British journal of nursing (Mark Allen Publishing)
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This article explores the management of patients with high-output stomas fashioned under acute surgical conditions where management may be difficult owing to the presence of a large laparostomy wound. Available products that meet the technical demands required to manage these patients, achieve optimal wound healing, manage high-output stoma and encourage patient independence are considered. A number of strategies to meet the physical and nutritional requirements of these patients are discussed along with the importance of the multidisciplinary team working together to provide holistic care.
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Based on the current available evidence, this article explores the nutritional management of those with a high-output stoma. The main alterations required to the intake of patients with a high-output stoma include the use of an oral rehydration solution to ensure optimum absorption of fluid and sodium, and a high-calorie, high-protein diet, with the aim of optimizing nutritional status. ⋯ Monitoring of electrolytes and micronutrients is essential, and long-term follow up from a multidisciplinary nutrition support team is invaluable in coordinating this. Patients with high-output stomas can enjoy good quality of life and long-term health if their condition is managed effectively by a well-organized multidisciplinary team.
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This question of sex selection and abortion in the UK was highlighted by recent reports in a national newspaper. This paper explores the current legal position and whether there is a case for reforming the law to align the situation of abortion with that of sex selection in the context of pre-implantation genetic diagnosis.
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The development of overgranulation tissue around gastrostomy sites isa common problem. While there is little evidence to suggest that one treatment is more effective than another, a review of current practice suggests that there is an opportunity to improve clinical practice and patient outcomes in this area of care. ⋯ A foam dressing impregnated with polyhexamethylene biguanide was used at the wound interface, providing a safe and effective alternative to managing overgranulation. Findings showed that a strategic approach to managing overgranulation tissue around gastrostomy devices can improve patient outcomes and clinical practice.
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Currently, there are many changes taking place in the area of paediatric palliative care. These include the role of the nurse, development of national policies, and recommendations for the future of paediatric palliative care. This article discusses palliative care for children with life-limiting conditions in the UK and Ireland, highlights national and international developments in this area, describes current services, and makes recommendations for future developments. ⋯ Palliative care should begin at the time of diagnosis and continue beyond illness, through the bereavement process. It should be adaptable to allow care delivery in any setting; home, hospice or hospital. Health professionals providing paediatric palliative care should be appropriately trained in this specialist field and the best interests of the child should always be at the forefront of care.