Diagnosing chronic obstructive pulmonary disease (COPD) can be complex and requires
considerable clinical skill. It is rather like putting together the pieces of a jigsaw
puzzle. But don’t despair. In this article, we take you through the key steps. A careful
history, particularly in smokers or ex-smokers who complain of breathlessness,
followed by clinical examination may indicate possible COPD. Further steps must then be taken
to exclude other causes of respiratory symptoms and spirometry is essential in diagnosing
airflow obstruction, which may help to confirm the diagnosis of COPD.
Research Made Easy
What do Patients Want from Asthma Therapy?
More than half of people with asthma in the UK have inadequate symptom control,
despite the range of effective therapies now available. Rather than blaming
patients when they fail to take their medications as prescribed, we need to
examine the way we conduct asthma consultations and ask whether we are failing
to meet the needs of individual patients. How can we gain greater understanding about what
people with asthma want from healthcare professionals and treatments, so we can achieve a
more patient-centred approach to care?
Still a breath of fresh air: 20th anniversary for the General Practice Airways Group (GPIAG)
The BJPCN interviewed Dr Steve Holmes (Chairman of the GPIAG) and
Stephanie Wolf (GPIAG General Committee member) on the 20th anniversary
of the organisation.
Oral Allergy Syndrome
Did you know…. that a large number of your hayfever patients may have a
condition known as oral allergy syndrome? In this article we explore what
causes oral allergy syndrome, why it occurs, the symptoms that patients may
suffer and how to manage the problem.
How Can I Assess and Manage Cough in Children?
Children with a cough commonly present to practice nurses. All children cough and often
cough repeatedly, with the majority of episodes associated with self-limiting viral
infections for which there are no effective treatments. Coughing can be highly
distressing for the child and their family members, and can have a significant impact on
a child’s sleep, play and performance in school. Although cough may often be related to
diagnosis of asthma, this is by no means the only cause. The British Thoracic Society recently
published guidelines for the assessment and management of cough in children up to 12 years of
age without known lung disease. Practice nurses and their GP colleagues will find these new
guidelines valuable for diagnosis and management of cough. This article summarises the main
recommendations.
Diagnosing allergy in asthma and allergic rhinitis
Patients with allergic asthma, intermittent (seasonal) or persistent (perennial) allergic
rhinitis, represent a significant proportion of primary care consultations. There is
growing awareness of allergy and the possibility of an allergic component as the cause
of a wide variety of symptoms. It is important to understand how to diagnose atopy to
ensure appropriate management and care of our patients. Diagnosing allergy is initially about
asking the right questions, followed by confirming or refuting the diagnosis by objective testing.
In this article, we explore history taking and objective testing that will help us to manage and
advise patients appropriately.
Reducing Hayfever Havoc: Keeping Symptoms at Bay
Hayfever affects around one in ten adults, and an even higher proportion of children and teenagers. Chronic symptoms may lead to poor concentration, impaired learning ability and school absenteeism in children, amongst other problems. In the run-up to the hayfever season, therefore, it is important to identify teenagers or young adults with persistent or severe hayfever symptoms and to treat their symptoms aggressively to prevent poor performance at school and in examinations. Given that approximately 80% of patients with asthma also have rhinitis, asking your asthma patients about their possible hayfever symptoms is a good starting point.
Editorial
Chronic kidney disease (CKD) has moved rapidly up the healthcare agenda over the last few years. It has shifted from being considered as a rather nebulous condition of interest mainly to nephrologists to the front line of chronic disease detection and prevention in primary care as part of integrated management of vascular risk. In fact, the links between cardiovascular disease, kidney disease and diabetes are so close that CKD could also stand for ‘cardiovascular, kidney, diabetes.’
Editorial
Feel the fear and do it anyway.’ That could be the message of this special issue of the British Journal of Primary Care Nursing focusing on chronic kidney disease (CKD). Kidneys can be really confusing for practice nurses, with lots of technical sounding tests and numbers. But the good news is that the step-by-step guides and clear articles in this issue will help you get to grips with this important condition and feel empowered to make a real difference to the health and wellbeing of your patients.
Monitoring Chronic Kidney Disease Practice
The NICE guideline for chronic kidney disease (CKD) was introduced in 2008, with the aim of assisting practitioners both in primary and secondary care in the early identification and management of patients with evidence of kidney disease. However, some debate still exists surrounding the implementation of this guideline in everyday clinical practice. In this article, we sort out
Making Sense of Chronic Kidney Disease (CKD)
What exactly is chronic kidney disease (CKD), what causes it and how is it diagnosed? In this article we get down to the basics of defining what CKD is, and explore the stages of CKD. We review CKD progression and the assessment and management recommendations for each stage of CKD.
