Brief: Nursing Diagnostic Applications Derived From National Academy of Clinical Biochemistry (NACB) Draft Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

This brief indicates how methods used by the National Academy of Clinical Biochemistry (NACB) in the development of its guidelines and recommendation for the laboratory analysis in the diagnosis and management of diabetes mellitus may be applied to advance nomenclature, clinical practice, and research development within nursing. Specifically, human response diagnoses require the identification of accurate tests to confirm or reject the diagnoses. Each test needs to be described in terms of its use, rationale, analytical, and emerging considerations. Accurate test development will move nursing nomenclature, clinical practice, and research forward.      

The Fascinating and Complex Role of the Placenta in Pregnancy and Fetal Well‐being

Existing evidence implicates the placenta as the origin of some common pregnancy complications. Moreover, some maternal conditions, such as inadequate nutrition, diabetes, and obesity, are known to adversely affect placental function, with subsequent negative impact on the fetus and newborn. The placenta may also contribute to fetal programming with health consequences into adulthood, such as cardiovascular, metabolic, and mental health disorders. There is evidence that altered placental development, specifically impaired trophoblast invasion and spiral artery remodeling in the first trimester, is the origin of preeclampsia. Prenatal care providers who understand the relationships between placental health and maternal‐newborn health can better inform and guide women to optimize health early in pregnancy and prior to conception. This article reviews the current understanding of placental function; placental contributions to normal fetal brain development and timing of birth; and impact of maternal nutrition, obesity, and diabetes on the placenta.     

Pediatric Obsessive‐Compulsive Disorder: An Update for Advanced Practice Psychiatric Nurses

Obsessive‐compulsive disorder (OCD) may have an onset in childhood or adolescence resulting in significant functional impairment and disability into adulthood. There are frequently developmental differences in the content of the obsessions and compulsions in youth compared to adults. Lack of insight or shame may result in failure of the youth to seek treatment. This delay in treatment may lead to the development of other psychiatric comorbidities, including suicide. Evidence‐based treatments for OCD include cognitive behavioral therapy and exposure/response prevention, and in moderate to severe cases, use of selective serotonin reuptake inhibitors is indicated. Advanced practice psychiatric nurses are in a unique position to provide psychoeducation, psychotherapy, and medications, if indicated, to youth with this condition to improve functioning and reduce morbidity and mortality. This article will provide an overview of the diagnostic criteria for OCD, etiologies, assessment strategies, differential diagnoses, common comorbidities, and evidence‐based treatment options.