Issue : January 2003
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Sexual health in cancer careSubscription
The sexual concerns of patients have generally been neglected in health care (Dustow, 1994). In cancer care specifically there appears to be a conception that people with cancer do not have sex. But Shell (1995) suggests that supporting patients to retain an intimate relationship during their cancer treatment may allow them and their partner moments when they do not have to look cancer squarely in the face. Savage (1989) describes sexuality as the ‘uninvited guest’ in the nurse/patient ...
Myocardial infarction (MI) occurs as a result of prolonged myocardial ischaemia that leads to irreversible injury and necrosis of myocardial tissue because of inadequate blood supply.
Iron deficiency anaemiaSubscription
NT Skills Update - RED BLOOD CELL COUNTSubscription
The Government’s white paper The New NHS: Modern, Dependable (Department of Health, 1997) and the consultation document A First Class Service (DoH, 1998) focused on modernising the NHS and improving the quality of care for patients. The concept of clinical governance was developed and defined as a ‘framework through which the NHS organisations are accountable for continuously improving the quality of the services and safe-guarding high standards of care by creating an environment in ...
Identifying food allergies in childrenSubscription
Food intolerance is an umbrella term encompassing any reproducible adverse reaction to a food that may produce a number of different responses, including allergy. A food allergy is a reproducible adverse reaction to a specific allergen or its ingredient - usually a protein - and is mediated by an immunological response. Food allergy affects 1.4-1.9 per cent of adults and five per cent of children in the UK (Sicherer, 2002). About 10 million people are affected in the UK with as many ...
Benchmarking and nutritionSubscription
Nutrition for hospitalised patients can be compromised by a number of common factors. These have been identified as a failure to detect or recognise poor nutrition, lack of patient nutritional data, for example weight and weight loss, lack of relevant referrals, fragmented working practices, and failures in education and training (British Association of Parenteral and Enteral Nutrition, 1999).
Management of intestinal failureSubscription
Intestinal failure (known as ‘short bowel syndrome’) occurs when a large portion of the intestine is unable to function, resulting in malabsorption of nutrients, electrolytes and gastrointestinal secretions (Forbes, 1997).
Every year deep vein thrombosis (DVT) occurs in about one in 2,000 people in the general population, ranging from less than one in 3,000 in those below the age of 40 to one in 500 in those over 80 (Department of Health, 2002). Thrombosis usually develops as a result of venous stasis or slow flowing blood around venous valve sinuses. Extension of the primary thrombus occurs within or between the deep and superficial veins of the leg. The propagating clot damages valves and may cause ...
NT Skills update: WOUND VACsSubscription
WHAT IS VAC?
Update on access to nutritional supportSubscription
VOL: 99, ISSUE: 03, PAGE NO: 55...
Living with intestinal failureSubscription
A number of studies have examined the quality of life of patients with intestinal failure (Jeppesen et al, 1999; Richards and Irving, 1997). Common factors reported are feelings of anger, anxiety and depression resulting from a profound sense of loss.
Diabetes: new treatments and guidanceSubscription
As the number of people with diabetes increases, the consequences of untreated or inadequately treated diabetes are being realised. People with diabetes are more likely to have coronary heart disease, to have a stroke, to develop renal failure and require dialysis or a renal transplant, to have visual impairment and to develop foot ulcers. They may also require amputation as a result of peripheral vascular disease or neuropathy. The cost of these complications has been estimated to ...
VOL: 99, ISSUE: 03, PAGE NO: 43
The aim of treatment for diabetes is to alleviate the symptoms, maintain quality of life and slow the progression of specific and non-specific complications. This Part looks at treatments for diabetes and related complications.
Anorexia nervosa is the strongest predictor of adolescent mortality with a rate 15 per cent higher than depression (Gowers et al, 2000). The term anorexia nervosa was first coined by Sir William Gull in the late 19th century but knowledge of the illness remained scant until the 1950s. The seminal work by Ancel Keys into starvation, involving a group of conscientious objectors in the 1950s, along with an increase in the popularity of psychiatry, promoted an interest among clinicians ...
The importance of good record-keeping for nursesSubscription
Comprehensive records are essential in healthcare and nurses need to dedicate time to documentation
Cystic fibrosis and exocrine gland disorderSubscription
NT Skills update - ELECTROCARDIOGRAMSubscription
Washable products for womenSubscription
This case study focuses on 55-year-old Dave Croft, who has a moderate learning disability and has been diagnosed as having bipolar disorder (this is currently in remission). In 1996, after the closure of the old-style residential institution that had been his home for nearly 30 years, he moved to an eight-bed NHS unit for people with learning disabilities/mental health needs and/or challenging behaviour.
Men’s health issues are relatively neglected in comparison with women’s. Men often avail themselves less of medical literature and doctors than do women (Peate, 1997). Although the numbers of men affected by testicular cancer may seem relatively small, its detection is essential because the disease affects young men in their reproductive years. About half of all cases occur in men aged less than 35 years (Cancer Research UK, 2002; see Fig 1).
Diabetes: signs, symptoms and making a diagnosisSubscription
At least 1.3 million people in the UK have diabetes. It can affect people of all ages and all ethnic groups. This first article in a three-part series provides an overview of type 1 and 2 diabetes. It explains the aetiology, signs and symptoms and how a diagnosis is reached. Risk factors and psychosocial implications are also considered.
