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.
Back to Basics: Pharmacokinetics of inhaled drugs – where inhaled drugs go
What are my responsibilities as a practice nurse?
The role of nurses working in the National Health Service has undergone major development
in recent years with new roles and expansion of skills into new areas which has included
respiratory care. However, as always, an increased role demands increased responsibility
and this article examines the key legislation affecting practice nurses, and how they can
reduce the risk of medico-legal action.
Spirometers in primary care: uses and limitations
Modern medical practice emphasises the use of objective measurements and
evidence. Nobody would diagnose hypertension without measuring the blood
pressure, or manage diabetes without measuring blood sugar and glycated
haemoglobin. Yet it is only relatively recently that any lung function
measurements to support diagnosis and guide management of respiratory disease were
undertaken in primary care.
Optimising nutrition in COPD
Although principally an inflammatory respiratory disease, chronic obstructive pulmonary
disease (COPD) is now recognised as a complex disorder that also manifests in
extrapulmonary and systemic effects. Nutritional manifestations of the disease, notably
weight loss and obesity, have been recognised. However, the complexity of nutritional
problems in COPD has been poorly understood, and the consequences largely underrated. Now,
linked to increasing knowledge regarding systemic inflammation, it is becoming clear that poor
nutritional status is not only a manifestation of COPD but also a predictor of mortality and
healthcare utilisation.
How are Patients with Respiratory Disease Treated for Anxiety
As mentioned in the last issue ( Sept 2008), anxiety is a significant and
distressing problem for patients with respiratory disease. Anxiety is more common in
respiratory disease than in cancer, heart failure or other chronic medical conditions
(Kvaal et al 2001). The previous article gave a background to anxiety and highlighted
that practice nurses are in an ideal position to screen for anxiety and to provide appropriate
support and basic treatment. This article focuses on the management of anxiety using cognitive
behavioural therapy skills and techniques.
Cystic Fibrosis: What do we need to know?
Cystic fibrosis (CF) is the most common inherited genetic disease in the UK.
Improvements in both diagnosis and treatment over the last 30 years have resulted in
increased survival with children born in the 1990s now likely to live into their forties.
Although much of the treatment is delivered in hospitals, healthcare professionals in
primary care should be aware of management principles and understand the impact of the
condition on patients and their families. This article provides an overview of CF and shows how
to support patients and families in primary care.
Lung Cancer: Diagnosis and Therapy
There are over 37,000 new cases of lung cancer each year in the UK and it is the most common cancer in males and second most common after breast cancer in females. The role of the multidisciplinary team is essential in the management of these patients and it is important for all members of the team to know the signs to look for and actions to take in cases of suspected lung cancer. This article reviews the current methods of diagnosis and treatments available for lung cancer and the role of the primary healthcare professional.
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.
