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Clinical articles

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  • Treatment and management of acute appendicitisSubscription

    26 December, 2004Updated: 5 March, 2009

    Acute appendicitis is an inflammation of the appendix due to infection (Bruce and Finlay, 1997). 

  • Reducing the risks of parenteral nutritionSubscription

    1 October, 2004Updated: 5 March, 2009

    Mary Bird, RGN.Intravenous and Nutrition Nurse Specialist, Peterborough and Stamford Hospitals NHS TrustNUTRITION

  • How 'nil by mouth' instructions impact on patient behaviourSubscription

    28 September, 2004Updated: 5 March, 2009

    VOL: 100, ISSUE: 39, PAGE NO: 32

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    How increased nurse prescribing can improve stoma care practiceSubscription

    17 August, 2004Updated: 5 March, 2009

    Nurse prescribing was first suggested by Cumberlege (Department of Health and Social Security, 1986) in a review of community nursing. It is now almost five years since the first nurse prescribers started prescribing. Stoma appliances and accessory products have always been on the Nurse Prescribers’ Formulary (NPF), which is a supplement of the British National Formulary.

  • LaxativesSubscription

    1 August, 2004Updated: 5 March, 2009

    Laxatives are drugs that change faecal consistency, speed the passage of faeces through the colon and aid in the elimination of stool from the rectum (Edmunds, 2003). They are used mainly to treat constipation and to prepare the bowel before surgery or investigative procedures. They may also be used in bowel training for patients who have lost neurogenic control of the bowel.

  • The prevention of Clostridium difficile associated diarrhoea in hospitalSubscription

    29 June, 2004Updated: 5 March, 2009

    The number of health care-associated infections has increased over the years and generated a lot of interest and concern. The attention tends to be focused on methicillin-resistant Staphylococcus aureus (MRSA), but the less publicised Clostridium difficile is a growing problem. It increases length of hospital stay, causes significant morbidity in patients, affects nurses’ workloads, adds to the cost of cleaning, laundry and disposables, and can lead to ward closures. All NHS trusts ...

  • The management of acute upper gastrointestinal bleedingSubscription

    29 June, 2004Updated: 5 March, 2009

    Gastrointestinal haemorrhage may be associated with an underlying disease state or trauma, or it may arise as a rare complication of investigative procedures such as diagnostic endoscopy. 

  • Effective bowel management for patients after spinal cord injury.Subscription

    18 May, 2004Updated: 5 March, 2009

    VOL: 100, ISSUE: 20, PAGE NO: 48 Maureen Coggrave, MSc, RN, is research training fellow for ‘Action Medical Research’ at the National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, and the physiology department, St Mark’s Hospital, Harrow

  • The correct positioning and role of an external fixation device on a PEGSubscription

    4 May, 2004Updated: 5 March, 2009

    A percutaneous endoscopic gastrostomy tube (PEG tube) also has an internal securing device. This may be a polyurethane cone, button, or air-filled foam sac. Correct positioning of both devices is essential to minimise complications.

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    The diagnosis and management of adult neurogenic dysphagia.Subscription

    4 May, 2004Updated: 5 March, 2009

    The process is commonly divided into three phases: oral, pharyngolaryngeal and oesophageal, which represent the anatomical structures involved in swallowing. The process requires a sophisticated means of voluntary and reflex central control for coordinated execution (Miller, 1982) (Box 1). Disruption of swallowing can have serious effects, with complications such as malnutrition, pulmonary aspiration and the associated psychosocial stigma of being unable to eat.