and nurse practitioner (NP) models of care emerge.

Goals for NPs caring for children and adolescents with weight problems are early identification and referral to treatment in order to prevent the well-known adverse effects the diagnosis of eating disorders places on the child, adolescent, and family members-and, in time, the overall health of the adult population.

Traditionally, first positions for graduating registered nurses (RNs) are hospital based, where many have expertise and experience in emergency management. However, when RNs attend graduate school to become primary care nurse practitioners, planning for managing emergencies in an outpatient medical office may or may not have been a part of graduate education.

Children in the foster care system are exposed early in life to adverse experiences by living within dysfunctional families and specific facts have not changed. What has changed is the recognition of the need for the healthcare system to change its care for these vulnerable children to prevent the adverse effects that traumatic stress imposes on their physical and emotional development and well-being.

Dr Bass’s article on “Factoring the Metabolic X Syndrome” in the latest issue of Contemporary Pediatrics provides us with information on the emergence of Metabolic X syndrome in the pediatric/adolescent populations, previously a syndrome seen only in adults. How can we, as nurse practitioners (NPs) prevent children from developing the symptoms for a diagnosis of Metabolic X Syndrome?

In their article, “Kid care on the slopes,” in the latest Contemporary Pediatrics, Drs. Brown and Fishman draw on their many years of caring for kids in Colorado ski country to provide this special primer on managing pediatric injuries sustained while skiing and snowboarding.

Do NPs specifically ask parents about their childhood parenting experiences? Dr. Howard King’s article “How to help adult children of alcoholic parents” prompts us to ask about important information that most likely is not a part of our routine family history questions, and thus not a part of our child’s treatment plan.

Over the past several months, we have received information from news reports, local and state departments of health, and from the Centers for Disease Control and Prevention (CDC) about the Zika virus, a mosquito-transmitted disease, and the devastating outcomes experienced by some pregnant women who contracted the Zika virus during pregnancy.

Caring for the medically complex neonatal intensive care unit (NICU) graduates is a challenge for everyone: the very stressed parents and family members, physicians, physician specialists, nurse practitioners, nurses, and early intervention specialists including physical therapists, occupational therapists, and education specialists.

How fitting is it that the subject article for this first commentary would be on a topic that impacts all of our practices: Childhood obesity (“’F’ for ‘Fat’ Grading Weight Report Cards”). In it, Dr. Petrou discusses some of the controversies regarding legislation implemented in 24 states requiring mandatory body mass index (BMI) surveillance and screening programs in schools with ‘report cards’ to parents.