British journal of nursing (Mark Allen Publishing)
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This article addresses the gap between the literature and practice in relation to the use of the Glasgow Coma Scale (GCS). It will explore level of consciousness and the GCS. ⋯ Attention is also given to the importance of including vital signs when using the GCS, as these can tell a lot, if not more, about the patient's neurological condition. Finally, the limitations of the GCS are examined to assist in a more accurate and consistent assessment tool for neurologically impaired patients.
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Although transfusion of blood and blood products is often of life-saving benefit for the many patients who receive transfusions every year, it is not without considerable risk. Nurses need to be aware of these risks so that they can respond to patient anxiety about transfusion. ⋯ Other significant adverse effects will be discussed briefly. Recent initiative aimed at monitoring the incidence of these adverse effects and increasing the safety of blood transfusion will be discussed, with special emphasis on the nurse's role in the transfusion process.
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The use of psychotropic medication for people with a learning disability is a controversial issue that has received much attention. This article explores some of the issues for learning disability nurses surrounding the use of psychotropic medication. There are concerns regarding the side-effects that antipsychotic medication can produce. ⋯ Learning disability nurses need a clear understanding of the reasons behind the prescription of such powerful medication especially when it is used in the management of challenging behaviour. There are indications that learning disability nurses would support alternative approaches to medication such as the use of behavioural interventions. More healthcare professionals, direct carers and clients should be encouraged to become part of the multidisciplinary drug-review process.
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The provision of artificial nutrition for critically ill patients is of great importance as many are unable to maintain their own nutritional needs. The administration of total parenteral nutrition (TPN) and enteral nutrition (EN) has become a daily practice in intensive care units. ⋯ In order to lessen the catabolic state which results from the hypermetabolism associated with critical illness, prompt and adequate nutritional support must be delivered. It is essential that members of the multidisciplinary team caring for critically ill patients are aware of the importance of nutrition and the deleterious effects of malnutrition to achieve the best possible outcome for patients.
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Staff nurse Paula Rose was on duty in the accident and emergency (A&E) department early one Sunday morning when a police constable came in asking for details of any patient who had been brought in and for whom there was evidence of a fall from height. The constable explained that a girl had been assaulted and raped while in her bedroom by an assailant who came in through the window. Her screams brought help, but he made his escape from the window and she believed that he had fallen and may have suffered fractures or bruises.