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PRIMARY CARE FOR WOMEN: Management of Common Respiratory Problems

Authors

  • Mary Mays CNM, MS, FNP,

    Corresponding author
    1. Mary Mays completed her midwifery and family nurse practitioner training in 1985 at the Frontier School of Midwifery and Family Nursing in Hyden, Kentucky, and received her master's degree from the University of California, Son Francisco. She is currently a nurse practitioner with Health Care for the Homeless in San Francisco, and provides prenatal care in the midwifery service at Son Francisco General Hospital.
    2. Both authors serve as Assistant Clinical Professors in the Department of Family Health Care Nursing at the University of California, San Francisco.
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  • Steven Leiner MS, FNP, PA

    1. Steven Leiner completed his master's degree and nurse practitioner training at Pace University. Pleasantville, New York in 1980. He currently works at Mission neighborhood Health Center in San Francisco.
    2. Both authors serve as Assistant Clinical Professors in the Department of Family Health Care Nursing at the University of California, San Francisco.
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Address correspondence to Mary Mays, 815-A 26th Ave., San Francisco, CA 94121.

ABSTRACT

This article reviews the clinical management of common respiratory illnesses that primary care providers encounter in an outpatient setting. The latest recommendations from the American Thoracic Society, the National Heart, Lung, and Blood Institute, and the Centers for Disease Control and Prevention are summarized. The article discusses the causative organisms and antibiotics of choice for community-acquired pneumonia, and how to determine which patients require hospitalization. The appropriate use of asthma medications is described in detail, along with strategies for reducing aeroallergen exposure and for educating patients. An extensive section covers the interpretation of tuberculin skin tests and use of prophylactic isoniazid for preventive therapy of latent tuberculous infection, as well as the treatment of active tuberculosis. Controversies regarding antibiotics for both acute and chronic bronchitis are discussed, along with other treatment options including over-the-counter medications, bronchodilators, and non-pharmacologic interventions. Finally, a strategy for dealing with the complaint of chronic cough is outlined. Although many of these conditions require active comanagement by collaborating physicians, the nurse-midwife will be better able to communicate with and advocate for her clients if she possesses expanded and current knowledge of treatment strategies.

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