Top 10 Common Conditions in Primary Care and How to Manage Them

by Posted on

→ A practical guide for NP students in NRNP-6531 / PRAC-6531

In primary care, you’ll see recurring patterns in patient complaints and chronic conditions. For students in NRNP-6531 / PRAC-6531, mastering the diagnosis and management of these core clinical conditions is key to becoming a confident, evidence-based practitioner.

This guide breaks down 10 of the most common conditions in adult primary care—highlighting key diagnostic tips, treatment plans, and patient education points.

🔟 1. Hypertension (HTN)

Diagnosis: BP ≥130/80 (confirmed over multiple visits)
Workup: Assess for end-organ damage (BMP, urinalysis, ECG)
First-Line Treatment:

  • Thiazide diuretics, ACE inhibitors, ARBs, or CCBs
  • Lifestyle: DASH diet, low sodium, weight loss, exercise
    Follow-up: Every 2–4 weeks until stable

🔟 2. Type 2 Diabetes Mellitus (T2DM)

Diagnosis:

  • A1c ≥6.5%, fasting glucose ≥126, or 2-hr OGTT ≥200 mg/dL
    Initial Labs: CMP, A1c, lipids, microalbumin, TSH, eye/foot exams
    Treatment:
  • Metformin first-line
  • Consider GLP-1 receptor agonists or SGLT2 inhibitors if ASCVD or CKD
    Education: Glucose monitoring, carb counting, foot care

🔟 3. Hyperlipidemia

Diagnosis: Based on fasting lipid panel
Treatment Guidelines: Use ASCVD risk calculator

  • Statins for LDL ≥190, diabetes, or 10-year risk ≥7.5%
    Follow-up: Lipids at 4–12 weeks after starting therapy

🔟 4. Hypothyroidism

Symptoms: Fatigue, weight gain, cold intolerance, dry skin
Diagnosis: ↑ TSH, ↓ Free T4
Treatment:

  • Start Levothyroxine (1.6 mcg/kg/day)
  • Adjust dose every 6–8 weeks based on TSH
    Education: Take on empty stomach, avoid calcium/iron 4 hrs before/after

🔟 5. GERD (Gastroesophageal Reflux Disease)

Symptoms: Heartburn, regurgitation, worse after meals
Diagnosis: Clinical; consider EGD if alarm symptoms
Treatment:

  • Lifestyle: Elevate HOB, avoid late meals/alcohol/spicy food
  • Start PPI daily for 4–8 weeks

🔟 6. Osteoarthritis

Symptoms: Joint pain/stiffness, worse with use, no systemic symptoms
Diagnosis: Clinical; imaging not required for diagnosis
Treatment:

  • NSAIDs (topical or oral), acetaminophen, exercise/PT
  • Avoid opioids; refer if severe or functional limitation

🔟 7. Depression (MDD)

Screening: PHQ-9
Diagnosis: DSM-5 criteria — ≥5 symptoms over 2 weeks
Treatment:

  • SSRIs (e.g., sertraline, escitalopram)
  • Monitor for side effects and suicidal ideation
    Referral: Consider if no response in 6–8 weeks or severe symptoms

🔟 8. Anxiety Disorders

Screening: GAD-7
Diagnosis: Excessive worry ≥6 months (GAD), panic episodes, etc.
Treatment:

  • SSRIs, CBT referral
  • Avoid benzodiazepines for long-term management

🔟 9. UTI (Uncomplicated)

Symptoms: Dysuria, urgency, frequency
Diagnosis: Urinalysis with +leukocytes, nitrites, and symptoms
Treatment:

  • Nitrofurantoin or TMP-SMX for 3–5 days
  • Encourage hydration, voiding after intercourse

🔟 10. Acute Upper Respiratory Infections (URI)

Symptoms: Cough, nasal congestion, sore throat
Treatment:

  • Supportive: Fluids, rest, nasal saline, acetaminophen
  • Avoid antibiotics unless bacterial sinusitis (≥10 days, purulent discharge, facial pain)

📌 Clinical Pearls for NP Students

  • Always document guideline-based reasoning in your notes
  • Use tools like UpToDate, Epocrates, and CDC guidelines
  • Engage in shared decision-making with patients
  • Monitor for medication adherence, side effects, and follow-up labs

📎 Bonus Download

Want a one-page cheat sheet or SOAP note templates for these 10 conditions? Just ask—I’ll create one customized for NRNP-6531 clinicals!

Published by Lisa