Drinking water in schoolsSubscription
Children do not drink enough during the school day - and the resulting dehydration contributes to continence problems (Box 1). One important part of treating these problems is an adequate and regular fluid intake during the day (Haines et al, 2000). However, it is not uncommon for pupils to go six or seven hours without a single drink, and those who do drink usually drink less than they need (Almond, 1993; Haines et al, 2000).
Manual evacuation of faecesSubscription
Controversy surrounds the manual evacuation of faeces by nurses, and many are confused about their professional and legal responsibilities when asked to undertake this procedure. The argument that it is a well established and successful procedure is supported by many professionals, but there is very little documented evidence of its effectiveness as a method of bowel management.
Pelvic floor muscle exerciseSubscription
The ICS Standardisation Committee (Abrams et al, 2002) defines the symptom of stress urinary incontinence as the complaint of involuntary leakage on effort or exertion, or on sneezing or coughing. Genuine stress incontinence (now known as urodynamically proven stress incontinence) is the involuntary loss of urine occurring when, in the absence of a detrusor contraction, the intravesical pressure exceeds the maximal urethral pressure. These definitions tend to look at the urinary mechanism ...
Provision of absorbent garmentsSubscription
VOL: 99, ISSUE: 01, PAGE NO: 63Linda Morrow, MSc, RGN, RM, Dip DN, continence adviser, Lothian Primary Care NHS TrustThe current challenge to continence services in England - to make equitable provision of absorbent products to patients regardless of where they live - was met by Scottish services 10 years ago.
Utilising frequency volume chartsSubscription
VOL: 99, ISSUE: 01, PAGE NO: 33Jane Healey BSc, RGN, is practice/professional development nurse, gastroenterology unit, Bradford Hospitals NHS Trust.As a practice/professional development nurse working in a busy gastroenterology unit, which cares for increasing numbers of patients with inflammatory bowel disease, I was interested in reading the article by Miller et al on the outpatient management of patients with this condition.
VOL: 99, ISSUE: 01, PAGE NO: 28 Aetiology
NT Skills Update - oral hygieneSubscription
Ensuring a patient’s mouth is kept clean and healthy is essential. If a patient’s mouth is unclean it causes discomfort and can lead to infection. Therefore, a patient’s mouth should be assessed and cleaned as appropriate.
Ian Jones, BSc (Hons), RN, PGCLT, DPSN. Lecturer in Cardiac Nursing, School of Nursing, University of Salford Professional Nurse 2003 Jan;18(5):289-92. …
Case study: Patient admitted to accident and emergency with severe chest pain.
Karen Hughes, BSc (Hons), RN.
Ian Jones, BSc (Hons), RN, PGCLT, DPSN.
Janet Riddell-Heaney, MA, RN, RHV, DipChild Protection, Cert Ed. Designated Nurse for Child Protection, Harrow Primary Care Trust, Harrow Professional Nurse 2003 Jan;18(5):280-4 The aim of this Study paper is to give the reader an overview of child protection.
Different cultures but equal needsSubscription
Janet Riddell-Heaney, MA, RN, RHV, DipChild Protection, Cert Ed. Designated Nurse for Child Protection, Harrow Primary Care Trust, Harrow Professional Nurse 2003 Jan;18(5):248-9. All health professionals who come into contact with children can contribute to identifying those in need of safeguarding or support. However, to enable them to fulfil this part of their role, they need policies to support their actions.
Sedation in the intensive care unitSubscription
Paul Wade, BPharm (Hons), MSc (Clin Pharm), MRPharmS. Principal Pharmacist for Clinical Services Professional Nurse 2003 Jan;18(5):285-6
Sarah V. O’Brien, BA, RN. Consultant Nurse - Diabetes Professional Nurse 2003 Jan;18(5):257-60. …
Dr Patricia Schofield, PhD, RN, DipEd, DipN. Lecturer Professional Nurse 2003 Jan;18(5):276-9.
Jennifer A. Deaville, BSc (Hons), PhD, PGDip (Public Health). Research Manager Professional Nurse 2003 Jan;18(5):262-4.
Managing erectile dysfunctionSubscription
Patricia Allen, MA, DipN (Lond), RM, RGN. Clinical Nurse Specialist, Andrology Service, Urology Department, Royal Hallamshire Hospital, Sheffield
Liz Onslow, BA (Hons), MSc, RN. Nurse Specialist - Elderly, Trauma and Orthopaedic Directorate, Southampton General Hospital This paper describes how an integrated care pathway was introduced for patients with fractured neck of femur in an acute hospital. Femoral neck fracture is the most common traumatic condition requiring admission to adult orthopaedic wards, and is currently approaching epidemic proportions among older people, especially women (Audit Commission, 1995).
Barry Weaver, RN.Team Leader, Gloucester Ward, Private Practice Unit, Royal Free Hospital, LondonThis paper focuses on a 67-year-old male with a long history of Crohn's disease and underlying diabetes. Robert George was admitted to hospital for an elective sub-total colectomy and ileo-rectal anastomosis due to obstructive Crohn's ileo-colitis. But he had to return to theatre four times due to postoperative bleeding, bile leakage and failure of the anastomosis.