Great video! This reminds me of a story I read about a family who was suing the NP of their son who died of kidney failure because the attorneys found amongst her charting that even though she diagnosed him with blood pressure and gave him the proper blood pressure medication she did not short that she educated him on what would happen if he did not take his blood pressure medication. The man end up dying from kidney failure and it was found that he did not take his blood pressure medication and he did not realize that failing kidneys could happen from high blood pressure. So that is something to really take serious! Charting what you have taught & what would happen if Patient is not compliant.
Love this! I am struggling with this as a new grad. I appreciate all of your videos and your truly "real world" way of explaining things. It is very hard as a new grad to translate our training and reading into real life but you are helping us do that little by little! Thank you!
Like you, I would want to see the patient sooner. In your 1st scenario you mentioned having the patient return in 3m. Is there any concern of insurance covering the frequency of often you have the patient return? I'm always afraid the insurance will deny covering the visit. TIA. BTW I'm still an FNP student grad 12/21 :)
That's a great question-- I work in the FQHC setting in Massachusetts and typically take Medicaid insurance, which is different than private insurances. Usually each clinic will give guidance about various insurance/billing rules, but as far as I know there isn't a mandated amount of time for follow up for a problem-based visit. There's definitely rules about the ICD code you use to order tests/labs and you can only bill a physical ICD code once per calendar year but other than that, none that I'm aware of. Each clinic also has "quality measures" that is tied to funding/grants like the number of A1Cs at goal vs >9% and BPs over a certain number, so those tend to be more pressing than the time to return to clinic. Make sense?
hello, is telmisartan taken with aspirin ok? i average 200/140 180/130 blood pressure. the lowest i've gotten recently is 160/110 and they needed to iv medication for that to happen
Hi! Sorry, but for legal and safety reasons I can't advise on your case. I always refer people back to their primary care provider as they know your history.
Great video! This reminds me of a story I read about a family who was suing the NP of their son who died of kidney failure because the attorneys found amongst her charting that even though she diagnosed him with blood pressure and gave him the proper blood pressure medication she did not short that she educated him on what would happen if he did not take his blood pressure medication. The man end up dying from kidney failure and it was found that he did not take his blood pressure medication and he did not realize that failing kidneys could happen from high blood pressure. So that is something to really take serious! Charting what you have taught & what would happen if Patient is not compliant.
All good input! Thank you!
Love this! I am struggling with this as a new grad. I appreciate all of your videos and your truly "real world" way of explaining things. It is very hard as a new grad to translate our training and reading into real life but you are helping us do that little by little! Thank you!
Thank you so much! I am so happy these are helpful to you.
I would love a video about managing hypertensive urgency, what is the assessment in the office and how do you start and titrate their meds.
Thanks again for the idea and we will add it to the list!
Thank you for your insight.
Glad it was helpful!
Like you, I would want to see the patient sooner. In your 1st scenario you mentioned having the patient return in 3m. Is there any concern of insurance covering the frequency of often you have the patient return? I'm always afraid the insurance will deny covering the visit. TIA. BTW I'm still an FNP student grad 12/21 :)
That's a great question-- I work in the FQHC setting in Massachusetts and typically take Medicaid insurance, which is different than private insurances. Usually each clinic will give guidance about various insurance/billing rules, but as far as I know there isn't a mandated amount of time for follow up for a problem-based visit. There's definitely rules about the ICD code you use to order tests/labs and you can only bill a physical ICD code once per calendar year but other than that, none that I'm aware of. Each clinic also has "quality measures" that is tied to funding/grants like the number of A1Cs at goal vs >9% and BPs over a certain number, so those tend to be more pressing than the time to return to clinic. Make sense?
Can you do a scenario where the pt tried lifestyle management of htn but now needs to start medications?
I'll add it to the list!
hello, is telmisartan taken with aspirin ok? i average 200/140 180/130 blood pressure. the lowest i've gotten recently is 160/110 and they needed to iv medication for that to happen
Hi! Sorry, but for legal and safety reasons I can't advise on your case. I always refer people back to their primary care provider as they know your history.