Complications Resources

Abnormal bleeding of any type is a cause of concern for women affected and is a frequent presentation in primary care. This is the second piece in a two-part series, the first part discussed amenorrhoea and oligomenorrhoea, while this article looks at dysmenorrhoea and menorrhagia. It gives an overview of signs and symptoms, risk factors, treatment and complications, with the purpose of giving nurses and non-medical prescribers more confidence in advising women who approach them for advice, so that earlier diagnosis and treatment can be possible to improve outcomes and quality of life.

This article looks at amenorrhoea and oligomenorrhoea, both of which can be a cause of concern for those women affected. Such issues can be difficult for clinicians to diagnose and treat, because of variations in bleeding patterns, complicated history in some patients, and associated problems. Signs and symptoms, causes, diagnosis, treatment, and complications are covered here, in the hope that general practice nurses (GPNs) and non-medical prescribers will feel more confident in recognising concerns and can then get earlier investigations and treatment, thus reducing the risk of complications and improving quality of life for women affected.

There are many different causes of liver disease and current estimates suggest that as many as one in 10 people have problems with their liver at some time in their life (Foundation for Liver Research, 2020). Perhaps most worrying is the fact that incidence of liver disease is increasing, with the number of deaths reported to have increased by 400% since 1970 (British Liver Trust, 2020). Most liver diseases are asymptomatic early on, frequently resulting in late diagnosis, potentially leading to a higher risk of poor outcomes. Many of the well-known liver diseases are preventable and this article, which covers fatty liver disease, hepatitis A, B and C and liver cancer, hopes to raise awareness of risk factors, recognition, causes and treatment of these conditions, and give general practice nurses (GPNs) and non-medical prescribers more confidence when caring for patients with these illnesses.

The trend for tattoos and body piercings has become increasingly popular in Europe and Western countries (Kluger, 2013). It has been estimated that 20% of the United Kingdom population has a tattoo and 10% of the adult population has a piercing of some kind, with a self-reported complication rate of 28% (Bone et al, 2008; White, 2012). It is therefore quite likely that general practice nurses (GPNs) will encounter wound-related problems, such as infection, associated with tattoos and piercings during their day-to-day clinical practice. This article explores some of the complications that can arise and provides an overview of how to manage them effectively.

Diabetes care takes up around 10% of the total NHS budget (Diabetes UK, 2015), and as type 2 diabetes mellitus (T2DM) makes up around 90% of all diabetes, it could be argued that prescribing for this largely preventable condition is the main culprit responsible for these costs. However, most of the money spent on treating diabetes is for managing its complications (Kerr, 2011). The key to preventing these complications is through effective prescribing aimed at reducing them. Possibly as a result of more clinicians thinking this way, prescribing costs for diabetes have been rising steadily (Health and Social Care Information Centre [HSCIC], 2014). So, how can clinicians be sure that newer and more expensive therapies are both clinically and financially effective? And crucially, how do clinicians ensure that patients are kept at the centre of all consultations and are fully involved in the decision-making process?