British journal of nursing (Mark Allen Publishing)
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Neuropathic pain is suffered by approximately 1% of the UK population and poses a vast socio-economic problem through unemployment and expenditure on medical and social services. It also presents a major therapeutic challenge to healthcare professionals, since it can be difficult to recognize and to treat. With the advent of new and effective medications, the prognosis for patients can be significantly improved by early recognition and aggressive therapy. This article aims to equip nurses with the assessment skills to identify neuropathic pain and a basis from which to expedite pain relief through appropriate intervention and referral within the multidisciplinary team.
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Pain is a commonly reported symptom of multiple sclerosis (MS). However, the literature surrounding pain management for people with MS appears limited. ⋯ It suggests that the MS nurse is pivotal in ensuring that patients receive adequate pain control. The MS nurse can coordinate timely assessment, monitor effectiveness and side effects linked with a pain management plan, and provide education and support to patients in order to allow them to take responsibility for their own pain management.
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The procedure of fasting from midnight until induction of anaesthesia arose from concern that patients could regurgitate during induction of general anaesthesia when the pharyngeal and laryngeal refluxes are depressed. In this situation, the contents of the stomach do not come out of the patient's mouth, but go up into the oesophagus and trachea and are drawn back down into the lungs. ⋯ This article considers the current evidence for preoperative fasting times and examines why patients are still being subjected to prolonged preoperative fasting. Based on the evidence presented, recommendations are made regarding this aspect of care.
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This article outlines the pathophysiology associated with hypovolaemic, cardiogenic and distributive shock, and discusses how each of these might present clinically in the patient. Nursing assessment of a patient in shock is explored, and the use of tools such as the pulse oximeter is examined. ⋯ The importance of recognizing the clinical presentation of shock is highlighted, with an emphasis on understanding the pathophysiology and potential systemic effects. Treatment is discussed and covers: providing optimal oxygen therapy, appropriate patient monitoring and location of care, using effective communication skills, assisting with activities of living, psychological support, and working collaboratively to maximize the overall quality of patient care delivered.
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Phantom limb pain (PLP) is thought to occur in most amputees. This common clinical phenomenon often provides a challenge to those involved in the treatment and management of pain, since the causes of PLP are often misunderstood. ⋯ The article will then consider pain management strategies used in PLP in the ward setting. These pain management strategies include the use of drugs not traditionally known as analgesics, but which are usually used in the treatment of epilepsy and depression.