British journal of nursing (Mark Allen Publishing)
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Neuropathic pain can take a heavy toll on quality of life, impacting negatively on emotions, disrupting sleep, and impairing energy and mobility. It can destroy the enjoyment of life and the opportunity to continue in employment. In some cases, it can lead to suicidal thoughts and intentions. ⋯ It explores strategies for the diagnosis of neuropathic pain and reviews a couple of typical case studies from clinical practice. Using these case studies, this article discusses assessment, patient expectation, treatment options and realistic outcomes. Finally, it is intended to stimulate debate as to why, when, how and where nurses could become key practitioners in identifying the development of neuropathic pain, assessing its impact on patients and encouraging the initiation of treatment.
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Review Case Reports
High-flow humidified oxygen therapy used to alleviate respiratory distress.
This article describes the utilization of humidified high-flow oxygen therapy systems, which can comfortably deliver optimal humidified high-flow oxygen therapy, via nasal cannulae, at flow rates of up to 40 litres per minute to adult patients, in hospital or at home. The oxygen is saturated with water vapour at body temperature allowing flow to be well tolerated. First, to set the scene, three clinical scenarios are presented of patients nursed in intensive care, who suffered severe respiratory distress. ⋯ Alternative oxygen delivery devices and systems are then outlined, and an example of a high-flow system introduced. Set-up of the system is explained and the need for decontamination propounded. Finally, the benefits of the humidified high-flow oxygen system are exemplified, with particular reference to the critically ill patients presented here.
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Bevacizumab (Avastin) is a humanized monoclonal antibody that inhibits the activity of vascular endothelial growth factor (VEGF), a key molecule controlling tumour blood vessel formation (angiogenesis). By inhibiting VEGF and thus tumour angiogenesis, bevacizumab inhibits tumour growth and survival. ⋯ Specific side-effects of special interest for bevacizumab include hypertension, proteinuria, arterial thromboembolic events, wound-healing complications, bleeding events and gastrointestinal perforation. Oncology nurses are key to early recognition and management of side-effects, in addition to having a key role in patient education, facilitating the optimal use of bevacizumab and thus survival of patients with metastatic CRC.
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This article considers national policy drivers promoting the development of advanced assessment skills and practical procedures for the safe and effective use of the stethoscope in the clinical area. The evidence base underpinning effective use of the stethoscope in clinical practice is explored, including the preparation of the patient and the environment, applying infection control policies, and placing an emphasis on privacy and dignity. This is followed by a practical guide to auscultation technique of the respiratory system for nurses developing advanced practice skills.