British journal of nursing (Mark Allen Publishing)
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Lymphoedema may be triggered by any type of injection. This is not just an issue for the cured breast cancer patient but for any patient who has undergone under-arm (axillary) lymph node removal to any degree for any type of cancer. Standard advice given to patients following axillary node removal is to avoid any injection or blood pressure measurement on the ipsilateral arm. ⋯ Patients have reported frustration that nurses are not informed of contraindications in carrying out such procedures on patients at risk of developing swelling. This article discusses the current evidence available on the subject of non-accidental skin puncture (NASP) relating to the patient at risk of lymphoedema and provides guidelines for any professionals conducting such procedures for patients with a history of cancer. The results from a small audit of the guidelines are cited and they reveal that out of 14 patients who underwent NASP procedures in the at risk arm, no patients reported swelling to that limb within a month of these procedures.
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Pancreatitis is an inflammation of the pancreas that can be either acute or chronic in origin and is caused by a varied range of aetiologies. However, in both types of the disease alcohol use may be a major contributor. ⋯ As the incidence of acute pancreatitis is increasing it is imperative that nurses are familiar with the causes, underlying pathophysiology, diagnostic tests and the potentially vast range of complications that can occur in acute pancreatitis. This article reviews the current medical and nursing management of this condition.
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New NICE guidance on the use of medicines for hypertension, published in June 2006, will prompt a major review of treatment for those already receiving medication and also sets out a new treatment pathway for the newly diagnosed. The major change in the guidelines is in the status of beta blockers, which are no longer to be used as a routine treatment for hypertension. The guidelines provide a consensus on treatment, and nurses and their patients now have a clear and straightforward algorithm to follow. It is envisaged that these changes to the way medicines are prescribed for hypertension will have a significant impact on the number of people reaching their target blood pressure, and therefore the number of cardiovascular events occurring each year.
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Post-herpetic neuralgia (PHN) is the neuropathic pain syndrome that may develop following an attack of shingles. While for many the symptoms subside, there can be long-term pain problems for up to 40% of those affected with PHN, and for 3% of these, symptoms can be severe (Dworkin and Portenoy, 1996). Knowledge and understanding of the symptoms and various treatments and approaches available is important to enable nurses and patients to work together in partnership to achieve the best outcomes. Realizing that more than one approach may be needed can allow for treatments which are complementary and for optimization of both biomedical and self-care approaches.