Nurse Practitioner Chronicles

New ACC Guidance on Obesity and Cardiovascular Disease: What Every NP Needs to Know If you're a nurse practitioner in primary care, family practice, or cardiology, you already know that the obesity conversation has fundamentally changed. We're no longer in the era of "eat less, move more" as the sole clinical recommendation. The American College of Cardiology dropped two major guidance documents in August 2025 that every NP managing cardiovascular risk needs to have on their radar — and if you missed them, consider this your clinical catch-up. Let's break down what matters for your practice. Two Documents, One Clear Message The ACC released a Concise Clinical Guidance (CCG) on the medical management of obesity and a Scientific Statement focused specifically on treating obesity in adults with heart failure. Both documents signal a seismic shift in how we should be thinking about weight management as a core component of cardiovascular care — not a side conv...

  Delivering a Down Syndrome Diagnosis with Confidence and Compassion: AAP Guidelines Meet the SPIKES Strategy If you've ever had to deliver difficult news to a patient or family — and let's be honest, most of us have — you know the weight of those moments. The clinical knowledge matters, but how you communicate can shape a family's trajectory for years to come. A powerful session at the NAPNAP 2026 National Conference in Pittsburgh brought this truth into sharp focus, pairing the updated AAP health supervision guidelines for Down syndrome with a structured communication framework called SPIKES. The session was co-presented by Kristina Banks, DNP, MSN, APRN, CPNP-PC, Specialty Director of Pediatric Nurse Practitioner programs at Case Western University, and Katharine Roanleigh, MSN, APRN, FNP-BC, CPNP-PC — a fellow NP who received a prenatal Down syndrome diagnosis for her own son in December 2023. Together, they modeled what evidence-based care looks like when it's...

  Clinical Updates · Cardiology The 2026 ACC/AHA Dyslipidemia Guidelines: Everything Primary Care NPs Need to Know Right Now A comprehensive clinical breakdown of the most significant cholesterol guideline update in nearly a decade. Published April 2026 · NP Chronicles · 12-minute read · Updated from the 2018 ACC/AHA Guideline The 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia dropped this spring — and if you manage patients with cardiovascular risk in primary care, this one is going to change your practice. Here's what you need to know, translated for the clinic floor. Whether you're seeing a 45-year-old with a new diabetes diagnosis, a 58-year-old post-MI patient not at LDL goal, or a young woman with a family history of premature heart disease, the 2026 guidelines give us clearer targets, updated risk tools, and several entirely new recommendations that simply didn't exist before. Let's break it down. 📋 Quick Cont...

  Testosterone Testing in Men: When to Check, How to Interpret, and the Prescribing Minefield of TRT A total testosterone of 280 at 8 AM in a symptomatic man means something. A total testosterone of 280 drawn at 3 PM after a night of poor sleep means almost nothing. Testosterone replacement therapy (TRT) is one of the fastest-growing prescriptions in men's health, driven by direct-to-consumer marketing, telehealth "optimization" clinics, and patient demand. For primary care NPs, this creates a two-sided problem: underdiagnosis of true hypogonadism in men who would benefit from treatment, and overprescription of testosterone in men who don't meet diagnostic criteria and face real risks. Getting the workup right is the foundation of safe prescribing. The Physiology: What Testosterone Does and How It's Regulated The hypothalamic-pituitary-gonadal (HPG) axis works as a feedback loop: GnRH from the hypothalamus stimulates LH and FSH from the anterior pituitary, LH stim...