Perfecting your practice

This article tells you about:

• What spirometry is and why it is used
• How to decide whether a patient is suitable for spirometry testing
•  How to perform spirometry
• What the results show
• Which patients are not suitable for spirometry

You would be likely to reference this article if you were researching:

• Respiratory nursing
• Chronic obstructive pulmonary disease
• Lung function
• Asthma
• Cystic fibrosis

In what situations will this article be useful to me?

If you are caring for a patient who is experiencing respiratory problems that are undiagnosed or with a diagnosed respiratory disorder that needs to be monitored. Spirometry is considered to be the “gold standard” method of assessing lung function. It should be used:

• For patients presenting with undiagnosed respiratory symptoms such as wheeze, cough and dyspnoea (difficulty in breathing or in catching the breath)
• For patients with suspected COPD
• To monitor patients with diagnosed long-term respiratory conditions

 Questions for your mentor/tutor

• How do I perform a spirometry test?
• What should I do with the results?

Student Nursing Times Decoder

• Spirometry: A method of measuring the speed and volume of air expelled from the lungs
• FVC: Forced vital capacity – the amount of air that can be forcibly expelled from the lungs after maximum inspiration
• FEV₁: Forced expiratory volume in one second - the volume of air exhaled during the first second of a forced expiration
• FEV₁/FVC ratio: The percentage of the FVC expired in the first second of a forced expiration
• VC:Vital capacity – the total volume of air expelled in a forced expiration after maximum inspiration
• PEF:Peak expiratory flow – the highest flow achieved during a forced expiration, measured in litres per minute

Other articles you might find useful

Best practice: Carrying out accurate spirometry testing - part 2

Guidance: The use of diagnostic spirometry in primary care

Interstitial lung diseases 1: Diagnosis and investigation

An overview of acute exacerbations of COPD

Using action plans for COPD patients

Reducing COPD admissions with a specialist chronic disease management team

This article tells you about:

• Using the correct equipment for this procedure
• Safe practice when giving medicines  via enteral feeding tubes
• Giving the correct dose at the right time
• How delivering medicines via enteral feeding tubes differs from other routes
• How to manage tube blockages

You would be likely to reference this article if you were researching:

• Enteral feeding
• Drug administration
• Nutrition
• Nasogastric feeding
• Patient safety 

In what situations will this article be useful to me?

• If you are caring for patients who are being fed through enteral feeding tubes who require medication. Patients require enteral feeding for a range of conditions. For example they are used for critically ill patients, those who have had recent surgery and those with swallowing difficulties. Enteral feeding is most commonly given via a nasogastric tube or a percutaneous endoscopic gastrostomy (PEG) feeding tube direct into the stomach.

Questions for your mentor/tutor

• How do I prepare medications for administering via an enteral feeding tube?
• How do you manage timing of enteral feeding and the giving of medication?

Student Nursing Times Decoder

• Enteral feeding: Enteral feeding is the giving of a nutritionally complete feed directly into the stomach, duodenum or jejunum via a feeding tube.
• Nasogastric tube: his is the most commonly used method of enteral feeding. The tube goes does through the nose and into the stomach. Nasogastric tubes can become displaced from position and end up in the lungs. Care  needs to be taken to ensure they are in correct place as giving a feed into the lungs is potentially fatal.
• Percutaneous endoscopic gastrostomy (PEG) feeding tube: These are used for longer-term enteral feeding. Often known as a PEG tube they are inserted directly into the stomach with an upper gastrointestingal endoscopy. They need to be monitored carefully for infection.

Other articles you might find useful

• Nutritional support: how to reduce the risk of harm
• Nasogastric tubes 1: insertion technique and confirming position
• Nasogastric tubes 2: risks and guidance on avoiding and dealing with complications
• Administration of drugs 2: non-oral

This article tells you about:

• Hypoglycaemia
• Its signs and symptoms
• What causes it to occur
• How to manage it

You would be likely to reference this article if you were researching:

• Diabetes
• Glycaemic control
• Hypoglycaemia

In what situations will this article be useful to me?

• If you are caring for patients with diabetes. Hypoglycaemia is much more common in type 1 diabetes but it can occur in patients with type 2 diabetes. Patients may be admitted for treatment of their diabetes or may be in hospital for another reason.
• If  their diabetes is not the primary reason for their admission you will still need to be aware of their diabetes, especially as they will be out of their normal routine and this will make it more difficult for them to control their blood glucose levels.

Questions for your mentor/tutor

• What advice should I be giving to a patient after a hypoglycaemic episode?
• Should I assume that all patients with diabetes understand hypoglycaemia?

Student Nursing Times Decoder

• Blood glucose: This is the level of blood glucose  in the blood. A normal level would be between 3.9-7.2 mmol/L
• Hypoglycaemia: This is when the blood glucose level falls to below 4mmol/L.
• Sulphonylureas: A group of oral drugs that are used in type 2 diabetes to stimulate the pancreas to produce insulin.

Other articles you might find useful:

• Hypoglycaemia
• Diabetes, type 1
• Diabetes, type 2

This article tells you about:

• This ethnic group
• Health problems of Gypsy Travellers
• Negative attitudes and bias towards this group
• How you can overcome negative attitude and bias 

You would be likely to reference this article if you were researching:

• Ethnic minority groups
• Prejudice
• Stereotyping

In what situations will this article be useful to me?

• It will help you to explore your own perceptions of this group
• It will help you to offer health care without bias

Questions for your mentor/tutor

• How can I ensure that I am not biased towards this group?
• What should I do if I notice prejudice from other health professionals?

Student Nursing Times Decoder

• Minority ethnic group: a group that has different national or cultural traditions from the majority of the population
• Gypsy travellers: Romany Gypsies and Irish Travellers are legally recognised as ethnic groups.   In terms of health and education, they are one of the most deprived groups in the Britain.
• Racial discrimination: this is when an individual or a group is treated less favourably on racial grounds than others in similar circumstances.

Other articles you might find useful

• Stamping out stigma in HIV
• How the Equality Act affects you