This case describes a 56-year old male with a productive cough and worsening breathlessness who presented to a practice nurse. This case study was part of a Health Assessment module at the University of Surrey. The case study was supervised by a GP.

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People with COPD should be reviewed at least annually according to the Quality and Outcomes Framework. However, there is little mention of the importance of assessing nutritional status and no ‘QOF’ points for doing so. This article describes the assessment and management of COPD patients with a risk of malnutrition.
Heart failure is characterised by fatigue, breathlessness and retention of fluid. The update of the National Institute for Health and Clinical Excellence chronic heart failure guidelines has simplified its management by using a stepped approach to investigation and treatment. In this article, we focus on the practical aspects of managing the two main symptoms associated with heart failure – oedema and breathlessness.
Chronic obstructive pulmonary disease (COPD) is a largely preventable, slowly progressive, inflammatory disease. Rates of COPD are rising faster in women than in men, yet women are less likely to be diagnosed. There is currently no cure, but best-practice management outlined in recently updated NICE guidelines can help to improve patients’ symptoms and quality of life.
Chronic clinical conditions have traditionally been regarded as individual disease categories within individual patients, although there is often considerable overlap across clinical systems. However, for those managing these patients the presence of various co-morbidities is all-too apparent. It may be time to consider a new approach to management of these patients.
Cardiovascular morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD) is nearly double the rate in the general population without COPD. And for those with cardiovascular disease (CVD) and COPD, heart failure is the most common cause of hospitalisation.
Chronic clinical conditions have traditionally been regarded as individual disease categories within individual patients, although there is often considerable overlap across clinical systems. The monitoring of patients with long-term conditions has historically centred around a traditional model of a nurse-led clinic, utilising an appropriate level of skill mix. The disease categories and associated clinical indicators of the Quality and Outcomes Framework (QOF) have encouraged this approach, but for those managing these patients the presence of various co-morbidities is all too apparent
Those of us working with patients suffering from COPD know anecdotally that cold
weather directly impacts exacerbation rates and hospital admissions in the same way
as thunderstorms affect those with asthma (see BJPCN Vol 1, Issue 2, March 2007).
This article explores the links between COPD and weather patterns. You may not want
to be thinking about the winter but action now should give time to put preventive systems in
place to help at-risk patients before the cold weather appears again.
Allergic diseases such as hayfever and allergic asthma are becoming increasingly common
in westernised countries such as the United Kingdom, with an estimated 25% of the
population now suffering from some form of allergic condition. Urticaria and angioedema
are commonly thought of as allergic problems although in general only acute symptoms
are related to allergen exposure. Here we discuss the diagnosis and management of urticaria and
angioedema in primary care, with particular focus on identifying allergic triggers and managing
long-term symptoms successfully.
Runny, blocked noses are a common problem in the winter months, accounting for a
substantial number of general practice consultations. Successful treatment depends
on identifying the correct cause of the symptoms. In this article we give you key
information on rhinitis – what it is, how to diagnose it and how to treat it successfully.